丁二磺酸腺苷蛋氨酸对胆汁淤积性肝炎的疗效观察

Clinical efficacy of adenosine methionine in treatment of cholestatic hepatitis patients

[目的]评估丁二磺酸腺苷蛋氨酸(SAMe)治疗胆汁淤积性肝炎的效果及不良反应。[方法]68例胆汁淤积性肝炎患者被随机分为治疗组(38例)和对照组(30例)。2组均予常规保肝治疗,治疗组加用SAMe针剂1.0g/d静脉滴注,对照组加用苦黄针剂30ml/d静脉滴注,2组疗程均为4周。观察2组治疗前后临床症状与体征、生化指标[总胆红素(TBil)、直接胆红素(DBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酸转肽酶("-GT)、总胆汁酸(TBA)]、疗效及不良反应。[结果]治疗后治疗组TBil、DBil、"-GT及TBA下降程度明显高于对照组(P<0.05或P<0.01);其灰白便和皮肤瘙痒改善率也明显高于对照组(P<0.05或P<0.01);治疗组总有效率为84.2%,明显高于对照组的60.0%(P<0.05)。2组患者耐受性良好,均无严重不良反应发生。[结论]SAMe治疗胆汁淤积性肝炎有确切的疗效,且安全性好。

[Objective]To observe the efficacy and adverse events of s-adenosy-L-methione（SAMe）S-adenosyl methionine in treatment of cholestatic hepatitis patients.[Methods]Sixty-eight patients with cholestasis hepatitis were randomly divided into the treatment group（38 cases）and the control group（30 cases）.The two groups were given conventional treatment,treatment group were added with SAMe injection 1.0 g/d intravenous drip,control group were treated with Kuhuang injection 30 ml/d intravenous drip.The regimen lasted for four weeks.Before and after treatment,the symptoms and signs,biochemical indexes （TBil,DBil,ALT,AST,γ-GT,TBA）,curative effect and adverse reaction of the two groups were observed.[Resnlts] After treatment,total bilirubin （TBil）,direct bilirubin （DBil）,gamma glutamyltranspeptidase （γ-GT）and total bile acid（TBA）in the treatment group decreased significantly than those in the control group （P＜0.05 or P＜0.01）.The improvement rates of cinereous stool and skin pruritus in treatment group were significantly higher than those in control group（P＜0.05 orP＜0.01）.The total effective rates of treatment group was 84.2％,which was higher than 60.0％ of control group（P＜0.05）.The two groups showed no serious adverse reactions.[Conclusion]SAMe has good clinical efficacy and safety for the treatment of cholestatic hepatitis patients.