异甘草酸镁治疗化疗药物性肝损害的临床疗效观察

Clinical control study of magnesium isoglycyrrhizinate in the treatment of liver function impairment caused by chemotherapy

目的 研究异甘草酸镁治疗化疗药物致肝损害的疗效.方法 151例化疗药物性肝损害Ⅰ～Ⅳ度患者,完全随机分为3个组,分别使用甘草酸单铵100 ml/d（甘草酸单铵组,50例）,异甘草酸镁100 mg/d（异甘草酸镁100 mg/d组,50例）,异甘草酸镁200 mg/d（异甘草酸镁200 mg/d组,51例）静脉滴注治疗化疗药物性肝损害,1个疗程（1周）后检测3组ALT、AST和总胆红素（TBil）值,评价3组的疗效.结果 ①治疗1个疗程后,甘草酸单铵组、异甘草酸镁100 mg/d组、200 mg/d组ALT恢复正常率分别为69.6％ （32/46）、80.9％ （38/47）和90.1％（46/51）,AST恢复正常率分别为75.5％ （37/49）、85.7％ （42/49）和93.7％ （45/48）,TBil恢复正常率分别为77.7％（ 14/18）、79.1％ （19/24）和92.0％（ 23/25）.肝功能3个指标恢复正常率3组之间两两比较,差异均有统计学意义（均P＜0.05）.②治疗1个疗程后,甘草酸单铵组、异甘草酸镁100 mg/d组、异甘草酸镁200 mg/d组的治疗总有效率分别为70.0％（35/50）、90.0％（45/50）和98.0％ （50/51）,3组之间两两比较差异均有统计学意义（P＜0.05）.结论 异甘草酸镁100 mg/d与200 mg/d治疗化疗药物性肝损害均有效,高剂量有效率更高.

Objective To explore the effects of magnesium isoglycyrrhizinate in the treatment of liver func- tion impairment caused by chemotherapy. Methods From Jan. 2009 to Jan. 2011, 151 patients with I -IV liver function impairment caused by chemotherapy were randomly divided into three groups. One group was treated by 100 mg/d ammonium glycyrrhizinate. The other two groups were treated by 100 mg/d and 200 mg/d magnesium isoglycyrrhizinate. The changes of Alanine aminotransferase （ALT）, aspartate aminotransferase （AST）and Total bilirubin （TBil） were recorded. Results After 1 course of treatment, the rates of ALT returning to normal in ammonium glycyrrhizinate group, magnesium isoglycyrrhizinate 100 mg/d group and 200 mg/d group were 69.6% （32/ 46）, 80.9% （38/47） and 90.1% （46/51）, AST returning to normal rates were 75.5% （37/49）, 85.7% （42/ 49） and 93.7% （45/48）, TBil returning to normal rates were 77.7% （ 14/18）, 79.1% （19/24） and 92.0% （23/25）. Liver function of 3 parameters returning to normal rates had statistical differences （ P 〈 0. 05）. After 1 course of treatment, the total effective rate in ammonium glycyrrhizinate group, magnesium isoglycyrrhizinate 100 mg/d group, magnesium isoglycyrrhizinate 200 mg/d group after treatment was 70.0% （35/50）, 90.0% （45/50） and 98.0% （50/51）（P 〈0.05 ）. Conclusions Both magnesium isoglycyrrhizinate with 100 mg/d and 200 mg/d can effectively treat the liver function impairment caused by chemotherapy. Meanwhile the effect of 200 mg/d magnesium isoglycyrrhizinate is higher.