复方甘草酸苷片联合盐酸西替利嗪治疗慢性荨麻疹患者的临床研究

Clinical trial of compound glycyrrhizin tablets and cetirizine hydrochloride in the treatment of patients with chronic urticaria

目的 探讨复方甘草酸苷片联合盐酸西替利嗪治疗慢性荨麻疹患者的疗效及作用机制。方法 将110例慢性荨麻疹患者采用随机数字表法分为对照组(55例)和试验组(55例)。对照组给予盐酸西替利嗪片,每次10 mg,每天1次,口服。试验组在对照组的基础上给予复方甘草酸苷片,以甘草酸苷计每次150 mg,每天3次,口服。2组均治疗12周,随访2个月。比较2组临床疗效、炎性因子、趋化因子水平、慢性荨麻疹评分、免疫功能、药物不良反应发生情况及复发情况。结果 治疗后,试验组总有效率(94.55%)高于对照组(80.00%,P<0.05)。治疗后,试验组和对照组血清白细胞介素-4(IL-4)水平分别为(4.22±1.24)和(7.35±1.73)ng·L^(-1);血清白细胞介素-10(IL-10)水平分别为(22.03±3.04)和(35.04±3.82)ng·L^(-1);血清白细胞介素-25(IL-25)水平分别为(120.78±14.31)和(162.08±17.48)ng·L^(-1);血清白细胞介素-33(IL-33)水平分别为(89.73±9.62)和(103.92±11.59)ng·L^(-1);血清干扰素-γ(IFN-γ)水平分别为(19.52±3.82)和(13.28±3.29)pg·mL^(-1);血清单核细胞趋化蛋白-1(MCP-1)水平分别为(284.30±37.59)和(331.82±41.95)pg·mL^(-1);血清正常T细胞表达和分泌因子(RANTES)水平分别为(29.94±3.52)和(48.78±6.41)μg·L^(-1);血清嗜酸性粒细胞趋化因子(Eotaxin)水平分别为(55.74±5.39)和(73.29±6.94)μg·L^(-1);慢性荨麻疹评分分别为(2.04±0.89)和(5.73±1.92)分;血清补体3(C3)水平分别为(0.98±0.24)和(0.89±0.21)g·L^(-1);血清补体4(C4)水平分别为(0.42±0.06)和(0.28±0.05)g·L^(-1);血清补体5a(C5a)水平分别为(38.58±3.28)和(49.72±5.28)ng·mL^(-1);血清免疫球蛋白E(IgE)水平分别为(106.84±11.27)和(184.37±28.47)U·mL^(-1),差异均有统计学意义(均P<0.05)。治疗期间,试验组和对照组总药物不良反应发生率差异无统计学意义(P>0.05)。随访2个月,试验组和对照组复发率分别为12.73%和27.27%,差异有统计学意义(P<0.05)。结论 复方甘草酸苷片辅助治疗慢性荨麻疹患者,可有效改善患者临床症状,降低患者机体炎症反应、趋化因子水平,调节患者机体免疫功能,安全性较好,同时可有效降低患者复发率,具有较好的治疗效果。

ObjectiveTo explore the efficacy and mechanism of compound glycyrrhizin tablets and cetirizine hydrochloride in the adjuvant treatment of patients with chronic urticaria.Methods A total of 110patients with chronic urticaria were divided into control group (55 cases)and treatment group (55 cases) by random number table method.The control group was treated with cetirizine hydrochloride tablets,10 mg each time,once a day.On the basis of control group,treatment group was treated with compound glycyrrhizin tablets,150 mg per time and 3 times a day.Both groups were treated for 12 weeks and followed up for 2 months.The clinical efficacy,inflammatory factors,chemokine levels,chronic urticaria score,immune function,incidence of adverse drug reactions and recurrence were compared between the two groups.Results After treatment,the total effective rate of the treatment group(94.55%) was higher than that of control group (80.00%,P<0.05).After treatment,the levels of serum interleukin-4 (IL-4) in treatment group and control group were (4.22±1.24) and (7.35±1.73) ng·L^(-1);the levels of serum interleukin-10 (IL-10) were (22.03±3.04) and (35.04±3.82) ng·L^(-1);the levels of serum interleukin-25 (IL-25)were (120.78±14.31) and (162.08±17.48) ng·L^(-1);the levels of serum interleukin-33 (IL-33) were(89.73±9.62) and (103.92±11.59) ng·L^(-1);the levels of serum interferon-γ (IFN-γ) were (19.52±3.82) and (13.28±3.29) pg·m L^(-1);the levels of serum monocyte chemotactic protein-1 (MCP-1) were(284.30±37.59) and (331.82±41.95) pg·m L^(-1);the levels of serum normal T cell expression and secretion factor (RANTES) were (29.94±3.52) and (48.78±6.41)μg·L^(-1);the levels of serum eosinophil chemotactic factor (Eotaxin) were (55.74±5.39) and (73.29±6.94)μg·L^(-1);score of chronic urticaria were (2.04±0.89)and (5.73±1.92) point;the levels of serum complement 3 (C3) were (0.98±0.24) and (0.89±0.21) g·L^(-1);the levels of serum complement 4 (C4) were (0.42±0.06) and (0.28±0.05) g·L^(-1);the levels of serum complement 5a (C5a) were (38.58±3.28) and (49.72±5.28) ng·m L^(-1);the levels of serum immunoglobulin E(Ig E) were (106.84±11.27) and (184.37±28.47) U·m L^(-1),the above indexes were statistically different between the two groups (all P<0.05).During the treatment period,there was no significant difference in the incidence of total adverse drug reactions between treatment group and control group (P>0.05).After 2 months follow-up,the recurrence rates of treatment group and control group were 12.73%and 27.27%,the difference was statistically significant (P<0.05).Conclusion Compound glycyrrhizin tablets could effectively improve the clinical symptoms of patients with chronic urticaria,reduce the level of inflammatory response and chemokine,regulate the immune function of patients,with good safety,and could effectively reduce the recurrence rate of patients,with good therapeutic effect.