四逆汤加味联合异甘草酸镁治疗急性药物性肝损伤疗效及对氧化应激、体液免疫功能的影响  

Effect of Sini Decoction combined with magnesium isoglycyrrhizinate on acute drug-induced liver injury and its effect on oxidative stress and humoral immune function

作　　者：李荣霞[1] 陈真英[1] 刘翔[1] 杨成双[1] LI Rongxia;CHEN Zhengying;LIU Xiang;YANG Chengshuang(Qinghai Provincial People’s Hospital,Xining 810007,Qinghai,China)

机构地区：[1]青海省人民医院,青海西宁810007

出　　处：《现代中西医结合杂志》2018年第36期4007-4011,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨四逆汤加味联合异甘草酸镁治疗急性药物性肝损伤(ADILI)疗效及对氧化应激、体液免疫功能的影响。方法将110例ADILI患者按照随机数字表法分为观察组和对照组,每组55例。对照组患者给予常规保肝及异甘草酸镁静滴治疗,观察组在对照组基础上给予四逆汤加味口服治疗,2组疗程均为4周。观察2组治疗后临床症状体征、ADILI分级情况、肝功能、氧化应激和体液免疫指标变化情况,统计2组临床疗效及不良反应发生情况。结果治疗后2组肝区隐痛、恶心呕吐、食欲减退、腹胀、乏力、皮肤泛黄、尿黄、皮疹发生率均显著降低(P均<0. 05),且观察组显著低于对照组(P均<0. 05)。治疗后2组ADILI分级均显著改善(P均<0. 05),观察组改善情况显著优于对照组(P均<0. 05)。治疗后2组丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBil)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、丙二醛(MDA)、Ig G、Ig A、Ig M水平均显著降低(P均<0. 05),还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)水平均显著升高(P均<0. 05),观察组治疗后以上指标改善情况均显著优于对照组(P均<0. 05)。观察组治疗总有效率显著高于对照组(P <0. 05)。2组不良反应发生情况无明显差异(P> 0. 05)。结论四逆汤加味联合异甘草酸镁治疗ADILI可显著缓解患者临床症状,具有显著的肝保护效应,且不良反应少,其机制可能与抑制氧化应激反应、调节机体体液免疫功能有关。Objective It is to investigate the curative effect of Sini Decoction combined with magnesium isoglycyrrhizinate on acute drug-induced liver injury(ADILI)and its effects on oxidative stress and humoral immunity.Methods 110 patients with ADILI were divided into observation group and control group according to the random number table method,55 cases in each group.The patients in the control group were treated with routine liver protection and intravenous treatment with magnesium isoglycyrrhizinate.The observation group was given oral administration of Sini Decoction on the basis of the control group.Both groups were treated for 4 weeks.The clinical symptoms and signs,ADILI grading,liver function,oxidative stress and humoral immunity indexes of the two groups were observed after treatment.The clinical efficacy and adverse reactions of the two groups were statistically analyzed.Results After treatment,the incidence of dull pain in liver,nausea and vomiting,loss of appetite,abdominal distension,fatigue,skin yellowing,urine yellow and rash were significantly decreased in the two groups(P<0.05),and the incidence in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the ADILI grades of the two groups were significantly improved(P<0.05),and the improvement of the observation group was significantly better than that of the control group(P<0.05).After treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),malondialdehyde(MDA),IgG,IgA and IgM were significantly decreased(P<0.05),and the levels of reduced glutathione(GSH)and superoxide dismutase(SOD)were significantly increased(P<0.05),the improvement of the above indicators in the observation group was significantly better than that in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the incid

关 键 词：急性药物性肝损伤 四逆汤加味 异甘草酸镁 氧化应激 体液免疫 

分 类 号：R595.4[医药卫生—内科学]