雷公藤多甙、硫唑嘌呤联合甘草酸二铵治疗自身免疫性肝炎患者初步临床研究

摘要

目的 探讨雷公藤多甙片、硫唑嘌呤片联合甘草酸二铵治疗自身免疫性肝炎(AIH)患者的疗效.方法 将2015年1月~2016年1月我院收治的68例AIH患者随机分为对照组和观察组,每组34例.给予对照组患者硫唑嘌呤片联合甘草酸二铵治疗,观察组在对照组治疗的基础上接受雷公藤多甙片治疗3个月,观察两组治疗前后血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和总胆红素(TBIL)、血清免疫球蛋白IgG、IgA和IgM以及肝纤维化指标透明质酸(HA)和层粘蛋白(LN)的变化,观察两组治疗期间不良反应事件发生情况.结果 在治疗3个月末,观察组患者血清ALT、AST、ALP和TBIL水平分别为(51.7±7.2)U/L、(45.6±8.1)U/L、(67.4±3.2)U/L和(11.4±1.2)μmol/L,显著低于对照组[分别为(79.7±11.9)U/L、(77.1±9.2)U/L、(87.1±4.0)U/L和(15.3±1.4)μmol/L,P<0.05];观察组血IgG、IgA和IgM水平分别为(11.29±2.24)mg/ml、(2171.4±100.3)mg/L和(2218.8±98.2)mg/L,均显著低于对照组[分别为(14.80±2.75)mg/ml、(2839.9±107.0)mg/L和(2912.0±113.1)mg/L,P<0.05];观察组血清HA、LN和PCⅢ水平分别为(112.4±6.8)μg/L、(61.3±4.6)μg/L和(52.4±3.3)μg/L,均较对照组显著降低[(164.2±7.3)μg/L、(82.6±5.7)μg/L和(79.2±4.4)μg/L,P<0.05];在治疗期间两组均未出现严重不良反应.结论 雷公藤多甙片、硫唑嘌呤片联合甘草酸二铵治疗AIH患者临床疗效优于硫唑嘌呤片联合甘草酸二铵治疗者.%Objective To explore the effect of tripterygium glycosides,azathioprine combined with diammonium glycyrrhizinate in the treatment of patients with autoimmune hepatitis (AIH). Methods 68 patients with AIH were recruited in our hospital between January 2015 and January 2016,and the patients were randomly divided into control and observation group with 34 cases in each. The patients in the control group were treated with azathioprine and diammonium glycyrrhizinate,and the patients in the observation group were given tripterygium glycosides,azathioprine combined with diammonium glycyrrhizinate for 3 months. Before and after treatment,serum ALT,AST,ALP and TBIL,serum immunoglobulin and hepatic fibrosis index (HA,LN and PC III) levels were detected. Results At the end of 3 months treatment,serum ALT,AST,ALP and TBIL levels in the observation group were (51.7 ±7.2) U/L,(45.6 ±8.1) U/L,(67.4 ±3.2) U/L and (11.4 ±1.2)μmol/L,respectively, significantly lower than those in the control group [(79.7±11.9) U/L,(77.1±9.2) U/L,(87.1±4.0) U/L and (15.3± 1.4)μmol/L,P<0.05];serum IgG,IgA and IgM levels in the observation group were (11.29±2.24) mg/ml,(2171.4± 100.3) mg/L and (2218.8 ±98.2) mg/L,significantly lower than those in the control group [(14.80 ±2.75) mg/ml, (2839.9±107.0) mg/L and(2912.0±113.1) mg/L,P<0.05];and serum levels of HA,LN and PCⅢ were (112.4±6.8)μg/L,(61.3±4.6)μg/L and(52.4±3.3)μg/L,significantly lower than those in the control group [(164.2±7.3)μg/L, (82.6 ±5.7)μg/L and (79.2 ±4.4)μg/L,P<0.05];No serious adverse reaction was observed in the two groups.