双环醇片在严重银屑病治疗中的药物性肝损害保护作用的临床及实验研究

发布时间：2018-03-29 02:26

本文选题：银屑病　切入点：药物性肝损害　出处：《南京中医药大学》2013年硕士论文

【摘要】：目的：银屑病俗称“牛皮癣”,是一种常见的、容易反复发作的慢性炎症性皮肤病。治疗中、重度银屑病的药物中如甲氨蝶呤、维A酸类等一线药物的长期使用则可能会引起肝损害。本课题通过临床观察和实验研究双环醇片对严重银屑病治疗中的药物性肝损害的保护作用,从而为优化临床治疗银屑病方案提供线索和实验根据。方法：实验一：按照患者就诊顺序将符合纳入标准的研究对象按随机数字表法分为2组,一组为治疗组,共12例；一组为对照组,共17例。治疗组在治疗银屑病期间,出现药物性肝损害后口服双环醇片(25mg,一日3次),治疗至肝功能指标恢复正常。对照组在治疗期间,出现药物性肝损害后连续口服甘利欣片(甘草酸二铵150mg,一日2次),治疗至肝生化指标恢复正常。观察两组的肝功能恢复至正常的情况。实验二：将40只ICR小鼠随机分为5组,分别为A组空白对照组、B组雷公藤造模组、C组双环醇高剂量组、D组双环醇低剂量组、E组甘利欣对照组。A、B组给予羧甲基纤维素混悬液口服,C组、D组、E组给予相应药物处理5天后,第6天后4组给予雷公藤口服。24h后取血处死,解剖取肝脏,观测血清指标及病理情况。结果：临床实验表明双环醇与甘利欣均有保肝降酶的作用(P0.05),双环醇的总有效率为100%,甘利欣的总有效率为94.12%两者疗效无明显差异(P0.05)。动物实验表明各组小鼠血清AST比较,模型对照组明显大于空白对照组,差异有统计学意义(P0.05)。双环醇高剂量组、甘利欣均小于模型对照组,差异有统计学意义(P0.05)。双环醇低剂量与模型组相似,差异无统计学意义(P0.05)。双环醇高剂量组与甘利欣组相似,差异无统计学意义(P0.05)。双环醇低剂量组大于甘利欣组,差异有统计学意义(P0.05)。结论：双环醇能降低药物所致的肝酶升高,减轻肝细胞的变性坏死程度,具有保肝降酶的作用。
[Abstract]:Objective: psoriasis commonly known as "psoriasis" is a common, chronic inflammatory skin disease easy to attack again. In the treatment of severe psoriasis drugs such as methotrexate, long-term use of vitamin A acid and other first-line drugs may cause liver damage. The protective effect of this issue through clinical observation and Experimental Research on Bicyclol Tablets serious psoriasis in the treatment of drug-induced liver injury, so as to optimize the clinical treatment of psoriasis solutions provide clues and experimental basis.
Methods: experiment one: according to the sequence of patients met the inclusion criteria of the study were divided into 2 groups randomly, one group was the treatment group, 12 cases; one was control group, a total of 17 cases. The treatment group in the treatment of psoriasis during the emergence of drug-induced liver injury after oral administration (25mg, Bicyclol Tablets 3 times a day), normal recovery treatment to liver function. The control group during the treatment period, the emergence of drug-induced liver injury after continuous oral tablets (diammonium glycyrrhizinate diammonium glycyrrhizinate 150mg, 2 times a day), normal recovery treatment to the liver biochemical indicators. The liver function of two groups recovered to normal. Experiment two: 40 ICR mice were randomly divided into 5 groups, group A control group, B group, C group, Tripterygium wilfordii model, bicyclol group D high dose group, low dose group of bicyclol group, E control group.A group B Diammonium Glycyrrhizinate, treated with carboxymethyl cellulose oral suspension, C group, D group E were given corresponding drugs After 5 days of treatment, after sixth days, the 4 groups were given blood from the 4 groups of Tripterygium wilfordii, and the liver was dissected and the serum indexes and pathological conditions were observed.
Results: the clinical experiment showed that bicyclol and Potenline were hepatoprotection effect of bicyclol (P0.05), the total efficiency is 100%, with the total effective rate was 94.12% in the two effects are not significantly different (P0.05). The animal experiment showed that the level of serum AST of mice in each group, model control group was significantly greater than the control group, there was statistical significant differences (P0.05). Bicyclol in high dose group, diammonium glycyrrhizinate were less than the model control group, the difference was statistically significant (P0.05). Low dose of bicyclol is similar with the model group, the difference was not statistically significant (P0.05). Bicyclol in high dose group and simvastatin group were similar, no significant difference (P0.05) double. Low dose of alcohol group than diammonium glycyrrhizinate group, the difference was statistically significant (P0.05).
Conclusion: dicyclic alcohols can reduce the increase of liver enzymes caused by drugs, reduce the degree of degeneration and necrosis of liver cells, and have the effect of protecting liver and reducing enzymes.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R758.63

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