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抗炎保肝药在自身免疫性肝炎治疗中的应用进展

张红霞 周璐 王邦茂

引用本文:
Citation:

抗炎保肝药在自身免疫性肝炎治疗中的应用进展

DOI: 10.3969/j.issn.1001-5256.2017.03.042
基金项目: 

国家自然科学基金资助项目(81470834); 

详细信息
  • 中图分类号: R575.1

Advances in the application of anti-inflammatory and liver-protecting drugs in treatment of autoimmune hepatitis

Research funding: 

 

  • 摘要: 自身免疫性肝炎(AIH)是首个经试验证实糖皮质激素治疗有效的肝脏疾病,其标准治疗为激素联合硫唑嘌呤。考虑到部分患者达不到免疫抑制治疗指征,以及长期应用免疫抑制治疗不良反应较多,故有必要规范合理的应用抗炎保肝药以使免疫抑制剂的剂量最小化,控制肝脏炎症,减少肝细胞的破坏,延缓疾病的进展。综述了抗炎保肝药在AIH治疗中的应用进展,以帮助临床医生进行合理决策。

     

  • [1]MANNS MP, CZAJA AJ, GORHAM JD, et al.Diagnosis and management of autoimmune hepatitis[J].Hepatology, 2010, 51 (6) :2193-2213.
    [2]SOLOWAY RD, SUMMERSKILL WH, BAGGENSTOSS AH, et al.Clinical, biochemical, and histological remission of severe chronic active liver disease:a controlled study of treatments and early prognosis[J].Gastroenterology, 1972, 63 (5) :820-833.
    [3]MURRAY-LYON IM, STERN RB, WILLIAMS R.Controlled trial of prednisone and azathioprine in active chronic hepatitis[J].Lancet, 1973, 1 (7806) :735-737.
    [4]COOK GC, MULLIGAN R, SHERLOCK S.Controlled prospective trial of corticosteroid therapy in active chronic hepatitis[J].Q J Med, 1971, 40 (158) :159-185.
    [5]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.Consensus on the diagnosis and mangement of autoimmune hepatitis (2015) [J].J Clin Hepatol, 2016, 32 (1) :9-22. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会.自身免疫性肝炎诊断和治疗共识 (2015) [J].临床肝胆病杂志, 2016, 32 (1) :9-22.
    [6]CZAJA AJ.Current and prospective pharmacotherapy for autoimmune hepatitis[J].Expert Opin Pharmacother, 2014, 15 (12) :1715-36.
    [7]TAKIGAWA T, MIYAZAKI H, KINOSHITA M, et al.Glucocorticoid receptor-dependent immunomodulatory effect of ursodeoxycholic acid on liver lymphocytes in mice[J].Am J Physiol Gastrointest Liver Physiol, 2013, 305 (6) :g427-g238.
    [8]WEITZEL C, STARK D, KULLMANN F, et al.Ursodeoxycholic acid induced activation of the glucocorticoid receptor in primary rat hepatocytes[J].Eur J Gastroenterol Hepatol, 2005, 17 (2) :169-177.
    [9]BEUERS U.Drug insight:mechanisms and sites of action of ursodeoxycholic acid in cholestasis[J].Nat Clin Pract Gastroenterol Hepatol, 2006, 3 (6) :318-328.
    [10]YOSHIKAWA M, TSUJII T, MATSUMURA K, et al.Immunomodulatory effects of ursodeoxycholic acid on immune responses[J].Hepatology, 1992, 16 (2) :358-364.
    [11]CHERNAVSKY AC, PALADINO N, RUBIO AE, et al.Simultaneous expression of Th1 cytokines and IL-4 confers severe characteristics to type I autoimmune hepatitis in children[J].Hum Immunol, 2004, 65 (7) :683-691.
    [12]ABE M, MASHIBA T, ZENIYA M, et al.Present status of autoimmune hepatitis in Japan:a nationwide survey[J].Gastroenterology, 2011, 46 (9) :1136-1141.
    [13]MIYAKE Y, IWASAKI Y, KOBASHI H, et al.Efficacy of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis[J].Hepatol Int, 2009, 3 (4) :556-562.
    [14]NAKAMURA K, YONEDA M, YOKOHAMA S, et al.Efficacy of ursodeoxycholic acid in Japanese patients with type 1 autoimmune hepatitis[J].J Gastroenterol Hepatol, 1998, 13 (5) :490-495.
    [15]LI SQ, ZHOU L, ZHANG J, et al.Clinical effect of ursodeoxycholic acid combined with immunosupp ssant in treatment of autoimmune hepatitis[J].Chin J Dig, 2015, 35 (11) :767-770. (in Chinese) 李树倩, 周璐, 张洁, 等.熊去氧胆酸联合免疫抑制剂治疗自身免疫性肝炎的疗效分析[J].中华消化杂志, 2015, 35 (11) :767-770.
    [16]CAO YR, GUO JS, PENG LJ, et al.The cI inical characteristics and treatment of 52 cases of autoimmune hepatitis[J].Chin Hepatol, 2012, 17 (1) :6-10 (in Chinese) 曹忆嵘, 郭津生, 彭利军, 等.52例自身免疫性肝炎的临床特点及其治疗[J].肝脏, 2012, 17 (1) :6-10.
    [17]CZAJA AJ, CARPENTER HA, LINDOR KD.Ursodeoxycholic acid as adjunctive therapy for problematic type 1 autoimmune hepatitis:a randomized placebo-controlled treatment trial[J].Hepatology, 1999, 30 (6) :1381-1386.
    [18]ZHANG MF, SHEN YQ.Glucocorticoid-like effect of glycyrrhizic acid and its aglycone glycyrrhetic acid[J].Drug Clin, 2011, 26 (1) :33-34. (in Chinese) 张明发, 沈雅琴.甘草酸及其苷元甘草次酸的糖皮质激素样作用[J].现代药物与临床, 2011, 26 (1) :33-34.
    [19]MURIEL P, RIVERA-ESPINOZA Y.Beneficial drugs for liver diseases[J].J Appl Toxicol, 2008, 28 (2) :93-103.
    [20]Expert Committee on Clinical Application of Glycyr-rhizin Preparation in the Treatment of Liver Diseases.Expert consensus on clinical application of glycyrrhizin preparation in the treatment of liver diseases[J].J Clin Hepatol, 2016, 32 (5) :844-852. (in Chinese) 甘草酸制剂肝病临床应用专家委员会.甘草酸制剂肝病临床应用专家共识[J].临床肝胆病杂志, 2016, 32 (5) :844-852.
    [21]BORDBAR N, KARIMI MH, AMIRGHOFRAN Z.Phenotypic and functional maturation of murine dendritic cells induced by 18 alpha-and beta-glycyrrhetinic acid[J].Immunopharmacol Immunotoxicol, 2014, 36 (1) :52-60.
    [22]KURODA N, INOUE K, IKEDA T, et al.Apoptotic response through a highmobility box 1 protein-dependent mechanism in LPS/GalN-induced mouse liver failure and glycyrrhizin-mediated inhibition[J].PLoS One, 2014, 9 (4) :e92884.
    [23]GONG G, XIANG L, YUAN L, et al.Protective effect of glycyrrhizin, a direct HMGB1 inhibitor, on focal cerebral ischemia/reperfusioninduced inflammation, oxidative stress, and apoptosis in rats[J].PLoS One, 2014, 9 (3) :e89450.
    [24]LI YR, WANG WB, ZHANG LY, et al.The analysis of efficacy of glycyrrhizin therapy for autoimmune hepatitis[J].J Clin Hepatol, 2007, 23 (2) :117-118. (in Chinese) 李蕴铷, 王文冰, 张黎颖, 等.甘草酸类药物治疗自身免疫性肝炎疗效分析[J].临床肝胆病杂志, 2007, 23 (2) :117-118.
    [25]YASUI S, FUJIWARA K, TAWADA A, et al.Efficacy of intravenous glycyrrhizin in the early stage of acute onset autoimnlune hepatitis[J].Dig Dis Sci, 2011, 56 (12) :3638-3647.
    [26]YANG Q, WANG J, LIU R, et al.Amelioration of concanavalin a-induced autoimmune hepatitis by magnesium isoglycyrrhizinate through inhibition of CD4 (+) CD25 (-) CD69 (+) subset proliferation[J].Drug Des Devel Ther, 2016, 10:443-453.
    [27]SONG FF, XU Y.The efficiency of magnesium isoglycyrrhizinate in treatment of autoimmune hepatitis cirrhosis with decompensated liver inflammatory activity[J].J Clin Med Pract, 2011, 15 (3) :28-30. (in Chinese) 宋菲菲, 徐芸.异甘草酸镁治疗自身免疫性肝炎肝硬化失代偿期炎症活动的疗效观[J].实用临床医药杂志, 2011, 15 (3) :28-30.
    [28]GAO SJ, BAO J, XU Y.The analysis on efficacy of diammonium glycyrrhizinate combined with bicyclol in treatment of mild autoimmune hepatitis[J].Chin Hepatol, 2015, 20 (3) :186-190. (in Chinese) 高素纪, 保洁, 徐芸.甘草酸二铵胶囊联合双环醇片治疗轻症自身免疫性肝炎疗效观察[J].肝脏, 2015, 20 (3) :186-190.
    [29]Expert Committee on Expert Consensus On Liver Inflammation and Its Prevention and Treatment, Chinese Society and Infection Disease, Chinese Medical Association.Expert consensus on liver in flammation and its prevention and treatment[J].Chin J Pract Intern Med, 2014, 34 (2) :152-162. (in Chinese) 中华医学会感染病学分会, 肝脏炎症及其防治专家共识专家委员会.肝脏炎症及其防治专家共识[J].中国实用内科杂志, 2014, 34 (2) :152-162.
    [30]GAO LY, MA P, JIA JW.Jia Jianwei’s experience in diagnosis and treatment of autoimmune hepatitis[J].Chin J Basic Med Tradit Chin Med, 2014, 20 (5) :635-636. (in Chinese) 高丽英, 马萍, 贾建伟.贾建伟诊治自身免疫性肝炎经验[J].中国中医基础医学杂志, 2014, 20 (5) :635-636.
    [31]XU HY.Diagnosis and treatment of autoimmune hepatitis with traditional Chinese medicine[J].Chin J Clin, 2008, 36 (11) :814-816. (in Chinese) 徐慧媛.自身免疫性肝炎的中医诊治[J].中国临床医生杂志, 2008, 36 (11) :814-816.
    [32]SUN T.An analysis TCM treatment of autoimmune hepatitis[J].Pract Tradit Chin Inter Med, 2011, 25 (5) :77-78. (in Chinese) 孙韬.中医辨治自身免疫性肝炎浅析[J].实用中医内科杂志, 2011, 25 (5) :77-78.
    [33]ZHANG HX, LIU XD.Effect of integrated traditional Chinese and Western medicine therapy in treatment of autoimmune hepatitis:an analysis of 30 cases[J].J Pract Tradit Chin Med, 2016, 32 (6) :555-556. (in Chinese) 张红星, 刘旭东.中西医结合治疗自身免疫性肝炎30例观察[J].实用中医药杂志, 2016, 32 (6) :555-556.
    [34]ZHONG QH, ZHOU GQ, WANG XB, et al.Research advances in non-hormonal therapies for autoimmune hepatitis[J].J Clin Hepatol, 2016, 32 (2) :378-381. (in Chinese) 钟启华, 周桂琴, 王宪波, 等.自身免疫性肝炎非激素疗法的研究进展[J].临床肝胆病杂志, 2016, 32 (2) :378-381.
    [35]PAN K, TAO YY, LIU CH.Experimental research progress on treating autoimmune hepatitis with Chinese materia medica[J].China J Tradit Chin Med Pharma, 2015, 30 (12) :4393-4396. (in Chinese) 潘凯, 陶艳艳, 刘成海.中药治疗自身免疫性肝炎的实验研究进展[J].中华中医药杂志, 2015, 30 (12) :4393-4396.
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  • 收稿日期:  2016-10-21
  • 出版日期:  2017-03-20
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