茵栀黄口服液联合硫普罗宁治疗药物性肝损伤的临床研究

Clinical study on Yinzhihuang Oral Liquid combined with tiopronin in treatment of drug-induced liver injury

目的探讨茵栀黄口服液联合注射用硫普罗宁治疗药物性肝损伤的临床疗效。方法选取2015年8月—2017年9月成都市新都区人民医院收治的药物性肝损伤患者100例为研究对象,根据随机区组设计法将患者分为对照组和治疗组,每组各50例。对照组静脉滴注注射用硫普罗宁,400 mg加入到5%葡萄糖注射液500 mL中,1次/d。治疗组在对照组基础上口服茵栀黄口服液,10 mL/次,3次/d。两组均连续治疗1个月。观察两组的临床疗效,比较两组的肝功能、临床症状和炎性因子。结果治疗后,对照组和治疗组的总有效率分别为72.0%、92.0%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转氨酶(AST)、总胆红素(TBIL)水平均显著下降,白蛋白(ALB)水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些肝功能指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组腹胀、乏力、纳差、黄疸、肝脾大改善率均显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(TNF-γ)水平显著降低,血清白细胞介素-10(IL-10)水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些炎症因子的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论茵栀黄口服液联合注射用硫普罗宁治疗药物性肝损伤具有较好的临床疗效,可改善患者的肝功能和临床症状,降低炎性因子水平,具有一定的临床推广应用价值。

Objective To investigate the effect of Yinzhihuang Oral Liquid combined with Tiopronin for injection in treatment of drug-induced liver injury. Methods Patients（100 cases） with drug-induced liver injury in Chengdu Xindu People＇s Hospital from August 2015 to September 2017 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were iv administered with Tiopronin for injection, 400 mg/time added into 5% glucose solution, once daily. Patients in the treatment group were po administered with Yinzhihuang Oral Liquid on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and liver function, clinical symptoms, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.0% and 92.0%, respectively, and there was difference between two groups（P＜0.05）. After treatment, the levels of ALT, AST, and TBIL in two groups were significantly decreased, but the levels of ALB in two groups were significantly increased, and the difference was statistically significant in the same group（P＜0.05）. And the liver function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P＜0.05）. After treatment, the improvement rates of bloating, fatigue, anorexia, jaundice, and hepatosplenomegaly in the treatment group were significantly higher than those in the control group, and there was difference between two groups（P＜0.05）. After treatment, the levels of TNF-α and IFN-γ in two groups were significantly decreased, but the levels of IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group（P＜0.05）. And the inflammatory factors in the treatment group were significantly better than those in the control group, with significant difference between two groups（P＜0.05）. Conclusion Yinzhihuang Oral Liquid combined with Tiopronin for injection has significant effect in treatment of drug-induced liver injury, can improve liver function and clinical symptoms, reduce the levels of inflammatory factors, which has a certain clinical application value.