Department of Hematology, Weifang People's Hospital, Weifang, Shandong, China.
Chin Med J (Engl). 2013;126(11):2083-6.
Cyclosporine A (CsA) has been widely used in the treatment of aplastic anemia (AA), but the application of CsA was limited in patients who had liver diseases or abnormal liver function due to its liver toxicity. Glycyrrhizin has long been used in China in the treatment of various liver diseases to lower transaminases. In this study, we observed the efficacy and safety of glycyrrhizic acid combined with CsA in the treatment of newly diagnosed patients with non-severe AA (NSAA).
A total number of 76 patients with newly diagnosed NSAA were enrolled into the study at our hospital between July 2005 and June 2010. The patients were divided randomly into two groups: the glycyrrhizin-treatment group (group A) and the control group (group B) with 38 patients in each group. All patients received 3 - 5 mg×kg(-1)×d(-1) CsA for at least 4 months and were treated either with or without glycyrrhizin for 4 months.
sixty-eight patients were eligible for evaluation. In the control group, 9.09% patients (n = 3) achieved a complete response while 51.52% (n = 17) attained a partial response. The overall response rate was 60.61% (n = 20). The remaining 13 patients (39.39%) did not have any response. In the glycyrrhizin-treatment group, complete response rate was 20% (n = 7) and partial response rate was 62.86% (n = 22). The overall response rate was 82.86% (n = 29) and the non-response rate was 17.14% (n = 6). Response rate was significantly increased with the addition of glycyrrhizin to CsA compared with CsA alone (P < 0.05).
The combination of glycyrrhizin and cyclosporine regimen was an effective treatment for NSAA in terms of improvement of response rate, reduction in CsA-related liver injury, and attenuation of severity of nausea and other adverse events in the treatment of patients with NSAA.
环孢素 A（CsA）已广泛用于治疗再生障碍性贫血（AA），但由于其肝毒性，CsA 在患有肝脏疾病或肝功能异常的患者中的应用受到限制。甘草酸在中国长期用于治疗各种肝脏疾病以降低转氨酶。在这项研究中，我们观察了甘草酸联合 CsA 治疗新诊断的非重型 AA（NSAA）患者的疗效和安全性。
2005 年 7 月至 2010 年 6 月，我院共收治 76 例新诊断的 NSAA 患者，随机分为两组：甘草酸治疗组（A 组）和对照组（B 组），每组 38 例。所有患者均接受 3-5mg×kg（-1）×d（-1）CsA 至少 4 个月，并分别联合或不联合甘草酸治疗 4 个月。
68 例患者符合评估标准。对照组中，9.09%（n=3）患者达到完全缓解，51.52%（n=17）患者达到部分缓解。总缓解率为 60.61%（n=20）。其余 13 例（39.39%）患者无任何反应。在甘草酸治疗组中，完全缓解率为 20%（n=7），部分缓解率为 62.86%（n=22）。总缓解率为 82.86%（n=29），无反应率为 17.14%（n=6）。与 CsA 单药治疗相比，加用甘草酸可显著提高 CsA 的缓解率（P<0.05）。
甘草酸联合环孢素方案治疗 NSAA 可提高缓解率，减轻 CsA 相关肝损伤，减轻恶心等不良反应的严重程度。
