丹参酮ⅡA联合异甘草酸镁治疗抗痨药致急性药物性肝损伤的临床观察  

Clinical observation of tanshinoneⅡA combined with magnesium isoglycyrrhizinate in the treatment of acute drug-induced liver injury induced by antispasmodic drugs

作　　者：焦记丽 许华[2] Jiao Jili;Xu Hua(Department of Hepatology,Third People′s Hospital of Taiyuan City,Shanxi,030012 China)

机构地区：[1]太原市第三人民医院肝病科,030012 [2]广州中医药大学第一附属医院儿科

出　　处：《中国药物与临床》2019年第18期3073-3075,共3页Chinese Remedies & Clinics

基　　金：国家自然科学基金(81373686)。

摘　　要：目的探讨丹参酮ⅡA联合异甘草酸镁在抗痨药致药物性肝损伤的临床效果。方法选择抗痨药致药物性肝损伤患者80例,随机数字表法分为2组,对照组(n=40)行异甘草酸镁保肝治疗,观察组(n=40)应用丹参酮ⅡA联合异甘草酸镁保肝治疗,记录2组患者治疗前、后肝功能,临床疗效,外周血T淋巴细胞及不良反应情况。结果①治疗后,2组患者肝功能均优于治疗前(P<0.05),且观察组天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、碱性磷酸酶(ALP)水平均显著低于对照组(P<0.05);②观察组治疗总有效率90%(36/40)显著高于对照组70%(28/40),经比较差异有统计学意义(P<0.05);③观察组外周血CD3^+、CD4^+、CD8^+T淋巴细胞比率及CD4^+/CD8^+比值均较治疗前明显改善,差异有统计学意义(P<0.05),且观察组同期CD3^+、CD4^+、CD8^+T淋巴细胞比率及CD4^+/CD8^+比值优于对照组,差异有统计学意义(P<0.05);④2组患者均未见严重不良反应,观察组不良反应发生率15%(6/40),对照组为12%(5/40),差异无统计学意义(P>0.05)。结论丹参酮ⅡA联合异甘草酸镁治疗抗痨药;引起急性药物性肝损伤的治疗效果较异甘草酸镁好,能更有效恢复患者的肝功能,用药安全,其作用机制可能与调控细胞免疫功能相关。Objective To investigate the clinical efficacy of tanshinoneⅡA combined with magnesium isoglycyrrhizinate in drug-induced liver injury induced by antispasmodic drugs.Methods Eighty patients with drug-induced liver injury induced by antispasmodic drugs were randomly divided into two groups.The control group(n=40)was treated with magnesium isoglycyrrhizinate for liver protection.The observation group(n=40)was treated with tanshinoneⅡA combined with magnesium glycyrrhizinate.Liver function,clinical efficacy,peripheral blood T lymphocytes and adverse reactions were recorded before and after treatment in the two groups.Results①After treatment,the liver function of the two groups was better than that before treatment(P<0.05),and the AST,ALT,TBIL and ALP levels in the observation group were significantly lower than those in the control group(P<0.05).②The total effective rate of treatment in observation group was 90%(36/40),which was significantly higher than that of the control group(70%,28/40),the difference was statistically significant(P<0.05).③The peripheral blood cell ratio of CD3^+,CD4^+,CD8^+T lymphocytes and CD4^+/CD8^+ratio in the observation group were significantly improved compared with those before treatment(P<0.05),and the ratio in the observation group were better than those in the control group,the difference was statistically significant(P<0.05);④No serious adverse reactions were observed in the two groups.The incidence of adverse reactions in the observation group was 15%(6/40),and that in the control group was 12%(5/40),the difference was not statistical significance(P>0.05).Conclusion The therapeutic effect of tanshinoneⅡA combined with magnesium isoglycyrrhizinate on acute drug-induced liver injury caused by anti-caries is better than that of magnesium iso-glycyrrhizinate.It can restore liver function more effectively and the drug is safe.The mechanism may be related to the regulation of cellular immune function.

关 键 词：药物性肝损伤 抗结核药 丹参酮ⅡA 异甘草酸镁 

分 类 号：R28[医药卫生—中药学]