Hepatoprotective drugs are very widely used in clinical practice and are commonly used in many departments, especially in cancer chemotherapy patients, where hepatoprotective drugs are routinely used to reduce the hepatotoxicity of chemotherapeutic drugs. Commonly used hepatoprotective drugs are categorized as follows.

1.Detoxification drugs These drugs can provide sulfhydryl or glucuronic acid, sulfhydryl can be combined with peroxides and free radicals in the body to counteract their damage to the liver, commonly used, such as reduced glutathione, thiopronin; glucuronolactone (hepatic tylenol) can be converted into glucuronic acid under the catalytic action of enzymes, which is an important detoxification substance in the body, and can be combined with phenolic, hydroxyl, carboxyl and amino groups contained in the liver or intestines, and form non-toxic glucuronic acid conjugates to be excreted in the urine. It is an important detoxifying substance in the body, which can combine with metabolites, poisons or drugs containing phenolic groups, hydroxyl groups, carboxyl groups and amino groups in the liver or intestines, and form non-toxic glucuronide conjugate to be excreted in urine.

2. Anti-inflammatory and enzyme-lowering drugs, such as glycyrrhizic acid diamine, magnesium isoglycyrrhizinate and compound glycyrrhizin, are hepatoprotective agents, which can inhibit hepatic β4-5-β reductase, thus inhibiting the metabolism of endogenous steroids in the liver, and have the effects of anti-inflammation, protecting the hepatocellular membrane and improving hepatic function. In addition, it can promote bile pigment metabolism, reduce the release of alanine aminotransferase and aspartate aminotransferase, and have the effect of de-yellowing and detoxification.

3. Choleretic drugs such as ursodeoxycholic acid and adenosylmethionine. Ursodeoxycholic acid is an isomer of normal bile components, which can increase bile secretion, inhibit hepatic cholesterol synthesis, reduce hepatic fat, relax sphincter of Oddi, and promote the dissolution of gallstones and bile discharge. Adenosylmethionine (Sematide) is an active substance in all body fluids, participating in important biochemical reactions as a precursor to methyl donors, and helping to prevent cholestasis in the liver.

4. Drugs to promote metabolism Including a variety of water-soluble vitamins, such as vitamin C, vitamin B complex and coenzyme A, etc., can promote energy metabolism and maintain the normal activity of various enzymes required for metabolism.

5. Enzyme-lowering drugs, such as biphenyldiphenyl ester and bicyclic alcohol tablets, have obvious induction of cytochrome P450 enzyme activity, thus enhancing the detoxification of carbon tetrachloride and certain carcinogens. They have rapid enzyme-lowering effect on drug-induced liver injury, but sudden stopping of the drugs will cause rebound of liver enzymes, so the drugs should be gradually reduced and stopped.

6. Hepatocyte membrane protection agents, such as polyenophosphatidylcholine (EZF), because phospholipids are important components of cell membranes, supplementing the body with exogenous phospholipids, these high-energy essential phospholipid molecules combined with hepatocyte membranes or organelle membranes, which can provide a large amount of energy for the diseased liver, thus promoting regeneration of hepatocyte membranes, coordinating the functions of phospholipids and cell membranes, and reducing fatty infiltration.

6... Drugs to Promote Hepatocyte Regeneration Such as hepatocyte growth factor, which is a synthetic biologic, can promote hepatocyte regeneration and is mostly used in severe hepatitis.

Hepatoprotective drugs come in many varieties and are widely used in the treatment of clinical liver diseases. Those commonly used in clinical practice are usually categorized into four types: physiologically active substances, active ingredients of natural medicines and their derivatives; chemically synthesized medicines; and compound preparations of proprietary Chinese medicines.

I. Physiologically active substances: These drugs are mainly extracted or biosynthesized from animals or their organs with active ingredients. For example, methionine, inosine, glucuronolactone, reduced glutathione, polyenylphosphatidylcholine, ornithinylmenthionine, hepatocyte growth promoter and so on.

1. Amino acid active substances: methionine provides exogenous methionine, which promotes the repair of cell membrane function and has more obvious curative effect on acute and chronic hepatitis, cirrhosis, especially fatty liver; ornithionyl menthionine provides L-ornithine, which is the starting substrate of the urea cycle and binds with ammonia in the blood, thus strengthening the detoxification function of the liver cells;

2, Energy active substances: Inosine: can directly enter the cell, participate in intracellular energy metabolism and protein synthesis, promote liver cell repair and regeneration;

3. Phospholipid-type active substances: such as polyene phosphatidylcholine: by supplementing the body with exogenous phospholipids and combining them into the membrane structure of liver cells, it can significantly improve the transmembrane process of nutrients and electrolytes and increase the activity of phospholipid-dependent enzymes;

4, detoxification and liver protection active substances: glucuronolactone can be converted to glucuronic acid under the catalytic action of enzymes. Reduced glutathione can be antioxidant damage to sulfhydryl groups, protect the cell membrane containing sulfhydryl proteins and enzymes.

5. Hepatocyte growth promoter can promote liver cell regeneration and is used in the adjuvant treatment of severe viral hepatitis and cirrhosis.

II. Natural pharmaceutical active ingredients and their derivatives:

Some of these drugs are glycyrrhizate and its complexes, silymarin extracts, etc.

1. Glycyrrhizic acid: it has strong hepatoprotective and anti-yellowing effects; magnesium isoglycyrrhizinate has stronger anti-inflammatory, hepatocyte membrane protection, detoxification, and anti-bio-oxidation effects.

2. Silymarin is the extract of silymarin, which has the effect of protecting and stabilizing the liver cell membrane, and can promote the division and growth of normal hepatocytes, but it cannot improve the histological changes of the liver and reduce the incidence of ascites in patients.

III. Chemically synthesized drugs:

Thiopronin is used to protect liver function by providing sulfhydryl groups, enhancing the liver's resistance to a wide range of damages, and has a variety of mechanisms such as anti-free radicals and protection of enzyme activity.

IV. Chinese medicine compound preparations

This kind of compound preparation mainly has Yin gardenia yellow injection, the mechanism is through inducing the liver enzyme system to increase the liver to bilirubin uptake, binding and excretion ability, reduce the liver parenchyma inflammation, prevent the liver cell degeneration and necrosis, promote the liver cell repair and regeneration and so on.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

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Let's start with a few types of medications that can cause liver damage!

According to statistics, 37.74% of Chinese medicines, 17.22% of synthetic antimicrobials, 6.26% of cardiovascular system drugs, 5.74% of antituberculosis drugs, 5.04% of antibiotics, and 0.87% of immunosuppressants cause drug-related liver injury in China. The top three drug types for drug-related liver injury in Western countries were antibiotics, herbal medicines and dietary supplements.

Pharmacologic liver injury is specifically categorized as follows:

The 17 hepatoprotective drugs commonly used in clinical practice are: polyenophosphatidylcholine, hepatocyte growth stimulating hormone, adenosylmethionine, ursodeoxycholic acid, biphenyl bisacodyl, bicyclic alcohols, glucuronolactone, glutathione, sulforaphane, silymarin, glycyrrhizic acid glycoside, diammonium glycyrrhizinate, magnesium isoglycyrrhizinate, bitter cucumber, lactulose, diisopropylammonium dichloride acetate, and ribonucleic acid II.

Among them.adenosylmethionine (ATP), an amino acidIt improves clinical symptoms and biochemical indices in patients with alcoholic liver disease;polyenophosphatidylcholineThere is a tendency to prevent histologic deterioration in patients with alcoholic liver disease;Glycyrrhizic acid preparations, silymarins, polyenophosphatidylcholine and reduced glutathioneThese drugs have different degrees of antioxidant, anti-inflammatory, and hepatocyte membrane protection effects, and their clinical application can improve liver biochemical indexes in patients with alcoholic liver disease.

bicyclic alcoholTreatment may also improve alcoholic liver injury. However, multiple anti-inflammatory and hepatoprotective drugs should not be applied at the same time to avoid aggravating the burden on the liver, as well as causing adverse reactions due to drug-drug interactions.

Rationalization of the use of hepatophilic viruses in co-infected patients with current hepatophilic virus infectionPolyene phosphatidylcholine, silymarin, glycyrrhizic acid preparations, bicyclic alcohol, ursodeoxycholic acid, S-adenosylmethionine and reduced glutathioneetc. 1~2 types.

Hepatoprotective drugs can be roughly divided into the following seven categoriesSee table:

I hope the above is helpful!