【作者】 吴成胜；

【导师】 尹常健；

【作者基本信息】 山东中医药大学 ， 中西医结合临床， 2007， 博士

【摘要】 目的:总结护肝饮治疗急性药物性肝损害的临床疗效并探讨其作用机制。方法:临床选择符合纳入标准的急性药物性肝损害患者60例,随机分为两组,观察组(30例)给予护肝饮水煎剂,对照组给予硫普罗宁片,观察两组的临床疗效;以不同剂量护肝饮与硫普罗宁对对乙酰氨基酚(AP)及四氯化碳(CCl4)造成的昆明系小鼠急性肝损害模型进行预防,分析护肝饮防治急性药物性肝损害的作用机制。结果:临床研究显示,护肝饮对胁肋疼痛、脘闷腹胀、口干而苦、烦躁易怒、神疲懒言、大便稀溏等症状的改善明显优于硫普罗宁,对头身困重、纳呆等症状的改善优于硫普罗宁,对身目发黄、口中粘腻、恶心厌油、嗳气、大便秘结、肝脾肿大等症状的改善与硫普罗宁相似,二者总有效率并无明显差异;护肝饮与硫普罗宁片对ALT、AST、ALP、GGT、TBiL、IBiL、DBiL的降低程度相似,但护肝饮促进肝功能恢复的速度较硫普罗宁快;护肝饮与硫普罗宁片对肝脏B超的改善程度相似。实验结果显示,护肝饮可对抗AP及CCl4所致小鼠急性肝损害,升高GSH、SOD水平,降低TNF-α及MDA水平,抑制CYP2E1表达,减轻肝细胞脂肪变性。结论:护肝饮能消除和改善急性药物性肝损害的临床症状,促进肝功能的恢复,疗效与硫普罗宁相似,在某些症状的改善方面及促进肝功能恢复的速度方面优于硫普罗宁,是治疗急性药物性肝损害的有效药物,其作用机制与维持GSH含量、抑制CYP2E1表达、抗肝细胞变性及抑制炎症反应、抗氧应激和脂质过氧化有关,尚有其他机制参与其中。更多还原

【Abstract】 Objective: To observe the effect of Huganyin on the Acute Drug-induced Disease and explore the mechanism of it. Methods: Clinical study :60 patients with Acute Drug-induced Disease were divided into two groups at random:the treatment group and the control group. The treatment group was given Huganyin,the control group was given Tiopronin Tablets. Observe the clinical efficacy. Experiment study: 90 normal KD mice were randomly divided into 9 groups. The Acute Drug-induced Disease rat Model were established with CCl4 and AP. Observe the decoction effects of Huganyin on ALT, AST, TNF-α, SOD , GSH, CYP2E1, fat content and cell construction. Results: The treatment group’s main effective rate of the syndrome of TCM、the results of liver function test are better than the control group’s. Huganyin can improve SOD and GSH, reduce TNF-αand MDA, restrain the expression of CYP2E1, correct lipid metabolism mess. Conclusions: Huganyin is a effective drug of treating Acute Drug-induced Disease, it can moderate clinical symptom, alleviate the patients’sufferings rapidly. The mechanism contains improving SOD and GSH, reducing TNF-αand MDA, restraining the expression of CYP2E1 and correcting lipid metabolism mess.更多还原