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Objective: To study the effect and mechanism of Ganbi decoction (GBD,肝痹汤) in treating patients with antituberculotic agent caused liver injury (ATB-LI). Methods: One hundred and twenty-eight patients with ATB-LI were randomly assigned to the treated group ( n = 66) and the control group ( n = 62) with the envelop method. Meanwhile, 60 healthy persons were selected as the healthy control group. The treated group was treated by GBD one dose every day with the constituents modified depending on patients' symptoms, and the control group was treated with glucuronolactone tablets and inosine injection. One week was taken as one treatment course. The changes of clinical syndromes, physical signs, T-lymphycyte sub-groups and serum level of nitric oxide (NO) were observed before and after treatment and the recovery time of liver function was recorded. The outcome was compared with that in the healthy control group. Results: In the treated group, 28 patients (42.4%) were cured, 30 (45.5%) improved and 8 ( 12.1% ) ineffectively cured,the total effective rate being 87.9% (58/66). In the control group, 17 patients (27.4%) were cured, 24 ( 38.7 %) improved, and 21 (33.9%) ineffectively cured, the total effective rate being 66.1% (41/62). The total effective rate in the treated group was significantly higher than that in the control group ( P＜0.05). Liver function was improved in both groups, recovery time in the treated group was 12.0 ±7.0 days, which was significantly shorter than that in the control group (16.0±8.0 days), showing significant difference between the two groups ( P＜0.05). The levels of CD3, CD4 and CD8 were significantly higher and level of NO significantly lower in the two groups of patients than those in the healthy control group ( P＜0.05), but these parameters were improved more significantly in the treated group after treatment, when compared with those before treatment or with those in the control group, all showing significant difference (P＜0.05). Conclusion: GBD could prevent ATB-LI, and its mechanism could be by way of reducing NO production induced by endotoxin of macrophage and stimulating the proliferation of T-lymphycyte to elevate immunity.