还原型谷胱甘肽联合水飞蓟宾治疗肝硬化的临床观察

Clinical Observation of Reduced Glutathione for Injection Combined with Silibinin Capsule in the Treatment of Cirrhosis

目的:观察还原型谷胱甘肽联合水飞蓟宾治疗肝硬化的疗效和安全性。方法:140例肝硬化患者随机均分为观察组和对照组。两组患者均要求戒烟禁酒,同时给予高蛋白、维生素、低脂饮食,服用保肝、降脂药物等常规治疗。在此基础上,对照组患者给予注射用还原型谷胱甘肽1.8 g,加入10%葡萄糖注射液250 ml中,静脉滴注,每日1次;观察组患者在对照组治疗的基础上给予水飞蓟宾胶囊105 mg,口服,每日3次。两组疗程均为5周。观察两组患者的临床疗效,治疗前后的肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)]水平,血清纤维化标志物[层黏连蛋白(LN)、玻璃酸(HA)、Ⅲ型前胶原(PC-Ⅲ)]及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者肝功能水平、血清纤维化标志物均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,还原型谷胱甘肽联合水飞蓟宾治疗肝硬化的疗效显著优于单用还原型谷胱甘肽,且安全性较好。

OBJECTIVE：To observe the efficacy and safety of Reduced glutathione for injection combined with Silibinin capsule in the treatment of cirrhosis. METHODS：140 cirrhosis patients were randomly divided into observation group and control group. All patients were required smoking prohibition and given high protein,high vitamin,low-fat diet,taking the liver protecting and lipid-lowering drugs,and other conventional treatment. Based on it,control group was given 1.8 g Reduced glutathione for injection,adding into 250 ml 10% Glucose injection by intravenous infusion,once a day;observation group was additionally given105 mg Silibinin capsule,orally,3 times a day. The treatment course for both groups was 5 weeks. Clinical efficacy,liver functions（ALT,AST,GGT）,serum fibrosis markers（LN,HA,PC-Ⅲ）before and after treatment and incidence of adverse reactions in2 groups were observed. RESULTS：The total effective rate in observation group was significantly higher than control group,the difference was statistically significant（P〈0.05）. after treatment,the liver functions and serum fibrosis markers in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant（P〈0.05）,and there was no significant difference in the incidence of adverse reactions（P〉0.05）. CONCLUSIONS：Based on the conventional treatment,the efficacy of Reduced glutathione for injection combined with Silibinin capsule is significantly superior to Reduced glutathione for injection alone in the treatment of cirrhosis,with similar safety.