Efficacy of silybin meglumine in combination with danning tablets in the treatment of alcoholic hepatitis

Abstract

Abstract: Objective To investigate the clinical efficacy of silybin meglumine combined with Danning tablets in the treatment of alcoholic hepatitis (AH), and to evaluate its effects on liver function, inflammatory response, oxidative stress, and related clinical symptoms. Methods A total of 116 patients with AH who were treated at our hospital between November 2023 and July 2025 were enrolled and divided into an observation group (n=56) and a control group (n=60) according to different treatment regimens. The control group received oral silybin meglumine tablets, while the observation group received Danning tablets in addition to silybin meglumine. Liver function parameters, inflammatory and oxidative stress markers, and improvements in AH clinical symptoms were compared between the two groups before and after treatment. Results After treatment, ALT, AST, GGT, ALP, and TBil in the observation group decreased to (54.7±18.9) U/L, (49.8±16.7) U/L, (72.6±29.1) U/L, (86.9±24.3) U/L, and (21.8±8.4) μmol/L, respectively, which were significantly lower than those in the control group [(69.3±22.4) U/L, (62.1±19.5) U/L, (95.8±34.6) U/L, (104.7±28.6) U/L, and (27.6±9.9) μmol/L; all P<0.05]. Regarding inflammatory and oxidative stress markers, CRP, TNF-α, and MDA in the observation group decreased to (7.9±3.2) mg/L, (24.5±8.3) pg/mL, and (3.8±1.2) nmol/mL, respectively, which were significantly lower than those in the control group [(10.6±4.1) mg/L, (30.8±9.6) pg/mL, and (4.9±1.4) nmol/mL], while SOD increased to (118.6±22.7) U/mL, higher than that in the control group [(103.2±21.4) U/mL] (all P<0.05). The remission times for jaundice and distending pain in the hepatic region in the observation group were (7.1±2.5) d and (6.7±2.2) d, respectively, which were shorter than those in the control group [(9.8±3.1) d and (9.2±2.7) d] (all P<0.05). Conclusion On the basis of alcohol abstinence and supportive therapy, silybin meglumine combined with Danning tablets is more effective than silybin meglumine alone in improving liver function, reducing inflammatory response and oxidative stress injury, and alleviating clinical symptoms in patients with alcoholic hepatitis, indicating favorable clinical application value.

Key words: Alcoholic hepatitis, Silybin meglumine, Oxidative stress, Alcohol intolerance

Li Mingming, Wang Chuanfu, Sun Tingting. Efficacy of silybin meglumine in combination with danning tablets in the treatment of alcoholic hepatitis[J]. Chinese Hepatolgy, 2026, 31(8): 1188-1191.

References

[1] Brakebush E. An update on treatment and outcomes for alcoholic hepatitis[J]. JAAPA, 2024, 37(4):42-44.
[2] Kang M K, Lee Y R, Park S Y, et al. Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein[J]. BMC Gastroenterol, 2024, 24(1):428.
[3] Singeap A M, Minea H, Petrea O, et al. Real-world utilization of corticosteroids in severe alcoholic hepatitis: eligibility, response, and outcomes[J]. Medicina (Kaunas), 2024, 60(2):311.
[4] Hirata Y, Sakuma Y, Ogiso H, et al. Targeted plasma bile acid metabolomic analysis in metabolic dysfunction-associated steatohepatitis and alcoholic hepatitis[J]. Biomedicines, 2024, 13(1):78.
[5] Gutierrez V, Kim-Vasquez D, Shum M, et al. The mitochondrial biliverdin exporter ABCB10 in hepatocytes mitigates neutrophilic inflammation in alcoholic hepatitis[J]. Redox Biol, 2024, 70:103052.
[6] Li W, Xia Y, Yang J, et al. Disrupted balance between pro-inflammatory lipid mediators and anti-inflammatory specialized pro-resolving mediators is linked to hyperinflammation in patients with alcoholic hepatitis[J]. Front Immunol, 2024, 15:1377236.
[7] Jampana S C, Khan R. Pathogenesis of alcoholic hepatitis: role of inflammatory signaling and oxidative stress[J]. World J Hepatol, 2011, 3(5):114-117.
[8] Li J, Yang C, Zhang S, et al. Ginsenoside Rg1 inhibits inflammatory responses via modulation of the nuclear factor κB pathway and inhibition of inflammasome activation in alcoholic hepatitis[J]. Int J Mol Med, 2018, 41(2):899-907.
[9] Kasper P, Lang S, Steffen H M, Demir M. Management of alcoholic hepatitis: a clinical perspective[J]. Liver Int, 2023, 43(10):2078-2095.
[10] Ma J, Guillot A, Yang Z, et al. Distinct histopathological phenotypes of severe alcoholic hepatitis suggest different mechanisms driving liver injury and failure[J]. J Clin Invest, 2022, 132(14):e157780.
[11] Zhang B, Jiang G, Wang L, et al. An analysis of silybin meglumine tablets in the treatment of drug-induced liver injury as assessed for causality with the updated Roussel Uclaf causality assessment method using a nationwide database[J]. Br J Clin Pharmacol, 2023, 89(4):1329-1337.
[12] 中华医学会消化病学分会功能性胃肠病协作组. 胆宁片临床应用专家共识[J]. 中华消化杂志, 2025, 45(6):361-368.
[13] 中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪性肝病专家委员会. 酒精性肝病防治指南(2018更新版)[J]. 中华肝脏病杂志, 2018, 26(3):188-194.
[14] Ramírez-Mejía M M, Morales-Galicia A E, Méndez-Sánchez N. Prognostic challenges in alcoholic hepatitis: from scoring systems to clinical predictors[J]. World J Hepatol, 2025, 17(5):105769.
[15] Zheng J, Li Z, Xu H. Intestinal microbiotas and alcoholic hepatitis: pathogenesis and therapeutic value[J]. Int J Mol Sci, 2023, 24(19):14809.
[16] Su C, Yang Q. Clinical study of ganshuang granule combined with tenofovir in the treatment of chronic hepatitis B complicated with nonalcoholic fatty liver disease[J]. Front Pharmacol, 2022, 13:1032789.
[17] 莫俊俏, 林景, 羊莉. 水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗抗结核药物所致药物性肝损伤患者疗效研究[J]. 实用肝脏病杂志, 2023, 26(5):666-669.
[18] 黄玮, 赵晓玲, 詹常森. 胆宁片增加非酒精性脂肪肝适应症的“三结合”研究进展[J]. 中成药, 2024, 46(8):2685-2688.
[19] Ma Y, Li J, Ju Z, et al. Danning tablets alleviate high fat diet-induced obesity and fatty liver in mice via modulating SREBP pathway[J]. J Ethnopharmacol, 2021, 279:114320.