茵陈蒿汤加味治疗药物性肝损伤65例

Yinchenhao Decoction Jiawei Treated 65 Cases of Drug-induced Liver Injury’s Clinical Study

摘要:

目的: 观察茵陈蒿汤加味治疗药物性肝损伤(DILI)的临床疗效。方法: 将130例DILI患者随机按数字法分为观察组和对照组各65例。两组均口服肌苷片0.4 g/次,3次/d,肝泰乐片0.2 g/次,3次/d。对照组口服多烯磷脂酰胆碱胶囊,2粒/次,3次/d;观察组采用茵陈蒿汤加味,1剂/d,疗程4周。每周监测肝功能变化、观察临床症状体征,检测治疗前后血清白细胞介素-10(IL-10)、γ-干扰素(IFN-γ)水平。结果: 治疗后观察组治愈率95.23%,优于对照组的63.07%(P<0.05);治疗后观察组黄疸、乏力、纳差、恶心呕吐、皮肤疹痒、大便、胁痛及脘闷腹胀评分均低于对照组(P<0.01);治疗后观察组丙氨酸氨基转移酶(ALT),谷草转氨酶(AST),总胆红素(TBIL)均低于对照组(P<0.01);治疗后观察组血清IL-10高于对照组,IFN-γ低于对照组(P<0.01)。结论: 茵陈蒿汤加味可降低患者ALT,AST,TBIL水平,减轻黄疸、乏力、纳差等临床表现,提高临床治愈率,其作用机制可能与调节免疫功能有关。

Abstract:

Objective: Observed the Yinchenhao decoction Jiawei treated drug-induced liver injury (DILI) clinical efficacy. Method: One hundred and thirty cases of DILI patients were randomly divided into observation group and control group grouping by digital method, each group had 65 cases. Both groups were oral inosine tablets of 0.4 g/time, 3 times/d. The Glucurolactone tablets were oral of 0.2 g/time, 3 times/d. The control group was treated with polyene phosphatidylcholine capsules, 2 pills/time, 3 times/d. Observation group used Yinchenhao decoction Jiawei. 1 dose/d. Lasted for 4 weeks. Every week was monitoring of liver function change. We observed clinical symptoms signs. Before and after treatment we tested serum levels of interleukin-10 (IL-10), gamma-interferon (IFN-gamma) levels. Result: After treatment, the observation group, the cure rate was 95.23%, better than 63.07% of the control group (P<0.05);After treatment, jaundice, fatigue, anorexia, nausea vomiting, skin rash itching, stool, hypochondriac pain and abdominal distension nausea scores were lower than the control group (P<0.01);after treatment, alanine aminotransferase(ALT), glutamic-oxaloacetic transaminase(AST), bilirubin(TBIL) were lower than the control group (P<0.01);after treatment, serum IL-10 was higher than control group, IFN-gamma was lower than the control group (P<0.01). Conclusion: Yinchenhao decoction Jiawei could be reduced in patients with ALT, AST, TBIL level, reduced the clinical manifestations such as jaundice, fatigue, anorexia, improved the clinical cure rate, and its mechanism may be related with regulated immune function.