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目的研究异甘草酸镁联合强的松治疗自身免疫性肝炎(AIH)的临床应用价值。方法 54例自身免疫性肝炎患者,随机分A组、B组和C组,各18例。A组给予强的松治疗,B组给予异甘草酸镁联合强的松治疗,C组给予异甘草酸镁治疗。观察比较三组临床疗效、肝功能各项指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]改善情况及不良反应发生情况。结果 A组总有效率为88.89%,B组为94.44%,C组为61.11%;A组总有效率与B组比较差异无统计学意义(P>0.05);B组总有效率高于C组,差异有统计学意义(P<0.05)。治疗后,A组ALT、AST、TBIL分别为(59.8±6.8)U/L、(57.4±5.0)U/L、(27.6±2.9)μmol/L;B组分别为(59.1±6.4)U/L、(56.3±4.8)U/L、(26.4±2.3)μmol/L;C组分别为(64.5±6.3)U/L、(76.4±5.2)U/L、(40.4±3.7)μmol/L;治疗后,B组肝功能各项指标水平明显低于C组(P<0.05);A、B两组肝功能各指标水平比较差异无统计学意义(P>0.05)。治疗期间A组出现水肿3例、头昏2例,消化道出血2例,不良反应发生率为38.89%;B组出现水肿1例,不良反应发生率为5.56%;C组出现头昏1例,不良反应发生率为5.56%;A组不良反应发生率明显高于B组和C组,差异有统计学意义(P<0.05)。结论异甘草酸镁联合强的松治疗自身免疫性肝炎临床疗效显著,不良反应少,临床可积极推广应用。
Objective To investigate the clinical value of magnesium glycyrrhizinate combined with prednisone in the treatment of autoimmune hepatitis (AIH). Methods Fifty-four patients with autoimmune hepatitis were randomly divided into group A, group B and group C, with 18 cases in each. Group A was given prednisone, group B was given magnesium glycyrrhizinate combined with prednisone, and group C was given magnesium isoglycyrrhizinate. The clinical efficacy, indexes of liver function (ALT, AST, TBIL) and the incidence of adverse reactions were observed and compared. Results The total effective rate was 88.89% in group A, 94.44% in group B, and 61.11% in group C. The total effective rate in group A was not significantly different from that in group B (P> 0.05). The total effective rate in group B was higher than that in group C Group, the difference was statistically significant (P <0.05). After treatment, the ALT, AST and TBIL in group A were (59.8 ± 6.8) U / L, (57.4 ± 5.0) U / L and (27.6 ± 2.9) μmol / L, (56.3 ± 4.8) U / L and (26.4 ± 2.3) μmol / L, respectively; while those in group C were (64.5 ± 6.3) U / L, After treatment, the indexes of liver function in group B were significantly lower than those in group C (P <0.05). There was no significant difference in each index of liver function between groups A and B (P> 0.05). There were 3 cases of edema, 2 cases of dizziness and 2 cases of gastrointestinal bleeding in group A, the incidence of adverse reactions was 38.89% in group A, 1 case of edema in group B and 5.56% of adverse reactions in group A, 1 case of dizziness in group C , And the incidence of adverse reactions was 5.56%. The incidence of adverse reactions in group A was significantly higher than that in groups B and C (P <0.05). Conclusion Isoglucan combined with prednisone treatment of autoimmune hepatitis has significant clinical efficacy, fewer adverse reactions, the clinical application can be actively promoted.