熊去氧胆酸与羟甲烟胺治疗慢性乙型肝炎肝内胆汁淤积的疗效比较

Efficacy Comparison of Ursodeoxycholic Acid and Hydroxymethylnicotinamide in the Treatment of Chronic Hepatitis B Complicating with Intrahepatic Cholestasis

目的:比较熊去氧胆酸与羟甲烟胺治疗慢性乙型肝炎肝内胆汁淤积的疗效。方法:将96例慢性乙型肝炎肝内胆汁淤积患者随机分为熊去氧胆酸组(56例)和羟甲烟胺组(40例),2组在抗病毒和护肝治疗的基础上分别加用熊去氧胆酸与羟甲烟胺治疗,疗程均为4周。分别比较2组治疗2、4周后的临床疗效。结果:治疗2周时,2组患者肝功能观察指标均有明显改善,但熊去氧胆酸组降低总胆红素、直接胆红素、碱性磷酸脂酶的幅度与羟甲烟胺组比较无显著性差异(P>0.05);治疗4周时,熊去氧胆酸组血清总胆红素、直接胆红素、碱性磷酸脂酶降幅较羟甲烟胺组高,差异有统计学意义(P<0.05)。熊去氧胆酸组总有效率优于羟甲烟胺组(75%vs.70%,P=0.02)。结论:熊去氧胆酸治疗慢性乙型肝炎肝内胆汁淤积的疗效优于羟甲烟胺。

OBJECTIVE： To observe therapeutic efficacy of ursodeoxycholic acid and hydroxymethylnicotinamide in the treatment of chronic cholestatic hepatitis B. METHODS： In this trial, 96 patients with chronic cholestatic hepatitis B were randomly divided into ursodeoxycholic acid group（n=56） and hydroxymethylnicotinamide group（n=40）. Ursodeoxycholic acid group received ursodeoxycholic acid for 4 weeks, and hydroxymethylnicotin group received hydroxymethylnicotinamide for 4 weeks. Clinical efficacy was evaluated two-week and four-week after treatment. RESULTS： After two-week treatment, the indicators of liver function had improved in both groups, but there was no statistical difference in the reduction of total bilirubin, bilirubin direct and placental alkaline phosphatase between 2 groups （P〈0.05）. After four-week treatment, the decrease of liver function indicators in ursodeoxycholic acid group were more significant than in hydroxymethylnicotin group, there was statistical significance （P〈0.05）. Effective rate of ursodeoxycholic acid group was significantly higher than that of hydroxymethylnicotin group（75% vs. 70%, P=0.02）.CONCLUSION： Ursodeoxycholic acid has better efficacy than hydroxymethylnicotinamide in the treatment of chronic hepatitis B complicating with intrahepatic cholestasis.