中西药诱导药物性肝炎的临床特征比较

发布时间：2018-04-13 17:47

本文选题：药物性肝炎 + 中药　；参考：《实用医学杂志》2017年13期

【摘要】：目的观察中西药诱导药物性肝炎的临床特征之异同。方法 2015年1-12月期间181例行肝穿术且因果关系评分3分确诊DILI住院患者中,中药组75例,西药组66例,中西药组40例。采集患者的性别、年龄、临床表现、体征、实验室检查、影像学特点等临床资料进行回顾性分析。结果中药组、西药组和中西药组在年龄、临床分型和急慢性病程等方面无统计学差异(P0.05)。纳差是各组中常见症状,无统计学差异(P0.05),黄疸在中药组中发生率最高,发热在西药组中发生率高,各组相比较,存在统计学差异(P0.05);3组凝血功能、白蛋白均正常,且均出现转氨酶水平明显升高,各组之间无统计学差异(P0.05);与西药组相比,中药组在血小板计数、总胆红素、总胆汁酸和血清铁水平上更高(P0.05),嗜酸性粒细胞百分比、碱性磷酸酶水平降低(P0.05)。结论中西药导致的药物性肝炎在年龄、临床分型、急慢性病程、转氨酶水平等方面类似,但西药易导致过敏性反应,中药易导致高胆红素血症。
[Abstract]:Objective to observe the similarities and differences of clinical characteristics of drug-induced hepatitis induced by Chinese and western medicine.Methods from January to December 2015, 181 cases of DILI were diagnosed with liver puncture and causality score. 75 cases were in Chinese medicine group, 66 cases in western medicine group and 40 cases in Chinese and western medicine group.Gender, age, clinical manifestations, signs, laboratory examination, imaging features and other clinical data were retrospectively analyzed.Results there was no significant difference in age, clinical type and acute and chronic course of disease between Chinese medicine group, western medicine group and traditional Chinese medicine group (P 0.05).The incidence of jaundice was the highest in the traditional Chinese medicine group, and the incidence of fever in the western medicine group was high. Compared with each group, there was statistical difference in coagulation function and normal albumin in the three groups.The level of transaminase was significantly increased in all groups, and there was no significant difference between the two groups (P 0.05). Compared with the western medicine group, the platelet count, total bilirubin, total bile acid and serum iron levels in the traditional Chinese medicine group were higher than those in the western medicine group, and the percentage of eosinophilic granulocytes was higher than that in the traditional Chinese medicine group.The level of alkaline phosphatase decreased P0.05.Conclusion the drug-induced hepatitis caused by Chinese and western medicine is similar in age, clinical type, acute and chronic course of disease, and level of transaminase, but it is easy to cause allergic reaction in western medicine and hyperbilirubinemia in traditional Chinese medicine.
【作者单位】：首都医科大学附属北京世纪坛医院中医科;解放军第302医院中西医结合肝病中心;
【基金】：首都医科大学基础临床与李桓英联合基金资助项目(编号:17JL-L04)
【分类号】：R575

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