异甘草酸镁联合还原型谷胱甘肽防治化疗药致肝损伤的疗效观察

Observation on Efficacy of Magnesium Glycyrrhizinate Combined with Reduced Glutathione in Prevention and Treatment of Chemotherapeutic Drug-induced Liver Injury

目的:探讨异甘草酸镁联合还原型谷胱甘肽防治化疗药致肝损伤的疗效。方法:选取2015年1月1日至2017年6月30日南阳市第一人民医院收治的化疗后肝损伤患者80例,以随机数字表法分为观察1组和对照1组,每组40例。观察1组患者给予异甘草酸镁联合还原性谷胱甘肽治疗,对照1组给予还原性谷胱甘肽治疗。治疗1周后,肝功能恢复至正常的患者继续按原有方案化疗,再次以随机数字表法分为观察2组和对照2组,观察2组患者给予异甘草酸镁联合还原性谷胱甘肽治疗,对照2组患者仅给予还原性谷胱甘肽治疗。观察所有患者的临床疗效、肝功能指标变化情况及不良反应发生情况,观察治疗后肝功能恢复至正常的患者再次化疗后肝损伤情况。结果:在治疗1周后,观察1组患者的总有效率明显高于对照1组;两组患者丙氨酸氨基转移酶、天门冬氨酸氨基转移酶水平均较治疗前明显降低,且观察1组患者明显低于对照1组,差异均有统计学意义(P<0.05)。保肝治疗后,49例显效(肝功能恢复正常)患者再次给予化疗后以随机数字表法分为观察2组25例和对照2组24例,观察2组患者的肝损伤率为12.0%(3/25),明显低于对照组的37.5%(9/24),差异有统计学意义(P<0.05)。治疗过程中,所有患者均未发现明显不良反应。结论:异甘草酸镁和还原型谷胱甘肽在防治化疗药致肝损伤方面可发挥较好的协同作用。

OBJECTIVE： To probe into the efficacy of magnesium glycyrrhizinate combined with reduced glutathione in prevention and treatment of chemotherapeutic drug-induced liver injury. METHODS： 80 patients with chemotherapeutic drug-induced liver injury admitted into the First People＇s Hospital of Nanyang from Jan. 1st,2015 to Jun. 30 th,2017 were extracted to be divided into observation group one and control one via the random number table,with 40 cases in each. Patients in observation group one was given magnesium glycyrrhizinate combined with reduced glutathione,while the control group one received reduced glutathione. After treatment of one week,patients with normal liver function returned to the normal chemotherapy and continued to be divided into observation group two and control group two by the random number table method. Patients in observation group two was given magnesium glycyrrhizinate combined with reduced glutathione,while the control group two only received reduced glutathione. The clinical efficacy,changes of liver function indicators and adverse drug reactions were observed in all patients,and the liver function injury after re-chemotherapy was observed in patients with normal liver function after treatment.RESULTS： After treatment of one week,the total effective rate of patients in observation group one was significantly higher than that in control group one; the ALT and AST levels of two groups were significantly lower than those before treatment,and the observation group one was significantly lower than the control group one,the differences were statistically significant（ P〈0. 05）. After hepatoprotective treatment,49 patients with significant efficacy（ Liver function return to normal state） were given chemotherapy again; and then the patients were randomly divided into observation group two（ n = 25） and control group two（ n = 24）; the liver function injury of observation group two was12. 0%（ 3/25）,significantly lower than that of the control group[37. 5%（ 9/24） ],the difference was statistically significant（ P〈0. 05）. During treatment, no significant adverse drug reactions were found in patients.CONCLUSIONS： Magnesium glycyrrhizinate combined with reduced glutathione have a good synergistic effect inprevention and treatment of chemotherapeutic drug-induced liver injury.