Abstract

To assess the clinical efficacy of diammonium glycyrrhizinate on drug induced liver injury and its effect on related inflammatory factors in the real world. A total of 234 inpatients diagnosed with drug induced liver injury in our hospital were continuously enrolled in this retrospective real world study, of whom 110 were treated with diammonium glycyrrhizinate and divided into three groups according to drug combination. Treatment group A (n=34) received diammonium glycyrrhizinate injection+reduced glutathione injection, treatment group B (n=45) received Kuhuang injection based on administration for treatment group A, and treatment group C (n=31) received ursodeoxycholic acid capsules based on administration for treatment group B. The remaining 124 cases did not undergo diammonium glycyrrhizinate treatment, including 37 cases in control group A receiving reduced glutathione injection alone, 55 cases in control group B receiving Kuhuang injection based on treatment for control group A, and 32 cases in control group C receiving ursodeoxycholic acid capsules based on treatment for control group B. The treatment lasted for 2 w. The biochemical indices such as serum gamma glutamyl transpeptidase, total bilirubin, alkaline phosphatase, glutamic pyruvic transaminase, tumor necrosis factor-α and interleukin-6 were observed before treatment and 1 w and 2 w after treatment, and adverse reactions were recorded. The efficacy was evaluated and compared. Compared with before treatment, the levels of alkaline phosphatase, glutamic pyruvic transaminase, tumor necrosis factor-α, interleukin-6 and total bilirubin in treatment group A, the levels of alkaline phosphatase, glutamic pyruvic transaminase, gamma glutamyl transpeptidase, tumor necrosis factor-α, interleukin-6 and total bilirubin in treatment group B, and the levels of alkaline phosphatase, glutamic pyruvic transaminase, tumor necrosis factor-α, interleukin-6 and gamma glutamyl transpeptidase in treatment group C all significantly declined (p<0.05). The levels of total bilirubin, tumor necrosis factor-α and interleukin-6 significantly declined in control group C (p<0.05), while the changes in biochemical indices had no significant differences in other control groups (p>0.05). Compared with before treatment, the levels of tumor necrosis factor-α, interleukin-6 and total bilirubin in treatment group A, the levels of alkaline phosphatase, glutamic pyruvic transaminase, tumor necrosis factor-α, interleukin-6 and gamma glutamyl transpeptidase in treatment group B, and the levels of alkaline phosphatase, tumor necrosis factor-α and interleukin-6 in treatment group C significantly declined (p<0.05), but the level of total bilirubin in treatment group C significantly rose (p<0.05). The response rates in treatment group A and B were higher than those in control group A and B, respectively (p<0.05), but it was lower in treatment group C than that in control group C (p<0.05). The response rates in treatment group A and B exceeded than in treatment group C (p<0.167), while it had no significant difference between treatment group A and B (p>0.167). The adverse reactions were all mild in treatment group A, B and C (p>0.05). Compared with reduced glutathione injection alone (control group A) and reduced glutathione injection+Kuhuang injection (control group B), double combination of reduced glutathione injection+diammonium glycyrrhizinate (treatment group A) and triple combination of reduced glutathione injection+Kuhuang injection+diammonium glycyrrhizinate (treatment group B) can improve the biochemical indices of liver function and increase the response rate, with a higher response rate than quadruple combination of reduced glutathione injection+Kuhuang injection+ursodeoxycholic acid capsules+diammonium glycyrrhizinate (treatment group C). The response rate had no clinical significance between quadruple combination and reduced glutathione injection+Kuhuang injection+ursodeoxycholic acid capsules (control group C). The administration for each treatment group was safe.