复方甘草酸苷片治疗肝硬化患者的临床研究

Clinical study on compound glycyrrhizin tablets in the treatment of patients with liver cirrhosis

目的观察复方甘草酸苷片治疗肝硬化患者的临床疗效及对氧化应激和炎性反应的影响。方法选择2016年4月—2018年11月解放军第988医院焦作院区消化科诊治的40例肝硬化患者,随机分为2组,对照组20例给予常规治疗,观察组20例在对照组治疗基础上给予复方甘草酸苷片治疗,2组疗程均为6个月。观察2组患者治疗前后血清肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)]、改良肝功能Child-Pugh分级、肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原氨基末端前肽(PⅢNP)、Ⅳ型胶原(Ⅳ-C)]、氧化应激指标[丙二醛(MDA)、黄嘌呤氧化酶(XO)]及炎性指标[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]的变化。结果治疗后,2组患者血清ALT、AST、TBil、HA、LN、PⅢNP、Ⅳ-C、MDA、IL-6、IL-8水平和XO活性均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组患者改良肝功能Child-Pugh分级均明显改善(P均<0.05),且观察组改善程度优于对照组(P<0.05)。结论复方甘草酸苷片可显著改善肝硬化患者的肝功能和肝纤维化情况,其作用机制可能与抑制氧化应激和炎性反应有关。

Objective It is to observe the clinical efficacy of compound glycyrrhizin tablets in the treatment of patients with liver cirrhosis and its influence on oxidative stress and inflammatory response.Methods Forty patients with liver cirrhosis who were diagnosed and treated in the Gastroenterology Department of Jiaozuo Hospital of the 988th Hospital of PLA from April 2016 to November 2018 were randomly divided into 2 groups.20 patients in the control group were given conventional treatment,and 20 patients in the observation group were treated with compound glycyrrhizin tablets on the basis of treatment in the control group.Both groups were treated for 6 months.The changes in serum liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil)],modified liver function Child-Pugh classification,liver fibrosis indexes[hyaluronic acid(HA),laminin(LN),N-terminal propeptide of typeⅢprocollagen(PⅢNP),type IV collagen(IV-C)],oxidative stress indicators[malonaldehyde(MDA),xanthine oxidase(XO)]and inflammatory indicators[interleukin-6(IL-6),interleukin-8(IL-8)]were observed before and after treatment in the two groups.Results After treatment,the levels of serum ALT,AST,TBil,HA,LN,PⅢNP,IV-C,MDA,IL-6,IL-8 and XO activity were significantly reduced in the two groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05);the Child-Pugh classification of modified liver function was significantly improved in the two groups(P<0.05),and the improvement degree of the observation group was better than that of the control group(P<0.05).Conclusion Compound glycyrrhizin tablets can significantly improve liver function and liver fibrosis in patients with liver cirrhosis,and its mechanism of action may be related to the inhibition of oxidative stress and inflammatory reactions.