葛根素联合复方甘草酸单铵S治疗酒精性肝炎的疗效探讨

姬会春; 刘庆德; 王洪旗; 李娟; 朱云; 孙阳; 周忠海; 刘军权

doi:10.3969/j.issn.1001-5256.2014.10.023

葛根素联合复方甘草酸单铵S治疗酒精性肝炎的疗效探讨

DOI: 10.3969/j.issn.1001-5256.2014.10.023

解放军第97医院

基金项目:

南京军区医学科技创新课题(13MS039)；

详细信息

中图分类号: R259
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出版历程
- 收稿日期: 2014-07-28
- 出版日期: 2014-10-20

Clinical efficacy of puerarin combined with compound ammonium glycyrrhetate S in treatment of alcoholic hepatitis

The 97th Hospital of PLA

Research funding:

摘要

摘要:
目的探讨葛根素联合复方甘草酸单铵S治疗酒精性肝炎的临床疗效。方法选取2011年2月-2014年2月解放军97医院收治的92例酒精性肝炎患者,随机分为联合组和对照组各46例。对照组在常规治疗方案的基础上,加用复方甘草酸单铵S治疗;联合组在对照组治疗方案的基础上,加用葛根素联合治疗。两组患者治疗20 d,对比其治疗前后的TBil、ALT、AST、GGT、白蛋白（Alb）水平、Glasgow酒精性肝炎（GAHS）评分及腹部超声,同时对比两组患者的临床疗效和不良反应。计量资料组间比较采用t检验,计数资料组间比较采用卡方检验。结果治疗后两组患者的GAHS评分、TBil、ALT、AST和GGT均显著低于治疗前,差异均有统计学意义（P值均<0.05）;联合组治疗后的TBil水平为（20.96±6.85）μmol/L,ALT水平为（33.72±14.18）U/L,AST水平为（38.69±6.38）U/L,均显著低于对照组,差异均有统计学意义（P值均<0.05）;联合组治疗后的显效率为63.04%,总有效率为93.48%,腹部超声的改善率44.44%,均显著高于对照组,差异均有统计学意义（...
- 肝炎,酒精性 /
- 葛根素 /
- 复方甘草酸单铵S
Abstract:
Objective To investigate the clinical efficacy of puerarin combined with compound ammonium glycyrrhetate S in the treatment of alcoholic hepatitis. Methods A total of 92 patients with alcoholic hepatitis who were admitted to our hospital from February 2011 to February 2014 were recruited in this study and randomly divided into two groups. The control group ( n = 46) was treated with conventional therapy combined with compound ammonium glycyrrhetate S. The test group ( n = 46) was treated with puerarin in addition to the regimen used in the control group. After 20 days of treatment, the levels of total bilirubin ( TBil) , alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , glutamyl transpeptidase ( GGT) , albumin ( Alb) , Glasgow alcoholic hepatitis score ( GAHS) , and abdominal ultrasound were measured and compared with the results before the treatment in both groups. The clinical efficacy and adverse reactions in the two groups were also compared. Results After the treatment, the GAHSs and levels of TBil, ALT, AST, and GGT in the two groups were all significantly lower than those before the treatment ( all P < 0. 05) . In the test group after the treatment, the levels of TBil ( 20. 96 ± 6. 85μmol/L) , ALT ( 33. 72 ±14. 18 U/L) , and AST ( 38. 69 ±6. 38 U/L) were all significantly lower than those in the control group ( all P<0. 05) . The marked response rate, overall response rate, and rate of improvement in abdominal ultrasound in the test group were 63. 04%, 93. 48%, and 44. 44%, respectively, all significantly higher than those in the control group ( all P < 0. 05) . There was no significant difference in adverse reactions between the two groups ( P >0. 05) . Conclusion For patients with alcoholic hepatitis, the combined therapy with puerarin and compound ammonium glycyrrhetate S can improve the treatment outcome and protect the liver function, and it has high safety and holds promise for clinical application.
- hepatitis, alcoholic /
- puerarin /
- compound ammonium glycyrrhetate S

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参考文献(18)

[1]LI YM.Epidemiological characteristics of alcoholic liver disease[J].J Pract Hepatol, 2012, 15 (3) :180-182. (in Chinese) 厉有名.酒精性肝病的流行病学特点[J].实用肝脏病杂志, 2012, 15 (3) :180-182.

[2]SOHAIL U, SATAPATHY SK.Diagnosis and management of alcoholic hepatitis[J].Clin Liver Dis, 2012, 16 (4) :717-736.

[3] Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association, Chinese Medical Association.Guidelines for prevention and treatment of alcoholic liver disease (revised version 2010) [J].J Clin Hepatol, 2010, 26 (3) :229-232. (in Chinese) 中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南 (2010修订版) [J].临床肝胆病杂志, 2010, 26 (3) :229-232.

[4]WU KM, HE CW.Effect of magnesium isoglycyrrhizinate in treatment of alcoholic hepatitis[J].China Med, 2012, 7 (10) :1263-1264. (in Chinese) 吴况明, 何蔡为.异甘草酸镁对酒精性肝炎的疗效观察[J].中国医药, 2012, 7 (10) :1263-1264.

[5]CHANG BX, WANG H, ZHOU ZS, et al.Pathogenesis and novel therapeutic targets of alcoholic liver disease[J].J Clin Hepatol, 2014, 30 (2) :113-117. (in Chinese) 常彬霞, 王华, 邹正升.酒精性肝病的发病机理和新的治疗靶点[J].临床肝胆病杂志, 2014, 30 (2) :113-117.

[6]WANG HY, LI X, XU YQ.Progress in the pathogenesis of alcoholic liver disease[J].J Pract Hepatol, 2014, 17 (1) :5-8. (in Chinese) 王洪岩, 李鑫, 徐有青.酒精性肝病发病机制研究进展[J].实用肝脏病杂志, 2014, 17 (1) :5-8.

[7]ANTAR R, WONG P, GHALI P, et al.A meta-analysis of nutritional supplementation for management of hospitalized alcoholic hepatitis[J].Can J Gastroenterol, 2012, 26 (7) :463-467.

[8]HUANG H, CHEN H, XU YH, et al.Quality control of ammonium glycyrrhinate[J].Chin Tradit Patent Med, 2013, 35 (10) :2199-2204. (in Chinese) 黄浩, 程荷, 徐云辉, 等.我国甘草酸铵盐原料药质量控制方法的研究探讨[J].中成药, 2013, 35 (10) :2199-2204.

[9]GAO J.Efficacy of compound monoammonium glycyrrhizinate injection in treatment of ulcerative colitis:a report of 100 cases[J].China Pharm, 2008, 17 (17) :50. (in Chinese) 高洁.复方甘草酸单铵注射液治疗溃疡性结肠炎100例[J].中国药业, 2008, 17 (17) :50.

[10]CHEN BC.Effect of compound monoammonium glycyrrhizinate S combined with Xueshuantong on liver fibrosis indices in patients with chronic hepatitis B[J].Intern Med China, 2013, 8 (4) :360-361. (in Chinese) 陈北昌.复方甘草酸单铵S联合血栓通对慢性乙肝患者肝纤维化指标的影响[J].内科, 2013, 8 (4) :360-361.

[11]HUANG XQ.Analysis on the efficacy of compound ammonium glycyrrhetate S in the treatment of antituberculosis drugs induced liver injury[J].Heilongjiang Med J, 2012, 36 (6) :436-438. (in Chinese) 黄修秋.复方甘草酸单铵S治疗抗结核药肝损害疗效及不良反应分析[J].黑龙江医学, 2012, 36 (6) :436-438.

[12]JI YK, ZHANG GF.Effect of compound ammonium glycyrrhetate S in preventing and curing hepatic injury caused by chemotherapy[J].Chin J Gen Pract, 2010, 8 (6) :696-697. (in Chinese) 姬永科, 张桂芳.莫邦防治化疗药物性肝损伤临床观察[J].中华全科医学, 2010, 8 (6) :696-697.

[13]WEI W, JIANG P.Progress of research on Puerarin pharmacological action[J].Heilongjiang Med J, 2014, 26 (1) :985-986. (in Chinese) 伟唯, 江培.葛根素药理作用研究进展[J].黑龙江医药, 2014, 26 (1) :985-986.

[14]FANG DM, ZHU Y, MING YZ, et al.Hepatoprotective effects of puerarin on brain death rats[J].Chin J Gen Surg, 2011, 20 (5) :503-506. (in Chinese) 方达明, 朱毅, 明英姿, 等.葛根素对脑死亡大鼠肝脏的保护作用[J].中国普通外科杂志, 2011, 20 (5) :503-506.

[15]QU ZW, WEN CY, WANG AP, et al.Protective effect of puerarin on rats with alcoholic hepatitis[J].World Chin J Dig, 2009, 17 (7) :657-661. (in Chinese) 曲智威, 温春阳, 王爱平, 等.葛根素对大鼠酒精性肝炎的影响及其机制[J].世界华人消化杂志, 2009, 17 (7) :657-661.

[16]WU GL, CHEN J, YU GY, et al.Effect of puerarin on levels of TGF-β1 andα-SMA in rats with alcoholic injury liver[J].China J Chin Mater Med, 2008, 33 (19) :2245-2249. (in Chinese) 吴国琳, 陈玖, 余国友, 等.葛根素对酒精性肝损伤大鼠肝组织TGF-β1和α-SMA表达的影响[J].中国中药杂志, 2008, 33 (19) :2245-2249.

[17]LU WW, CHEN J, WU GL, et al.Influences on serum transaminase and hepatic fibrosis of alcohilic liver damage rats treated with puerarin[J].Zhejiang J Tradit Chin Med, 2008, 43 (1) :7-9. (in Chinese) 卢雯雯, 陈玖, 吴国琳, 等.葛根素对酒精性肝损伤大鼠血清转氨酶及肝纤维化指标的影响[J].浙江中医杂志, 2008, 43 (1) :7-9.

[18]GU CH, LIU X.Protective efficacy of puerarin on acute hepatic injury of mice induced by alcohol[J].Jiangsu J Prevent Med, 2006, 17 (3) :69-70. (in Chinese) 顾呈华, 刘协.葛根素对酒精诱发小鼠急性肝损伤的保护作用[J].江苏预防医学, 2006, 17 (3) :69-70.

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