• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Systematic Review and Meta-Analysis of Hugan Tablets(護(hù)肝片) in the Treatment of Drug-Induced Liver Injury

    2020-03-18 01:32:20SHAJingyu沙靖昱LVJianSUNMenghua孫夢(mèng)華XIEYanming謝雁鳴SUNLinxi孫粼希
    關(guān)鍵詞:護(hù)肝片雁鳴夢(mèng)華

    SHA Jing-yu (沙靖昱), LV Jian (呂 健), SUN Meng-hua (孫夢(mèng)華),XIE Yan-ming (謝雁鳴), SUN Lin-xi (孫粼希)

    1. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China

    ABSTRACT Objective:To systematically evaluate the efficacy and safety of Hugan Tablets (護(hù)肝片) in the treatment of drug-induced liver injury.Methods:Totally seven Chinese and English databases, including CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science were searched for randomized controlled trials (RCTs) of Hugan Tablets (護(hù)肝片) for the treatment of drug-induced liver injury , which were published from the date of establishment to April 20, 2019. The meta-analysis software RevMan 5.3 software and Excel were used to build a database into combine and analyze the studies that met the standards and to draw a forest plot.Results:Forty five RCTs were included with 7478 patients. The quality of included studies was uneven. Meta-analysis showed that the outcome index of liver injury rate was divided into seven subgroups. Hugan Tablets (護(hù)肝片) were used in the treatment of anti-tuberculosis drugs was superior to the conventional western medicine treatment group (RR=0.27, 95% CI[0.22, 0.33],P<0.00001). Which was also better than the without Hugan Tablets (護(hù)肝片) treatment group (RR=0.32, 95% CI[0.20, 0.52],P<0.00001).For the role of drug-induced liver injury in the treatment of type 2 diabetes, the Hugan Tablet + conventional treatment group is better than the conventional treatment group (RR=0.16, 95% CI [0.03, 0.88],P=0.03).The effect of drug-induced liver injury in the treatment of hypertension was superior to the conventional western medicine treatment group (RR=0.07, 95% CI[0.03, 0.14],P<0.00001). The effect of drug-induced liver injury during the treatment of hyperlipidemia was not statistically significant (RR=0.57, 95% CI[0.33,1.00],P=0.05). There was no statistical difference between the two groups in the effect of drug-induced liver injury during the treatment of coronary heart disease (RR=0.09, 95% CI[0.01, 1.61],P=0.10). There was no significant difference between the two groups in the treatment of cerebral thrombosis for drug-induced liver injury (RR=0.11, 95% CI[0.01, 2.01],P=0.14). The effect of anti-hyperthyroidism on liver injury was better than that of conventional western medicine treatment group (RR=0.45, 95% CI[0.25, 0.82],P=0.009).Outcome index of total effective rate was divided into two subgroups. The effect of drug-induced liver injury caused by the type of drug was not mentioned was superior to the conventional western medicine treatment group (RR=0.78, 95% CI[0.70, 0.88],P<0.0001). There was no significant difference between the two groups in the liver injury caused by antipsychotic drugs (RR=0.97, 95% CI[0.81, 1.16],P=0.72).Conclusion:When used in the treatment of tuberculosis and psychiatric drug treatment, combineduse of Hugan Tablets(護(hù)肝片) can significantly reduce the incidence of drug-induced liver damage, and can significantly improve clinical symptoms caused by liver damage. In the treatment of hypertension, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the incidence of drug-induced liver injury, improving the safety of medication.In the treatment of drug-induced liver injury caused by which drug is not mentioned, Hugan Tablet has a therapeutic effect. Slight adverse reactions were reported, including rash, headache, palpitations,hypoglycemia, flushing, fatigue, nausea, bowel sounds, flatulence, diarrhea, and gastrointestinal discomfort.All studies reported minor adverse reactions that were well tolerated by patients and recovered without treatment after discontinuation. Oral administration of Hugan Tablets (護(hù)肝片) has positive effects on druginduced liver injury, but this conclusion still needs further evidences delete. It is necessary to adopt a larger sample, more design, and accord with the international standards to improve the quality of evidence.

    KEYWORDS Hugan Tablets (護(hù)肝片); Drug-induced liver injury; Meta-analysis; Systematic review;Randomized controlled trial

    Drug-induced liver injury (DILI) refers to direct toxic effect on the liver by various prescription or over-the-counter chemical drugs, biological agents,traditional Chinese medicines, natural medicines,health products, dietary supplements and their metabolites and even excipients[1], It also refers to liver injury induced by idiosyncracy of the body,including allergic (immunity-specific) and metabolic(metabolic-specific), which can be clinically manifested as a variety of acute and chronic liver diseases. Patients with mild symptoms can restore to normal after stopping the drug, while severe cases can endanger life. Based on epidemiological surveys, the annual incidence of DILI in Iceland was 19.1/100,000, and the annual incidence of DILI in France was 13.9/100,000. The United States collected 5,404,705 eligible patients through the GPRD medical database between 1994 and 1999,among which 128 cases of DILI were found The estimated annual incidence of DILI was 2.4/100,000.A Chinese multi-center retrospective survey of sixteen large general hospitals covering thirteen regions across the country showed that 1492 adult patients with acute DILI were admitted between 2000 and 2005[1]. According to the above data, the incidence of DILI varies greatly in different research methods,different regions and countries. DILI is often ignored or misdiagnosed due to lack of specific diagnostic markers or being be masked by the primary disease,so the actual incidence may be higher.

    By 2018, more than 1,100 drugs with potential liver toxicity have been marketed worldwide[1]. The general treatment principles include the immediate discontinuation of relevant or suspicious drugs (the key to treatment), the promotion of drug removal for liver injury, drug treatment, liver transplantation,etc. In principle, medication should be streamlined as much as possible. Traditional Chinese medicine(TCM) can relief symptoms, improve patients'quality of life, and reduce recurrence rates in the treatment of DILI. Hugan Tablets (護(hù)肝片), as a distinctive Chinese patent medicine, has been found in early clinical and experimental studies. Kuihua Hugan Tablets (葵花護(hù)肝片) which is composed of Radix Bupleuri (Chai Hu), Herba Artemisiae Scopariae (Yin Chen), Radix Isatidis (Ban Lan Gen), Fructus Schisandrae Chinensis (Wu Wei Zi),Pulvis Fellis Suis (Zhu Dan Fen), and Phaseolus Radiatus L. (Lv Dou). It was extracted came from modification of Yinchenhao Decoction (茵陳蒿湯)and Xiaochaihu Decoction (小柴胡湯) in Treatise on Cold Pathogenic Diseases (《傷寒論》). It has the functions of relieving liver and regulating qi,strengthening spleen and digesting food, enhancing the detoxification function of the liver, reducing the blood concentration of serum transaminase,protecting liver cells, promoting the metabolism rate of chemical drugs by the liver and improving the symptoms of patients with drug-induced liver damage. On the one hand, due to the increasing incidence of DILI, more and more attention has been paid to it. On the other hand, the importance of rational clinical use of drugs has become increasingly prominent. However, the effectiveness and safety of Hugan Tablets (護(hù)肝片) in the treatment of drug-induced liver injury are stil unclear without comprehensive evidence-based study. In this study, a rigorous research and selection of literature was conducted, and a systematic review of clinical studies was cited to evaluate Hugan Tablets'(護(hù)肝片) clinical effectiveness and safety. The study result could be used as an evdience for rational drug use in clinical medication.

    MATERIALS AND METHODS

    Screening Criteria of Literature

    Inclusion criteria

    Studies that meet the following conditions were included: a. The types of experimental studies were randomized controlled trials (RCTs); b. The study subjects were clearly diagnosed with druginduced liver injury, or meet drug-induced liver injury after administration; c. Intervention measures: the experimental group was treated with Hugan Tablets(護(hù)肝片), or combined with Hugan Tablets (護(hù)肝片)on the basis of the control group; the control group was treated with conventional Western medicine or took one or two Western medicine except Hugan Tablets (護(hù)肝片) based on conventional treatment; d.The primary outcome indicators: liver damage rate,total effective rate was decreased or decreased to normal range of physical and chemical examination of liver function (total effective rate = (effective +markedly effective) / total cases×100%); e. The secondary outcome indicator was the occurrence of adverse reactions.

    Exclusion criteria

    a. Reviews, short reports, and documents that cannot be obtained in full text; b. Repeated publication of articles and repeated data; c.serious errors or missing data in the experiment;d. Complicated with toxic hepatitis in the study; e.Others liver diseases in the study, such as patients with alcoholic, autoimmune or liver cancer and liver transplantation; f. Study objects who were given other ways of administration besides oral administration; g. Studies with traditional Chinese medicine, Chinese patent medicines, Chinese materia medica extracts, acupuncture, moxibustion,auricular pressure and other traditional Chinese medicine treatment in the intervention measures.

    Search Strategy

    Eligible data from seven major Chinese and English databases, including Chinese Journal Fulltext Database (CNKI), Wanfang Date (Wanfang),VIP Database for Chinese Technical Periodicals(VIP), Chinese Biomedical Literature Database(CBM), Public Medine (PubMed), EMBASE database and Web of Science were retrieved by the researchers. The retrieval content was randomized controlled clinical study on Hugan Tablets (護(hù)肝片) for the treatment of drug-induced liver injury,which was published from the date of database establishment to April 20, 2019 with no publication language restrictions. In order to conduct a more comprehensive literature review, the Chinese search formula was made as: "huganpian (護(hù)肝片)"and "yaowuxinggansunshang (藥物性肝損傷)" or"yaowuxingganyan (藥物性肝炎)" or "gansuanhai (肝損害)"; "gansunshang (肝損傷)" or "jiakang (甲亢)"or "kangjiangshanbing (抗精神病)" or "kangjiehe (抗結(jié)核)" or "tangniaobing (糖尿病)" or "gaoxueya (高血壓)"; "gaozhixuezheng (高脂血癥)" or "guanxinbing(冠心病)" or "naoxueshuan (腦血栓)". The English search formula was "Huganpian" and "DILI, DILI",without any other restriction.

    Evaluation Methods

    Literature screening

    After two people cross-screened the literature,two researchers independently completed the data inclusion, extraction and cross-checking. The disagreement was resolved through discussion and consultation with the third researcher.Through checking repeated literature, preliminary screening (title + abstract) of relevance, exclusion,and preliminary inclusion of literature for full-text evaluation, the researchers then decided which literature should be included.

    Literature data management and extraction

    The main author, year, research object(experimental group, control group, total number of cases), intervention measures (dose of western medicine type), course of treatment, main outcome indicators, adverse reactions. were summarized into tables to observe research results, rigor of research conclusions, and heterogeneity between studies.The above-mentioned literature data management and extraction were planned to be summarized qualitatively and listed in table.

    Methodological quality evaluation of the included studies

    The quality of the literature is evaluated according to Risk of Bias risk assessment tool of the Cochrane. The quality evaluation included the following main contents: a. the generation of random sequences; b. the allocation and hiding; c. the implementers and participants were double-blinded;d. blinding in outcome assessment; e. incomplete outcome data; f. publication bias; g. other bias. Based on the bias of each item, high-risk, low-risk, and uncertain risk judgments were made to evaluate the methodological quality of the included studies[2].

    Statistical analysis

    Qualitative analysis mainly adopted descriptive methods. The descriptive analysis was conducted for the indicators that calculated by scientific and accurate mathematical models in the literature and the series of values involved were performed for descriptive analysis. Quantitative analysis (Meta-analysis):RevMan 5.3 software package provided by Cochrane was used. Relative risk (RR) was used for calculating data, and mean difference (MD) or standardized mean difference (SMD) and 95% CI were used for data measurement. Ifwhich means that the homogeneity between studies is better, then a fixed effect model was used; if I2>50%, which means that there is significant statistical heterogeneity, then a random effect model was used. If the source of heterogeneity can be identified, further heterogeneity analysis will be performed according to the factors that may cause heterogeneity. In this study, if there were ten or more studies included in an outcome indicator,funnel plot would be used for bias analysis publication.

    Subgroup analysis

    The data of all subjects were divided into multiple groups and then being compared between groups, which can be used to explore heterogeneous sources, or to explore specific types of DILI or specific types of intervention. The data can be divided into two or more subsets according to the types of drugs that cause DILI in the study subjects.According to the study subjects, the characteristics of conventional Western medicine are divided into two or more subsets.

    RESULTS

    Literature Search Results

    A total of 541 related papers were initially retrieved and imported into the literature management software NoteExpress5.0. After removing repeated ones, 253 literature were collected, After reading the title. We found out abstract, 107 papers were selected for full-text evaluation. During the full-text evaluation,there were five papers in English, which could not be obtained by searching the English database,and the source journals were Chinese journals, so it was considered to be Chinese literature, and the corresponding Chinese documents were downloaded.In addition, two papers were not available in full text.Finally, forty five papers were included, all of which were in Chinese. The literature selection process was shown in Figure 1.

    Figure 1. Literature Screening Process and Results

    Basic Characteristics of Included Literature

    The database search obtained 541 records,and finally included forty 5 Chinese RCTs. Among them, with 4 papers did not mention which type of drug caused liver injury[3,4,43,46], 1 paper of liver injury caused by anti-hyperthyroidism drug[5], one paper of liver injury caused by anti-psychiatric drugs[6], 22 papers of liver injury caused by anti-tuberculosis drugs[7-23,41,42,44,45,47]. 3 papers of type 2 diabetes mellitus treated combined with Hugan Tablets (護(hù)肝片)[24-26], 9 papers for treating hypertension[27-35],3 papers for treating hyperlipidemia[36-38], 1 paper for treating coronary heart disease[39], 1 paper for treating cerebral thrombosis[40](Table 1).

    Evaluation of Methodological Quality of Included Studies

    The results of the methodological quality evaluation of the included studies were shown in Figure 2 and the specific results were shown in Table 2. A total of 45 RCTs included in this study,15 RCTs[10,13-17,19-21,23,41,42,44,45,47]did not mention the course of treatment and there was a certain bias; six RCTs[4,7,8,11,32,38]reported the correct random grouping method. 4 RCTs[42-47]did not mention randomness.One RCT[45]was grouped by visiting time. The previous study only reported random grouping, but the specific method was not described. All studies did not report the implementation of hidden allocation, and bias could not be judged. Besides, neither mentioned blinding method nor bias could not be judged. The data included in the literature was relatively complete,so the data was evaluated as low risk. By comparing the methodology and results of the literature, 3 RCTs[4,39,46]mentioned adverse reactions in the abstract, but the results were not listed, which was determined as high bias in selective report. 20 RCTs[7-9,11-13,15,17-23,28,32,39,42,43-45]did not mention adverse reactions. There was some bias, and data were provided for the rest; all studies were determined to be low risk if no other bias was mentioned.

    Figure 2. Methodological Quality Evaluation Results of the Included Studies

    Meta-Analysis

    Liver damage rate

    Effects of Hugan Tablets (護(hù)肝片) on liver damage caused by antituberculosis drugs: A total of 20 studies were included in the conventional western medicine treatment group[7,8,10-14,16-19,21-23,41,42,44,45,47].After the heterogeneity test, there was no heterogeneity between the studies (P=0.64, I2=0%).Meta-analysis was performed through applying a fixed-effects model. The results showed that the treatment group of Hugan Tablets (護(hù)肝片) for liver injury was superior to the conventional treatment group (RR=0.27, 95% CI [0.22, 0.33], P<0.00001)(Figure 3). 3 studies were included in the group that not taking hepatoprotective drugs[9,15,20]. After the heterogeneity test, there was no heterogeneity between the studies (P=0.59, I2=0%). Meta-analysis was performed by applying a fixed-effects model. The results showed that the treatment group of Hugan Tablets (護(hù)肝片) for liver injury was superior to the treatment group without taking hepatoprotective drugs (RR=0.32, 95% CI [0.20, 0.52], P<0.00001)(Figure 4). Heterogeneity tests showed statistical heterogeneity among the included studies. For the values of the two groups, the average of the experimental group was smaller than that of the control group, suggesting that the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the incidence of drug-induced liver damage during the treatment of tuberculosis.

    Effect of Hugan Tablets (護(hù)肝片) on druginduced liver injury during the treatment of type 2 diabetes: 3 studies[24-26]were included. After heterogeneity testing, there was no heterogeneity among the studies (P=0.83, I2=0%). Meta-analysis was performed through applying a fixed-effects model.The results showed that the treatment group of the Hugan Tablets (護(hù)肝片) + conventional treatment for liver injury were superior to the conventional treatment group (RR=0.16, 95% CI [0.03, 0.88], P=0.03) (Figure 5). The average of the experiment group was smaller than that of the control group, suggesting that in the treatment of type 2 diabetes, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the incidence of drug-induced liver damage.

    Effects of Hugan Tablets (護(hù)肝片) on DILI during the treatment of hypertension: 9 studies[27-35]were included. After heterogeneity testing, there was no heterogeneity between the studies (P=0.60,I2=0%). Meta-analysis was performed by applying a fixed-effects model. The results showed that the treatment group of the Hugan Tablets (護(hù)肝片) +conventional treatment for liver injury was superior to the conventional treatment group (RR=0.07, 95% CI[0.03, 0.14], P<0.00001) (Figure 6). The mean value of the experiment group was smaller than that of the control group, suggesting that in the treatment of hypertension, the addition of Hugan Tablets (護(hù)肝片)can significantly reduce the incidence of drug-induced liver damage.

    Effects of Hugan Tablets (護(hù)肝片) on druginduced liver injury during the treatment of hyperlipidemia: 3 studies[36-38]were included. After the heterogeneity test, the heterogeneity between the studies was statistically different. Because the control groups of two studies were statins in these 3 included studies, 1 study was excluded[38]for descriptive analysis. After the heterogeneity test,there was no inter-study heterogeneity between the 2 groups of statins (P=0.73, I2=0%). Meta-analysis was performed using a fixed-effects model. The results showed that the treatment group of the Hugan Tablets (護(hù)肝片) + statin treatment for liver injury were no statistical difference to the conventional treatment group (RR=0.57, 95% CI [0.33, 1.00],P=0.05) (Figure 7).

    Table 2. Methodological Quality Evaluation Results of the Included Studies

    Figure 3. Liver Damage Caused by Anti-Tuberculosis Drugs, Hugan Tablets (護(hù)肝片) versus Western Medicine Routine

    Figure 4. Liver Damage Caused by Anti-Tuberculosis Drugs, Hugan Tablets (護(hù)肝片)Compared with No Liver-Protecting Drugs

    Figure 5. Effect of Hugan Tablets (護(hù)肝片) in the Treatment of Type 2 Diabetes on DILI

    Effects of Hugan Tablets (護(hù)肝片) on druginduced liver injury during the treatment of coronary heart disease Only one study[39]was included.The number of events in the experiment group was zero, and the total sample size was 60. The number of events in the control group was 5, and the total sample size was 60. The results showed no significant difference between the experimental group and the control group (RR=0.09, 95% CI [0.01,1.61], P=0.10).

    Figure 6. Effect of Hugan Tablets (護(hù)肝片) on the Treatment of DILI During Hypertension

    Figure 7. Effect of Hugan Tablets (護(hù)肝片) on DILI in the Ttreatment of Hyperlipidemia

    Effects of Hugan Tablets (護(hù)肝片) on druginduced liver injury during the treatment of cerebral thrombosis Only one study[40]was included. The number of events in the experiment group was 0,and the total sample size was 50. The number of events in the control group was 4, and the total sample size was fifty. The results showed no statistical difference (RR=0.11, 95% CI [0.01, 2.01],P=0.14).

    Effects of Hugan Tablets (護(hù)肝片) on drugliver injury caused by antihyperthyroidism drugs Only one study[5]was included. The number of events in the experiment group was 12, and the total sample size was 64. The number of events in the control group was 24, and the total sample size was 58. The results showed that the experiment group was better than the control group (RR=0.45,95% CI [0.25, 0.82], P=0.009). In the course of antihyperthyroidism drug treatment, by setting up a control group, it can be seen that adding Hugan Tablets (護(hù)肝片) or western medicine conventional treatment can prevent drug-induced liver damage,but the efficacy of Hugan Tablets (護(hù)肝片) was significantly better than that of conventional western treatment, which reduced the occurrence of drug-induced liver damage.

    Total effectiveness rate

    Effects of Hugan Tablets (護(hù)肝片) on druginduced liver injury caused by the type of drug not mentioned Compared with conventional treatment of Western medicine, a total of 4 studies were included[3,4,43,46], and the heterogeneity among the studies was statistically heterogeneous.Because only one of the 4 studies has 2 main pharmacological effects: anti-hepatitis virus and anti-hepatocyte damage, descriptive analysis is needed[3]. The other 3 articles have pharmacological effects to protect liver cells and have no heterogeneity after testing (P=0.76,I2=0%). Meta-analysis was performed using a fixedeffects model. The results showed that the Hugan Tablets (護(hù)肝片) treatment group was better than the conventional treatment group (RR=0.78, 95%CI [0.70, 0.88], P<0.0001) (Figure 8). The mean value of the experimental group was smaller than that of the control group, suggesting that Hugan Tablets (護(hù)肝片) has therapeutic effects in the treatment of DILI.

    Figure 8. Effect of Hugan Tablets (護(hù)肝片) on DILI Cause by Which Type of Drug Is Not Mentioned

    Figure 9. ADRs: Outcome Indicatoor-Liver Loss Rate

    Effect of Hugan Tablets (護(hù)肝片) on liver damage caused by antipsychotic drugs One study[6]was concluded. The number of events occurred in the experiment group was 31, with a total sample size of 35. 30 events occurred in the control group with a total sample size of 35. The results showed no statistical difference between the experimental group and the control group (RR=0.97, 95% CI [0.81, 1.16], P=0.72).

    Incidence of adverse reactions

    3 papers[5,40,47]did not report adverse reactions.19 papers did not mention adverse reactions[7-9,11-13,15,17-23,32,39,42,44,45]. 23 papers[3,4,6,10,14,16,24-31,33-38,41,43,46]mentioned adverse reactions. One paper[46]could not extract data. A total of 22 reports of adverse reactions were included in all studies. All studies reported minor adverse reactions, such as rash,fatigue, poor appetite, bloating, abdominal pain,diarrhea, etc., which patients can tolerate and disappeared without treatment after treatment. The analysis was as follows.

    The outcome index was the liver damage group. A total of 18 studies were included. After the heterogeneity test, there was no heterogeneity between the studies (P=0.73, I2=0%). It was used the fixed effect model. The results showed that the results of the 2 groups were statistical significance(RR=0.37, 95% CI [0.25, 0.54], P<0.00001). The adverse reactions of Hugan Tablets (護(hù)肝片) in treating drug-induced liver injury were less than those in the control group (Figure 9).

    Figure 10. ADRs: Outcome Indicatoor-Total Efficiency

    The outcome index was the total effective rate group. Four studies were included. After the heterogeneity test, there was no heterogeneity between the studies (P=0.38, I2=0%). The fixed effect model was used. The results showed that there was no statistical difference (RR=0.27, 95% CI[0.07, 1.05], P=0.06) (Figure 10).

    Publication Bias

    In this study, the liver damage rate outcome indicators of liver injury caused by anti-tuberculosis drugs were all greater than or equal to ten. For the above outcome indicators, funnel plot was used to analyze the publication bias. The funnel chart analysis results showed that the study distribution was asymmetric, suggesting that there might be publication bias or poor methodological quality.The reasons may be due to the small sample size of the included studies, the preferred publication of positive results, and the inclusion of studies in Chinese (Figure 11).

    Figure 11. Evaluation of Publiction Bias for Liver Damage Caused by Anti-Tuberculosis Drugs

    DISCUSSION

    Effectiveness

    Hugan Tablets (護(hù)肝片) is composed of Fructus Schisandrae Chinensis (Wu Wei Zi), Radix Bupleuri (Chai Hu), Herba Artemisiae Scopariae (Yin Chen), Radix Isatidis (Ban Lan Gen), Pulvis Fellis Suis (Zhu Dan Fen), and Phaseolus Radiatus L. (Lv Dou). It has the effects of relieving liver qi, clearing heat and nourishing the liver, relieving dampness and detoxifying, and strengthening the spleen and digesting food. Modern pharmacological studies have found that Fructus Schisandrae Chinensis (Wu Wei Zi) extract, schisandrin B and pentasitol, etc.can improve liver mitochondria and block calciuminduced membrane permeability transition, prevent fatty changes, and significantly reduce serum ALT activity. Prevents apoptosis in the state of high oxidative stress, thereby reducing liver fibrosis,increasing liver cell activity[48], enhancing liver function, to a certain extent reducing the damage of drugs to liver cells and enhancing the body's immunity. Radix Bupleuri (Chai Hu) contains saikosaponin, saikosol, and α-spinasterol, which can promote liver cell DNA synthesis, directly protect biofilms, improve the body's ability to resist nonspecific stimuli, and other liver-protective effects,promote bile excretion, and reduce bile[49]. Bile acid,bile pigments and other choleretic effects, lower cholesterol levels and lower blood lipids. The extract of Herba Artemisiae Scopariae (Yin Chen) includes 6,7-dimethoxycoumarin (Amylin), caffeic acid, Yin Chen chromone, methyl Chen Chan ketone, etc.have promoted bile secretion and excretion in the test[48]. Certain hepatoprotective effects can reduce liver cell swelling, fatty lesions and necrosis to varying degrees. The qingdanone in Radix Isatidis(Ban Lan Gen) can reduce the damage to liver cells and remove oxygen free radicals in liver cells. The structure of phytosterols contained in mung bean is similar to that of cholesterol. The two compete for esterification enzymes, making them unable to esterify and reducing the absorption of cholesterol in the intestine. It can also promote cholesterol alienation or prevent cholesterol biosynthesis in the liver. Reduces serum cholesterol levels. Radix Isatidis (Ban Lan Gen) and Pulvis Fellis Suis (Zhu Dan Fen) can improve the body's immunity and antiallergic effects. The results of this study showed that when Hugan Tablets (護(hù)肝片) is used in the treatment of tuberculosis. During antihyperthyroidism drug treatment, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the incidence of druginduced liver damage and can significantly improve the clinical symptoms caused by liver damage;In the treatment of hypertension, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the occurrence of drug-induced liver damage and improve the safety of medication. In the treatment of drug-induced liver injury caused by the type of drug not mentioned, Hugan Tablets (護(hù)肝片) has a therapeutic effect. Hugan Tablets (護(hù)肝片) has obvious advantages in improving drug-induced liver damage when used alone; When combined with western medicine, the improvement of druginduced liver damage is significantly better than that of western medicine alone. Other symptoms such as quality of life and life satisfaction, and other relevant biochemical indicators and safety, due to too few included studies, and most of them are of low quality, exact results have not been obtained.In addition, because all studies did not follow up and report primary outcome indicators, it was not possible to determine whether the incidence of death events was effective.

    Safety

    The results of this study showed that a total of twenty three papers reported adverse reactions,and values of twenty two papers were extracted.There were thirty-three cases in the Hugan Tablets(護(hù)肝片) group and ninety four cases in the control group. For Hugan Tablets (護(hù)肝片) on drug-induced liver damage caused by anti-tuberculosis drugs[40],adverse reactions in the Hugan Tablets (護(hù)肝片)group reported one case of rash; Hugan Tablets(護(hù)肝片) for drug-induced liver injury during the treatment of type 2 diabetes[23,24], adverse reactions in the Hugan Tablets (護(hù)肝片) group reported two cases of hypoglycemia. Adverse reactions of the digestive system reported three cases of flatulence and bowel sounds, three cases of diarrhea; For Hugan Tablets (護(hù)肝片) on drug-induced liver injury during the treatment of hypertension[28,29], adverse reactions were reported in the Hugan Tablets (護(hù)肝片) group: five cases of headache, four cases of palpitations, and three blushes; Hugan Tablets (護(hù)肝片) combined on drug-induced liver injury during the treatment of hyperlipidemia[35-37], the Hugan Tablets (護(hù)肝片) group reported adverse reactions:four cases of dizziness, palpitations and other adverse reactions, three cases of gastrointestinal discomfort, three cases of fatigue reactions, two cases of nausea. For Hugan Tablets (護(hù)肝片) on drug-induced liver injury[3,42]caused by the type of drug not mentioned: one case of rash, one case not mentioned symptoms. All studies reported minor adverse reactions, such as rash, fatigue, poor appetite, bloating, abdominal pain, diarrhea, etc.,which patients can tolerate and disappear without treatment after drug withdrawal.

    Methodological Quality

    This paper performed a subgroup analysis to consider the drug-induced liver injury caused by different drugs. The degree of injury, treatment course and observation interval are all considered as grouping factors. By comparing different subgroups, the degree of liver damage caused by different drugs and the course of treatment have a significant relationship with Hugan Tablets (護(hù)肝片)in treating drug-induced liver damage. For example,liver damage caused by anti-tuberculosis drugs have a greater degree of liver damage, and the course of treatment is generally thirty daysix months;when combined with hypertension, the degree of liver damage is lower, and the course of treatment is generally seven day(four-eight) weeks. Possible problems are analyzed. The usage and dosage used in most studies are concentrated at four tablets/time, three times/d. The number of studies included in each group is different, and the weight ratio is different. As a result, a clear relationship between liver damage and dose and course of treatment cannot be obtained based on horizontal and vertical comparison. In addition, the conclusions of the above systematic reviews may also be affected by the following factors: a. Methodological quality of the included studies: In this systematic review,the quality of included studies is generally low,mainly because most studies mentioned "random",but random methods and random concealment schemes were not explained. Most studies did not report blind methods, withdrawal and lost followup. b. Differences in diagnostic criteria: Although most of the diagnoses included in the study were liver damage, inconsistent diagnostic criteria may bring selective bias of the subjects, and reduce the homogeneity of the research subjects; c. Judgment differences of the efficacy indicators: All the included studies used liver function tests as the primary effect indicators, but the criteria were different, which led to inconsistent measurement standards. There will be some misalignment bias.

    Limitation and Suggestion

    Hugan Tablets (護(hù)肝片) has obvious effects on the treatment of drug-induced liver injury. Due to the large number of drugs that cause drug-induced liver injury, the number of studies included in each type of drug is uneven and the number is not large.Many factors can affect the results, which reduces the reliability of the conclusions of this systematic review, so the methodological quality of the research needs to be improved. It is suggested that future research in this area should be accompanied by reasonable research design, increased research sample size, and strict implementation and process supervision. It is better to have a multi-center large-sample randomized controlled double-blind trial to further verify its efficacy to obtain reliable conclusion.

    CONCLUSION

    The results of this study show that in the treatment of tuberculosis, anti-hyperthyroidism drug treatment, and psychiatric drug treatment, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the occurrence of drug-induced liver damage and can significantly improve the clinical symptoms caused by liver damage; In the treatment of type two diabetes, hypertension, hyperlipidemia, coronary heart disease, and cerebral thrombosis, the addition of Hugan Tablets (護(hù)肝片) can significantly reduce the occurrence of drug-induced liver damage and improve the safety of medication. In the treatment of drug-induced liver injury caused by the type of drug not mentioned, Hugan Tablets (護(hù)肝片) has a therapeutic effect. All studies reported minor adverse reactions that disappeared without treatment after drug discontinuation. In summary, oral administration of Hugan Tablets (護(hù)肝片) has positive significance for the treatment and prevention of drug-induced liver injury, but this conclusion still lacks high-quality research evidence to support it. It is recommended that clinical trial protocols with large samples,rigorous design and meeting international standards should be used in future so as to improve the level of evidence quality.

    猜你喜歡
    護(hù)肝片雁鳴夢(mèng)華
    Evolution of Subkilometer-scale Impact Craters on the Lunar Maria as Constrained from Mini-RF Data and Topographic Degradation Model
    喝酒前吃護(hù)肝片真的有用嗎
    肝博士(2023年4期)2023-04-29 01:52:00
    領(lǐng)略宋朝極致生活美學(xué)——讀《大宋夢(mèng)華》
    Status and Development Trend of Evaluation of Post-Marketing Traditional Chinese Medicines in China
    無(wú)題(1)
    Clinical Study on the Treatment Efficacy of Cerebral Hemorrhage with Xingnaojing Injection in Real World
    “護(hù)肝片”吃不對(duì)反傷肝
    護(hù)肝藥吃不對(duì)更傷肝
    “護(hù)肝片” 吃不對(duì)反傷肝
    Enlightenment from WHO Pharmacovigilance in Construction of Chinese Materia Medica Pharmacovigilance System
    日韩,欧美,国产一区二区三区| 1024视频免费在线观看| 国产精品成人在线| 午夜激情久久久久久久| 少妇猛男粗大的猛烈进出视频| 成年人午夜在线观看视频| 午夜精品国产一区二区电影| 欧美日韩一区二区视频在线观看视频在线| 男女无遮挡免费网站观看| 黑人巨大精品欧美一区二区蜜桃 | 精品一区二区三区视频在线| 一本大道久久a久久精品| 热re99久久国产66热| 美女内射精品一级片tv| 午夜老司机福利剧场| 少妇猛男粗大的猛烈进出视频| 黄色怎么调成土黄色| 看免费av毛片| 91精品国产国语对白视频| 中国国产av一级| 免费大片18禁| 一区二区三区乱码不卡18| 一本久久精品| 麻豆乱淫一区二区| 欧美老熟妇乱子伦牲交| 最近最新中文字幕大全免费视频 | 国产亚洲av片在线观看秒播厂| 国产毛片在线视频| a级毛片在线看网站| 国产极品粉嫩免费观看在线| 少妇猛男粗大的猛烈进出视频| 国产亚洲一区二区精品| 在线观看免费视频网站a站| 久久久久久久久久久免费av| 免费人妻精品一区二区三区视频| 欧美精品av麻豆av| 在线免费观看不下载黄p国产| 久久久国产欧美日韩av| 欧美日韩综合久久久久久| 免费人妻精品一区二区三区视频| 国产精品女同一区二区软件| 国产精品国产三级国产专区5o| 日韩精品免费视频一区二区三区 | 国精品久久久久久国模美| 啦啦啦啦在线视频资源| 宅男免费午夜| 亚洲精品,欧美精品| 免费久久久久久久精品成人欧美视频 | 99热全是精品| 宅男免费午夜| 这个男人来自地球电影免费观看 | 一区二区av电影网| 少妇猛男粗大的猛烈进出视频| 香蕉精品网在线| a级片在线免费高清观看视频| 午夜福利在线观看免费完整高清在| 日韩伦理黄色片| 丰满迷人的少妇在线观看| 亚洲欧美一区二区三区国产| 成年女人在线观看亚洲视频| 满18在线观看网站| 一级片'在线观看视频| av电影中文网址| 欧美成人午夜免费资源| 99视频精品全部免费 在线| 最新中文字幕久久久久| 咕卡用的链子| 九九爱精品视频在线观看| 深夜精品福利| 国产欧美日韩综合在线一区二区| 亚洲 欧美一区二区三区| 国产精品一二三区在线看| 国产淫语在线视频| 欧美精品一区二区大全| 国产高清国产精品国产三级| 99热这里只有是精品在线观看| h视频一区二区三区| 91成人精品电影| 亚洲中文av在线| 如日韩欧美国产精品一区二区三区| 精品一区在线观看国产| 少妇人妻精品综合一区二区| a级片在线免费高清观看视频| 成人毛片a级毛片在线播放| 大码成人一级视频| 午夜激情av网站| 日韩精品免费视频一区二区三区 | 国精品久久久久久国模美| 欧美国产精品va在线观看不卡| 丝袜美足系列| 国产老妇伦熟女老妇高清| 老熟女久久久| 成人18禁高潮啪啪吃奶动态图| 免费av中文字幕在线| 欧美日韩视频高清一区二区三区二| 综合色丁香网| 国产成人a∨麻豆精品| 久久热在线av| 丰满迷人的少妇在线观看| 人人妻人人添人人爽欧美一区卜| 99久久综合免费| 又黄又粗又硬又大视频| 日韩免费高清中文字幕av| 久久国产亚洲av麻豆专区| 国产精品久久久久久av不卡| av不卡在线播放| 少妇人妻精品综合一区二区| 丰满饥渴人妻一区二区三| 丝瓜视频免费看黄片| 日韩精品免费视频一区二区三区 | 久久精品人人爽人人爽视色| 制服丝袜香蕉在线| 国产精品无大码| 26uuu在线亚洲综合色| 色哟哟·www| 咕卡用的链子| 国产又爽黄色视频| 国产永久视频网站| 欧美精品av麻豆av| 免费黄网站久久成人精品| 欧美激情国产日韩精品一区| 国产国语露脸激情在线看| 校园人妻丝袜中文字幕| 国产爽快片一区二区三区| 大香蕉久久网| 精品午夜福利在线看| 中文乱码字字幕精品一区二区三区| 一级爰片在线观看| 日韩av在线免费看完整版不卡| 国产精品欧美亚洲77777| 黄色视频在线播放观看不卡| 国产淫语在线视频| 大香蕉久久成人网| 美女内射精品一级片tv| 乱码一卡2卡4卡精品| 中文字幕另类日韩欧美亚洲嫩草| 一级a做视频免费观看| 熟女人妻精品中文字幕| 又黄又爽又刺激的免费视频.| 成年美女黄网站色视频大全免费| 一级a做视频免费观看| 国产亚洲一区二区精品| 多毛熟女@视频| 久久久精品94久久精品| 啦啦啦视频在线资源免费观看| 我要看黄色一级片免费的| 久久久久网色| 亚洲五月色婷婷综合| 天天躁夜夜躁狠狠躁躁| 国产xxxxx性猛交| 午夜福利,免费看| 五月开心婷婷网| 欧美激情极品国产一区二区三区 | 国产亚洲一区二区精品| 亚洲人成77777在线视频| 欧美日韩精品成人综合77777| 国产免费视频播放在线视频| 久久婷婷青草| 美女主播在线视频| 美国免费a级毛片| 国产日韩欧美在线精品| 如日韩欧美国产精品一区二区三区| 久久国产亚洲av麻豆专区| 亚洲图色成人| 一级片免费观看大全| 久久午夜综合久久蜜桃| 久久精品国产鲁丝片午夜精品| 午夜福利在线观看免费完整高清在| 一级a做视频免费观看| 热99国产精品久久久久久7| 青春草视频在线免费观看| 久久免费观看电影| 91精品伊人久久大香线蕉| 国产精品麻豆人妻色哟哟久久| 大话2 男鬼变身卡| 日本av手机在线免费观看| 欧美日韩亚洲高清精品| 亚洲国产精品一区二区三区在线| 制服人妻中文乱码| 国产在线一区二区三区精| 日本-黄色视频高清免费观看| 免费久久久久久久精品成人欧美视频 | 自拍欧美九色日韩亚洲蝌蚪91| 日韩欧美精品免费久久| 男女无遮挡免费网站观看| 亚洲激情五月婷婷啪啪| 亚洲婷婷狠狠爱综合网| 少妇被粗大的猛进出69影院 | 美女国产高潮福利片在线看| 国产精品不卡视频一区二区| 26uuu在线亚洲综合色| 午夜91福利影院| 乱码一卡2卡4卡精品| 男女免费视频国产| 天美传媒精品一区二区| 免费少妇av软件| 边亲边吃奶的免费视频| 精品第一国产精品| 自线自在国产av| 99精国产麻豆久久婷婷| 亚洲国产欧美在线一区| 欧美xxxx性猛交bbbb| 精品少妇黑人巨大在线播放| 亚洲精品色激情综合| 少妇熟女欧美另类| 波野结衣二区三区在线| 一级a做视频免费观看| 黄色 视频免费看| 国产av码专区亚洲av| 色哟哟·www| 国产一级毛片在线| 国产免费现黄频在线看| 伦理电影免费视频| 狠狠精品人妻久久久久久综合| 波野结衣二区三区在线| 久久影院123| 飞空精品影院首页| 高清黄色对白视频在线免费看| 久久午夜综合久久蜜桃| 久久精品国产亚洲av天美| 亚洲国产精品一区二区三区在线| 人人妻人人添人人爽欧美一区卜| 久久久国产欧美日韩av| 日本与韩国留学比较| 国产av国产精品国产| 亚洲国产毛片av蜜桃av| 午夜av观看不卡| 久久精品国产综合久久久 | 人人澡人人妻人| 久热久热在线精品观看| 高清黄色对白视频在线免费看| 国产成人av激情在线播放| av黄色大香蕉| av播播在线观看一区| 国语对白做爰xxxⅹ性视频网站| 蜜桃在线观看..| 菩萨蛮人人尽说江南好唐韦庄| 曰老女人黄片| 你懂的网址亚洲精品在线观看| 在线观看国产h片| 三上悠亚av全集在线观看| 高清黄色对白视频在线免费看| 亚洲,一卡二卡三卡| 日韩精品免费视频一区二区三区 | 久久人人爽人人片av| 熟女电影av网| 欧美性感艳星| 男人添女人高潮全过程视频| 女人精品久久久久毛片| 纯流量卡能插随身wifi吗| 一级,二级,三级黄色视频| 精品国产国语对白av| 久热这里只有精品99| 国产欧美日韩综合在线一区二区| 黄网站色视频无遮挡免费观看| 熟女电影av网| 卡戴珊不雅视频在线播放| 97超碰精品成人国产| 一本色道久久久久久精品综合| 性色av一级| 日本免费在线观看一区| 日本爱情动作片www.在线观看| 男人添女人高潮全过程视频| 成人国产av品久久久| 国产成人免费无遮挡视频| 久热这里只有精品99| 一区在线观看完整版| 97人妻天天添夜夜摸| 大陆偷拍与自拍| 人人妻人人添人人爽欧美一区卜| 国产午夜精品一二区理论片| 亚洲综合色网址| 久久精品国产亚洲av天美| 在线观看免费日韩欧美大片| 久久久久国产精品人妻一区二区| 亚洲国产精品一区二区三区在线| 午夜福利影视在线免费观看| av视频免费观看在线观看| 中文字幕另类日韩欧美亚洲嫩草| 久久这里只有精品19| 日本爱情动作片www.在线观看| 欧美 日韩 精品 国产| 免费看不卡的av| 日本与韩国留学比较| 综合色丁香网| 国产精品人妻久久久久久| 亚洲国产av新网站| 亚洲国产欧美日韩在线播放| 国产极品天堂在线| 国产精品久久久久久精品电影小说| 精品酒店卫生间| 男女国产视频网站| 国产xxxxx性猛交| 人人妻人人澡人人看| 人妻系列 视频| 高清黄色对白视频在线免费看| 国产精品久久久久久av不卡| 九草在线视频观看| 欧美日韩视频高清一区二区三区二| 亚洲国产毛片av蜜桃av| 久久久久久久久久成人| 国产乱人偷精品视频| 精品人妻熟女毛片av久久网站| 国产精品偷伦视频观看了| 国产精品一区二区在线不卡| 人妻少妇偷人精品九色| 夜夜爽夜夜爽视频| 纵有疾风起免费观看全集完整版| 亚洲av福利一区| 国产精品国产三级国产专区5o| 久久精品人人爽人人爽视色| 十分钟在线观看高清视频www| 亚洲av免费高清在线观看| 国产又爽黄色视频| 亚洲av欧美aⅴ国产| 中文精品一卡2卡3卡4更新| 国产精品嫩草影院av在线观看| 男女无遮挡免费网站观看| 九九在线视频观看精品| 亚洲美女视频黄频| 欧美日韩国产mv在线观看视频| 免费黄网站久久成人精品| 大香蕉久久网| 日本wwww免费看| 婷婷色综合www| 精品亚洲成a人片在线观看| 天堂中文最新版在线下载| 国产亚洲午夜精品一区二区久久| 亚洲人与动物交配视频| 不卡视频在线观看欧美| 精品国产一区二区久久| www日本在线高清视频| 久久久精品免费免费高清| 男人操女人黄网站| 欧美国产精品va在线观看不卡| 在线观看免费视频网站a站| 日韩不卡一区二区三区视频在线| 韩国精品一区二区三区 | 久久久久精品性色| 天天操日日干夜夜撸| www日本在线高清视频| 精品熟女少妇av免费看| 亚洲av免费高清在线观看| 日本免费在线观看一区| 欧美国产精品va在线观看不卡| 中文字幕人妻丝袜制服| 国产精品嫩草影院av在线观看| 肉色欧美久久久久久久蜜桃| av不卡在线播放| 肉色欧美久久久久久久蜜桃| 精品久久久精品久久久| 精品国产露脸久久av麻豆| 亚洲国产最新在线播放| 国产精品久久久久久久电影| 又黄又粗又硬又大视频| 国产成人精品无人区| 老司机亚洲免费影院| av.在线天堂| 我要看黄色一级片免费的| 你懂的网址亚洲精品在线观看| 美国免费a级毛片| 人体艺术视频欧美日本| 丰满迷人的少妇在线观看| 午夜视频国产福利| 狂野欧美激情性xxxx在线观看| av视频免费观看在线观看| 欧美少妇被猛烈插入视频| 久热这里只有精品99| 国产精品欧美亚洲77777| 人妻 亚洲 视频| 有码 亚洲区| 日韩欧美一区视频在线观看| 国产视频首页在线观看| 久久久久久久久久成人| 久久 成人 亚洲| 国产白丝娇喘喷水9色精品| 黄色毛片三级朝国网站| 老司机影院毛片| 99九九在线精品视频| 99精国产麻豆久久婷婷| 免费日韩欧美在线观看| 欧美精品人与动牲交sv欧美| 欧美成人午夜精品| 亚洲天堂av无毛| 久久久久久人人人人人| 日本vs欧美在线观看视频| 中文字幕免费在线视频6| 26uuu在线亚洲综合色| 亚洲美女搞黄在线观看| 成人国产av品久久久| 男人操女人黄网站| 美女xxoo啪啪120秒动态图| 纯流量卡能插随身wifi吗| 伊人亚洲综合成人网| 一二三四中文在线观看免费高清| 精品亚洲乱码少妇综合久久| av在线观看视频网站免费| 人妻人人澡人人爽人人| 亚洲,欧美精品.| 色婷婷av一区二区三区视频| 国产精品99久久99久久久不卡 | 欧美日韩视频高清一区二区三区二| 亚洲,欧美精品.| 在线观看美女被高潮喷水网站| 不卡视频在线观看欧美| 校园人妻丝袜中文字幕| 人人妻人人澡人人爽人人夜夜| 99九九在线精品视频| 欧美日韩一区二区视频在线观看视频在线| 亚洲国产精品成人久久小说| 视频在线观看一区二区三区| 国产成人欧美| 亚洲国产av新网站| 久久国产精品男人的天堂亚洲 | 91精品三级在线观看| av在线播放精品| 成人免费观看视频高清| 春色校园在线视频观看| 久久免费观看电影| 亚洲精品中文字幕在线视频| 日韩制服骚丝袜av| 亚洲国产看品久久| 激情五月婷婷亚洲| 99re6热这里在线精品视频| 一二三四中文在线观看免费高清| 你懂的网址亚洲精品在线观看| 国产片特级美女逼逼视频| 日韩人妻精品一区2区三区| 三级国产精品片| 男人操女人黄网站| 亚洲少妇的诱惑av| 一边亲一边摸免费视频| 亚洲国产精品999| 国产av国产精品国产| 久久久久久久久久人人人人人人| 精品一区二区三区视频在线| 国产黄频视频在线观看| 久久人人97超碰香蕉20202| 我的女老师完整版在线观看| 丰满迷人的少妇在线观看| 国产毛片在线视频| 国产成人免费无遮挡视频| 九九在线视频观看精品| 九色亚洲精品在线播放| 日本午夜av视频| 乱人伦中国视频| 亚洲精品色激情综合| av视频免费观看在线观看| 欧美日韩视频高清一区二区三区二| 五月开心婷婷网| 又黄又粗又硬又大视频| 国产黄色免费在线视频| 午夜精品国产一区二区电影| 精品久久蜜臀av无| 亚洲精华国产精华液的使用体验| 一二三四中文在线观看免费高清| 欧美xxⅹ黑人| 国产精品国产三级国产专区5o| 最黄视频免费看| 涩涩av久久男人的天堂| 欧美国产精品一级二级三级| 成年人免费黄色播放视频| 好男人视频免费观看在线| 最近最新中文字幕大全免费视频 | 搡女人真爽免费视频火全软件| 免费黄频网站在线观看国产| 97在线视频观看| 精品人妻熟女毛片av久久网站| 王馨瑶露胸无遮挡在线观看| 天天操日日干夜夜撸| 在线观看www视频免费| 免费在线观看黄色视频的| 国产色爽女视频免费观看| 久久久精品94久久精品| 少妇高潮的动态图| 欧美 亚洲 国产 日韩一| 天天躁夜夜躁狠狠久久av| 国产精品久久久久久精品古装| 精品国产一区二区久久| 久久精品熟女亚洲av麻豆精品| 免费大片18禁| 熟女电影av网| 国产日韩欧美视频二区| 精品一区二区三区四区五区乱码 | 精品一区二区免费观看| 日韩精品免费视频一区二区三区 | 少妇被粗大的猛进出69影院 | 亚洲成人一二三区av| 18在线观看网站| 久久精品夜色国产| 亚洲精品乱码久久久久久按摩| 9热在线视频观看99| 久久99一区二区三区| 国内精品宾馆在线| 国产男女超爽视频在线观看| 国语对白做爰xxxⅹ性视频网站| 国产永久视频网站| 在线亚洲精品国产二区图片欧美| 777米奇影视久久| 深夜精品福利| 又黄又粗又硬又大视频| 国产精品偷伦视频观看了| 十八禁高潮呻吟视频| 亚洲欧洲日产国产| 五月开心婷婷网| 国产片特级美女逼逼视频| 国产一区二区三区av在线| 亚洲精品一区蜜桃| 国产精品三级大全| 成人免费观看视频高清| 97人妻天天添夜夜摸| 看非洲黑人一级黄片| 国产色婷婷99| 午夜免费鲁丝| 美女脱内裤让男人舔精品视频| 亚洲欧美日韩另类电影网站| 日本wwww免费看| 国产av一区二区精品久久| 一区二区三区四区激情视频| 男女下面插进去视频免费观看 | 七月丁香在线播放| 国产伦理片在线播放av一区| 王馨瑶露胸无遮挡在线观看| 亚洲一区二区三区欧美精品| 国产在线一区二区三区精| 黑人猛操日本美女一级片| 少妇高潮的动态图| 欧美精品亚洲一区二区| 亚洲av成人精品一二三区| 午夜免费观看性视频| 久久国产亚洲av麻豆专区| 中文天堂在线官网| 久久人人97超碰香蕉20202| 亚洲欧洲日产国产| 亚洲经典国产精华液单| 亚洲欧美日韩另类电影网站| 99热网站在线观看| 国产精品不卡视频一区二区| 亚洲精品国产av成人精品| 国产黄频视频在线观看| 久久久a久久爽久久v久久| 在线观看国产h片| 精品国产露脸久久av麻豆| 黄网站色视频无遮挡免费观看| 女人精品久久久久毛片| 午夜福利,免费看| 我要看黄色一级片免费的| 国产精品无大码| 日本欧美视频一区| 不卡视频在线观看欧美| 亚洲精品日本国产第一区| 看非洲黑人一级黄片| 午夜免费观看性视频| 亚洲成人手机| 美女大奶头黄色视频| 久久精品国产亚洲av天美| www.熟女人妻精品国产 | 人妻少妇偷人精品九色| 搡女人真爽免费视频火全软件| 国产午夜精品一二区理论片| 一级毛片我不卡| 黄片无遮挡物在线观看| 国产一区有黄有色的免费视频| 一级毛片电影观看| 最近中文字幕2019免费版| 麻豆乱淫一区二区| 少妇的丰满在线观看| 日本黄色日本黄色录像| 在线 av 中文字幕| 国产欧美日韩综合在线一区二区| av视频免费观看在线观看| 成人无遮挡网站| av播播在线观看一区| 亚洲第一av免费看| 久久 成人 亚洲| 1024视频免费在线观看| 91成人精品电影| 校园人妻丝袜中文字幕| 男的添女的下面高潮视频| 久久人人97超碰香蕉20202| 狂野欧美激情性xxxx在线观看| 香蕉丝袜av| 韩国av在线不卡| 久久久久视频综合| 看免费成人av毛片| 欧美xxxx性猛交bbbb| 99久久中文字幕三级久久日本| 亚洲精品美女久久久久99蜜臀 | 午夜av观看不卡| 亚洲丝袜综合中文字幕| 美女内射精品一级片tv| av播播在线观看一区| 精品一区二区三卡| 中文字幕av电影在线播放| 视频在线观看一区二区三区| 免费黄频网站在线观看国产| 国精品久久久久久国模美| 亚洲av中文av极速乱| 少妇精品久久久久久久| 亚洲 欧美一区二区三区| 1024视频免费在线观看| 国产色爽女视频免费观看| 亚洲,一卡二卡三卡| 这个男人来自地球电影免费观看 | 熟妇人妻不卡中文字幕| 中国国产av一级| 国产成人精品无人区| 亚洲精品一区蜜桃| 午夜免费鲁丝| 男女啪啪激烈高潮av片| 免费黄频网站在线观看国产| 啦啦啦视频在线资源免费观看| 国产精品国产三级专区第一集| 精品一区二区三卡| 午夜91福利影院|