牛磺熊去氧胆酸治疗丙型肝炎肝硬化的临床观察

Clinical observation of tauroursodeoxycholic acid in the treatment of liver cirrhosis with hepatitis C

目的观察牛磺熊去氧胆酸治疗丙型肝炎肝硬化的临床效果。方法 2013年1月至2015年6月,我院收治的72例丙型肝炎肝硬化患者随机分为治疗组(TUDCA组)36例和对照组(UDCA组)36例,治疗组给予牛磺熊去氧胆酸(TUDCA)250 mg、水飞蓟宾葡甲胺100 mg 3次/d口服;对照组给予熊去氧胆酸(UDCA)250 mg、飞蓟宾葡甲胺100 mg 3次/d口服。治疗3个月后,观察两组患者临床症状和肝功能指标的变化。结果治疗3个月后,TUDCA组血清TBIL、AST、ALP和GGT有明显改善(P<0.05);UDCA组治疗结束时,血清TBIL、ALP和GGT水平有明显改善(P<0.05)。不考虑肝功能Child-Pugh分级,TUDCA组同UDCA组比较,肝功能改善无明显差异(P>0.05)。Child-Pugh A级患者TUDCA组AST改善优于UDCA组,且差异有统计学意义(P<0.05)。在Child-Pugh C级患者中,无论TUDCA组还是UDCA组,治疗后肝功能均无明显改善(P>0.05)。结论TUDCA可以有效降低丙肝肝硬化患者TBIL、AST、ALP和GGT水平,在Child-Pugh A级患者中,TUDCA改善肝脏生化学指标的效果可能优于UDCA。

Objective To observe the effect of tauroursodeoxycholic acid（TUDCA） on liver cirrhosis with hepatitis C.Methods Seventy-two patients in our hospital from January 2013 to June 2015 were divided into TUDCA group（n =36） and UDCA group（n = 36） randomly.TUDCA group was treated with TUDCA（250 mg three times daily） and silybin meglumine（100 mg three times daily）.UDCA group was treated with ursodeoxycholic acid（UDCA,250 mg three times daily） and silybin meglumine（100 mg three times daily）.Symptoms and liver functions were compared between the two groups after 3 months of treatment Results After 3 months treatment,TBIL,AST,ALP and GGT levels significantly decreased in TUDCA group（P 〈0.05）,and TBIL,ALP and GGT levels significantly decreased in UDCA group（P 〈0.05）.The therapeutic efficacy had no significant difference between TUDCA group and UDCA group（P 〉 0.05）.Among patients of Child-Pugh class A,AST level was improved more significantly in TUDCA group than UDCA group.Among liver cirrhosis patients of Child-Pugh class C,liver function was not improved in TUDCA group or UDCA group.Conclusion TUDCA can significantly decrease the levels of TBIL,AST,ALP and GGT in the patient with hepatitis C-related liver cirrhosis.Compared with UDCA,TUDCA appears to be more effective than UDCA in improving the biochemical expression in the treatment of patients with hepatitis Crelated liver cirrhosis and Child-Pugh class A.