熊去氧胆酸胶囊联合甘草酸二铵治疗自身免疫性肝炎的临床研究

Clinical study on Ursodeoxycholic Acid Capsules combined with diammonium glycyrrhizinate in treatment of autoimmune hepatitis

目的探讨熊去氧胆酸胶囊联合甘草酸二铵胶囊治疗自身免疫性肝炎的临床效果。方法选取青海省第四人民医院2015年3月—2017年3月收治的自身免疫性肝炎患者118例,随机分为对照组(59例)和治疗组(59例)。对照组口服甘草酸二铵胶囊,3粒/次,3次/d。治疗组在对照组基础上口服熊去氧胆酸胶囊,1粒/次,3次/d。两组均连续治疗3个月。观察两组患者临床疗效,同时比较治疗前后两组患者肝纤维化指标、炎性因子和T淋巴细胞水平。结果治疗后,对照组临床有效率为79.66%,显著低于治疗组的94.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清透明质酸(HA)、Ⅲ型前胶原(PCⅢ)和层黏连蛋白(LN)水平均显著降低(P<0.01),且治疗组上述肝纤维化指标比对照组下降更明显(P<0.01)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6水平较治疗前均显著下降(P<0.01),IL-10水平显著升高(P<0.01),且治疗后治疗组上述炎性因子改善水平明显优于对照组(P<0.01)。治疗后,两组患者外周血Th17细胞百分率、Th17/Treg比率均显著降低(P<0.01),Treg细胞百分率均显著升高(P<0.01),且治疗后治疗组T淋巴细胞水平明显优于对照组(P<0.01)。结论熊去氧胆酸胶囊联合甘草酸二铵胶囊治疗自身免疫性肝炎更能有效缓解患者症状体征,改善自身免疫功能和肝功能。

Objective To investigate the clinical efficacy of Ursodeoxycholic Acid Capsules combined with diammonium glycyrrhizinate in treatment of autoimmune hepatitis. Methods Patients（118 cases） with autoimmune hepatitis in the 4 th People’s Hospital of Qinghai Province from March 2015 to March 2017 were randomly divided into control（59 cases） and treatment（59 cases） groups. Patients in the control group were po administered with Diammonium Glycyrrhizinate Capsules, 3 grains/time, three times daily. Patients in the treatment group were po administered with Ursodeoxycholic Acid Capsules on the basis of the control group, 1 grain/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the indicators of liver fibrosis, inflammatory cytokines and T lymphocyte levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79.66%, which was significantly lower than 94.92% in the treatment group, and there were differences between two groups（P 〈 0.05）. After treatment, the HA, PCⅢ, and LN levels in two groups were significantly decreased（P 〈 0.01）, and these liver fibrosis indicators in the treatment group after treatment were significantly lower than those in the control group（P 〈 0.01）. After treatment, the TNF-α and IL-6 levels in two groups were significantly decreased（P 〈 0.01）, and IL-10 levels were significantly increased（P 〈 0.01）, and these inflammatory cytokines in the treatment group were significantly better than those in the control group（P 〈 0.01）. After treatment, the percentage of Th17 cells in peripheral blood and Th17/Treg in two groups were significantly decreased（P 〈 0.01）, and percentage of Treg cells was significantly increased（P 〈 0.01）, and the T lymphocyte levels in the treatment group were significantly better than those in the control group（P 〈 0.01）. Conclusion Ursodeoxycholic Acid Capsules combined with diammonium glycyrrhizinate in treatment of autoimmune hepatitis can relieve the symptoms and signs, improve the autoimmune functions and liver function.