腺苷蛋氨酸联合熊去氧胆酸治疗淤胆型病毒性肝炎的疗效观察

Effect of combination therapy of s-adenosylmethionine and ursodeoxycholic acid on patients with cholestatic virus hepatitis

目的观察腺苷蛋氨酸联合熊去氧胆酸治疗肝内胆汁淤积性病毒性肝炎的临床疗效。方法选择急性淤胆型肝炎和慢性淤胆型肝炎患者132例,随机分为治疗组和对照组,每组各66例。治疗组给与腺苷蛋氨酸冻干粉针剂1000mg加入5%葡萄糖液250ml中静脉滴注,1次/d,熊去氧胆酸（尤思弗）250mg,2次/d口服,疗程均为4周。对照组采用门冬氨酸钾镁针剂30ml加入5%葡萄糖液250ml中静脉滴注,1次/d,疗程4周。观察症状、体征,并分别于2、4周复查肝功能,观察丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、血清总胆红素（STB）、血清结合胆红素（SCB）变化。结果两组治疗4周后乏力、腹胀、恶心、呕吐、肝区痛等症状均基本消失;治疗组的皮肤瘙痒的有效率、肝肿大回缩有效率以及肝功能主要指标下降幅度显著高于对照组,两组比较差异有统计学意义。结论腺苷蛋氨酸和熊去氧胆酸联合治疗无明显的毒副反应,其安全性和耐受性较好,是治疗淤胆型病毒性肝炎的有效方法。

Objective To observe the effect of combined application of s-adenosylmethionine and ursodeoxycholic acid in treating patients with cholestatic virus hepatitis.Methods One hundred and thirtytwo patients were enrolled and randomized into treated group（66 patients） and control groups（66 patients）.The treated group received s-adenosylmethionine and ursodeoxycholic acid simultaneously for 4 weeks.The control group received potassium-magnesium-aspartate alone for 4 weeks.Their symptoms were observed and liver function were evaluated at 2 and 4 weeks.Results After 4 weks of treatment,the symptom improve ment rate in treatment group were significant higher than that in control group.The treatment group had a better effect in improving of the liver function.Conclusion Conmbined application of s-adenosylmethionine and ursodeoxycholic acid could enhance the therapeutic effect in treating cholestatic virus hepatitis.