The acute treatment of tuberculous pleurisy includes two aspects: 1) systemic anti-tuberculosis treatment; 2) drainage of pleural effusion, release of pleural fluid on the heart and lungs and other intrathoracic organs, and maximum preservation and restoration of lung function. Once tuberculous pleurisy is diagnosed, as long as there is no abnormality in blood count and liver and kidney function, anti-tuberculosis drugs should be added to the treatment. Common first-line drugs include isoniazid, rifampin, ethambutol, pyrazinamide, etc. Levofloxacin is also commonly used. Most clinicians do not recommend the use of free anti-tuberculosis combination drugs, the clinical effect is biased and there are many side effects. Because of the combination drugs, if patients have adverse drug reactions, such as allergic reactions, it is not easy to determine which drug they are reacting to, resulting in clinical limitations of drug use. The duration of antituberculosis drug therapy for tuberculous pleurisy is similar to that for pulmonary tuberculosis, generally one year, with intensive treatment often lasting 4-5 weeks. Anti-tuberculosis treatment should also follow the same five principles: early, regular, appropriate, combined, and complete. Otherwise, drug resistance and incomplete treatment are likely to develop and relapse. In the acute exudate stage, a large amount of pleural fluid exudes from the pleura and gathers in the pleural cavity, occupying a certain space, and the lungs and heart are obviously under pressure, resulting in clinical symptoms such as chest tightness, shortness of breath and difficulty in breathing. When there is not much pleural fluid, it can be extracted by puncture needle. In some patients, one thoracentesis can completely reopen the lungs when there is less exudation. However, most patients clinically require multiple thoracentesis. In recent years, due to the progress of drainage equipment, most of the patients who need multiple punctures adopt the method of indwelling drainage tube to remove the fluid, commonly used are deep vein tube, pigtail tube, and thicker chest drainage tube, which can continuously drain, drain more thoroughly, reduce the pain and trouble of multiple thoracentesis, and easily accepted by patients. However, thoracic surgeons often do not recommend the thinner deep vein tubes for drainage because the thin diameter of the tubes can easily be blocked by fibrin, resulting in poor drainage and chronic inflammation.