腺苷蛋氨酸联合熊去氧胆酸治疗黄疸型乙型慢性病毒性肝炎的疗效观察

Clinical Observation of Combining Transmtil and Ursodeoxycholic Acid in the Treatment for Viral Hepatitis Type B with High Aundice

目的:观察思美泰(SAMe)联合熊去氧胆酸(UDCA)治疗黄疸型乙型慢性病毒性肝炎的临床疗效。方法:选择69例黄疸型乙型慢性病毒性肝炎患者,随机分成三组:思美泰组静脉滴注1000mg,1次/d;优思弗组口服优思弗50 mg,3次/d;联合组同时使用以上两种治疗方法,记录治疗前、第1、2周的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、直接胆红素(DBil)、血胆汁酸(TBA)以及症状、体征的变化,使用X2检验及t检验统计分析数据。结果:三组患者治疗1周后仅ALT下降显著,各组间差异无统计学意义(P>0.05)。而治疗2周后,ALT、AST、TBil、DBil、TBA均明显下降,66.7%的患者黄疸症状消退,32.3%的肝肿大不能触及,思美泰组与优思弗组的治疗效果差异无统计学意义(P<0.05),而联合组则较以上两组更能改善肝功能及黄疸情况(P<0.05)。结论:联合使用思美泰及优思弗治疗黄疸型乙型病毒性肝炎效果优于单独使用思美泰或优思弗,而单独使用思美泰或优思弗差异不大。

Objective：To observe the clinical effects of combined use of transmetil（SAMe） and ursodeoxycholic acid（UDCA） in the treatment for viral hepatitis B with high aundice.Method：69 cases of viral hepatitis B with high aundice were randomly divided into three groups：SAMe group with intravenous SAMe 1000rag/times,1 time/d;UDCA group with oral SAMe,50mg with once,3 times per day;combined group with both treatments above.The change value of ALT,AST,TBil,DBil,TBA and improvement of clinical manifestation before and 1week,2 weeks after treatment were recorded.All data was statistically analyzed by X2 test and t test.Result：There was only ALT decrease dramatically and no statistical difference when comparing the three groups 1 week after treatment（P〉0.05）.However,after 2 weeks,there were great reductions in the levels of ALT,AST,TBil,DBil,TBA and 66.7% of patients with jaundice and 32.3% of patients with hepatomegalia were improved.There’s no statistical difference between SAMe group and UDCA group（P〉0.05）,but combined group was superior to the efficacy of than each of single therapy（P〈0.05）.Conclusion：Combined use of SAMe and UDCA in the treatment for viral hepatitis B with high aundice is superior to the efficacy of than each of single therapy,but there was no statistical difference between SAMe and UDCA.These results provide the reference to the clinical practice and guidance to election of treatment methods.