复方甘草酸苷片结合大剂量泼尼松治疗自身免疫性肝炎的疗效及对T细胞亚群的影响

Efficacy of Compound Glycyrrhizin Tablets Combined with High dose Prednisone in the Treatment of Autoimmune Hepatitis and Its Influence on T Cell Subsets

目的探讨复方甘草酸苷片结合大剂量泼尼松治疗自身免疫性肝炎的临床效果。方法选取2018年9月至2020年10月收治自身免疫性肝炎患者112例,采用随机数字表法将其分为对照组、观察组,每组56例,对照组予以大剂量泼尼松,观察组予以复方甘草酸苷片+大剂量泼尼松,对两组总体疗效,相关生化指标,T细胞亚群水平,安全性进行比较。结果治疗总有效率观察组(91.07%)相较于对照组(75.00%),明显较高(P<0.05);治疗前,谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)、免疫球蛋白G(IgG)水平组间比较,无明显差异(P>0.05),治疗6个月后,相较于同期对照组,观察组上述指标水平下降更明显(P<0.05);治疗前,CD4+、CD8+、CD4+CD25+水平组间比较,无明显差异(P>0.05),治疗6个月后,相较于同期对照组,观察组上述指标改善更明显(P<0.05);不良反应发生率观察组、对照组分别为17.86%、14.29%,组间比较,无明显差异(P>0.05)。结论复方甘草酸苷片结合大剂量泼尼松治疗自身免疫性肝炎,可增强疗效,调节T细胞亚群水平,未明显增加不良反应,值得推广。

Objective To explore the clinical effect of compound glycyrrhizin tablets combined with high-dose prednisone in the treatment of autoimmune hepatitis.Methods A total of 112 patients with autoimmune hepatitis were selected from Sep 2018 to Oct 2020,used random number table method,grouped them into control group and observation group,56 cases in the ea ch group,control group given high-dose prednisone,observation group given compound glycyrrhizin tablets+high-dose prednisone.Compared the Overall efficacy,the related biochemical indicators,the T cell subsets,the security between the two groups.Results The total effective in the observation group(91.07%)was significantly higher than the control group(75.00%)(P<0.05).Before treatment,the alanine aminotransferase(ALT),total bilirubin(TBIL),aspartate aminotransferase(AST)and immunoglobulin G(IgG)levels were compared between the groups,no significant difference(P>0.05),after 6 months of treatment,compared with the control group at the same period,the above indicators decreased more significantly in the observation group(P<0.05).Before treatment,the CD4+、CD8+、CD4+CD25+levels were compared between the groups,no significant difference(P>0.05),after 6 months of treatment,compared with the control group at the same period,the above indicators improvement more significantly in the observation group(P<0.05).The incidence of adverse reactions in the observation group and the control group were 17.86%and 14.29%respectively,no significant difference(P>0.05).Conclusion Compound glycyrrhizin tablets combined with high-dose prednisone in the treatment of autoimmune hepatitis can enhance the curative effect,regulate the level of T cell subsets,and do not significantly increase the adverse reactions,worthy of promotion.