还原型谷胱甘肽联合丹参川芎嗪对酒精性肝炎患者肝纤维化及炎性因子的影响

Effect of reduced glutathione combined with Danshen Chuanxiongqin injection on liver fibrosis and inflammatory factor in patients with alcoholic fatty liver

目的:探讨还原型谷胱甘肽联合丹参川芎嗪对酒精性肝炎(AH)患者肝纤维化及炎性因子的影响。方法:选择我院2013-03-2017-08收治的AH患者104例,按随机数字表法分为对照组和治疗组各52例,对照组给予常规药物和还原型谷胱甘肽治疗,治疗组在对照组的基础上加用丹参川芎嗪,连续治疗4周。2组患者均于治疗前及治疗后4周观察临床症状改善情况,同时检测谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)、Ⅲ型前胶原肽(PⅢNP)、Ⅳ型胶原(ⅣC)、肿瘤坏死因子-α(TNF-α)和白介素-18(IL-18)水平的变化;分析AH患者血IL-18与ALT、PⅢNP水平的相关性。结果:治疗组的总有效率(94.2%)高于对照组总有效率(71.2%),差异有统计学意义(P<0.05);治疗前2组患者ALT、AST、PⅢNP、ⅣC、TNF-α和IL-18水平比较,差异无统计学意义。治疗后4周,2组患者ALT、AST、PⅢNP、ⅣC、TNF-α和IL-18水平均较治疗前降低,治疗组低于对照组,差异均有统计学意义(P<0.05)。AH患者血IL-18与ALT、PⅢNP水平呈正相关(r=0.315、0.277,P<0.01)。结论:还原型谷胱甘肽联合丹参川芎嗪对AH患者的疗效优于单药治疗,能降低ALT、AST、PⅢNP、ⅣC、TNF-α和IL-18水平,降低肝纤维化,取得良好疗效,值得推广应用。

Objective：To investigate the effect of reduced glutathione combined with Danshen Chuanxiongqin injection on liver fibrosis and inflammatory factor in patients with Alcoholic fatty liver（AH）.Method：A total of104 patients with AH treated in our hospital from Mar.2013 to Aug.2017 were divied into control group（52 cases,treated with routine drug and Reduced Glutathione）and therapy group（52 cases,treated by Danshen Chuanxiongqin injection based on control group）.4 weeks for one therapeutic course.To observe the changes of the clinical symptoms prior and after the study.Before treatment and 4 weeks after treatment,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,Type III procollagen peptide（PⅢNP）,collagen typeⅣ（ⅣC）,tumor necrosis factor a（TNF-α）and interleukin-18（IL-18）of patients were detected.Pearson correlation test was used to analyze the correlation between IL-18 and ALT,PⅢNP in patients with AH.Result：Total effective rate of therapy group（94.2%）was higher than control group（71.2%）.There were significant difference between the two groups（P0.05）.In admission,there were no differences in the levels of ALT,AST,PⅢNP,ⅣC,TNF-αand IL-18 between the two groups.At 4 weeks after treatment,the levels of ALT,AST,PⅢNP,ⅣC,TNF-αand IL-18 were lower than than those before treatment,and the therapy group were lower than control group（P0.05）;The level of serum IL-18 in patients with AH were positively correlation with ALT and PⅢNP（r=0.315,0.277,P0.01）.Conclusion：Therapeutic effect of Reduced Glutathione combined with Danshen Chuanxiongqin injection in AH patients is superior to single therapy.It could decrease the levels of ALT,AST,PⅢNP,ⅣC,TNF-αand IL-18,reduce liver fibrosis.The clinical curative effect is distinct,and is worthy of clinical popularizing and application.