Observation Of Hormone Application Timing In Drug-induced Cholestatic Hepatitis

BackgroundCholestatic hepatitis is a major type of hepatitis characterized by cholestasis of small bile ducts in the liver.Its pathogenesis is complex and the course of disease is difficult to be cured.It can exist in various types of viral hepatitis,especially in patients with long-term use of drugs,with sustained liver damage.Therefore,cholestatic hepatitis has been a serious threat to the health and life safety of patients.In the process of drug treatment,there will be high cost,poor effect and low effect of yellowing,and there will be many side effects.In the process of using hormone drugs to treat cholestatic hepatitis,the treatment effect of patients is often reduced because of the inappropriate use time,so when to use hormone in the treatment process has become a hot issue in the current research.This study discusses and demonstrates the issue based on the application time of hormone,and gives treatment drugs in practice The basis of the application time of sex cholestatic hepatitis hormone.ObjectiveTo explore the application time of hormone in the treatment of drug-induced cholestasis hepatitis,so as to provide clinical basis for effectively improving the treatment of drug-induced cholestasis hepatitis.Methods In this study,115 cases of drug-induced cholestatic hepatitis in our hospital from January 2017 to December 2018 were randomly divided into three groups: group A(32 cases),group B(43 cases)and group C(40 cases).All patients in the three groups were treated with comprehensive liver protection and symptomatic treatment,among which group A was treated with ursodeoxycholic acid combined with glucocorticoid;group B was treated with ursodeoxycholic acid alone After one week of oxycholic acid treatment,it was treated with glucocorticoid;group C was treated with ursodeoxycholic acid alone for two weeks,and then with glucocorticoid;the above three groups were treated with glucocorticoid for four weeks.The biochemical indexes,symptoms and signs of the three groups were observed before and after treatment,and the clinical effects and complications of the three groups were compared.Results(1)Before and after treatment,there was no significant difference in alt,AST,ALP,GGT,ALB,TBIL,DBIL and ibil among the three groups.The three groups were comparable.After treatment,the biochemical indexes of alt,AST,ALP,GGT,ALB,TBIL and DBIL in group C were better than those in group A and B,and the differences were statistically significant(P < 0.05).There was no statistical significance in the biochemical indexes of alt,AST,ALP,GGT,Alb,TBIL and DBIL between group A and group B,but there was no statistical significance in the indexes of ibil among the three groups(P > 0.05))(2)The improvement of symptoms and signs before and after treatment: hepatomegaly,pruritus,anorexia,asthenia and yellow urine in the symptoms and signs before treatment in the three groups were not statistically significant,and the three groups were comparable.After treatment,the symptoms and signs of hepatomegaly,pruritus,poor appetite,asthenia and yellow urine in group C were better than those in group A and B,and the difference was statistically significant(P < 0.05).However,there was no significant difference in the improvement of symptoms and signs between group A and group B(P > 0.05),(3)Comparison of clinical efficacy among the three groups: 12 cases in group A,10 cases in effect,10 cases in invalidity,with a total effective rate of 68.75%;15 cases in group B,18 cases in effect,10 cases in invalidity,with a total effective rate of 76.74%;23 cases in group C,13 cases in effect,4 cases in invalidity,with a total effective rate of 90%.The total effective rate of group C was significantly higher than that of group A and group B,and the difference was statistically significant(x2 = 40.661,P < 0.001).(4)Complications of three groups: group A: 7 cases of gastrointestinal hemorrhage,8 cases of infection and 9 cases of ascites;group B: 6 cases of gastrointestinal hemorrhage,7 cases of infection and 8 cases of ascites;group C: 3 cases of gastrointestinal hemorrhage,3 cases of infection and 5 cases of abdominal water;none of the three groups had hepatic encephalopathy.According to statistics,the incidence of complications in group C was better than that in group A and group B,and the difference was statistically significant.ConclusionGlucocorticoids can be used to treat drug-induced cholestatic hepatitis quickly,safely and effectively after the second week of treatment.However,in the course of glucocorticoid application,we should pay strict attention to the principle of gradual reduction to avoid the occurrence of complications.