熊去氧胆酸与腺苷蛋氨酸治疗胆汁性肝硬化的比较分析

Comparative analysis of ursodeoxycholic acid and S-adenosyl methionine in treatment of biliary cirrhosis

目的比较熊去氧胆酸(UDCA)与腺苷蛋氨酸(SAM)治疗胆汁性肝硬化的疗效。方法采用前瞻性研究方法 ,选择80例原发性胆汁性肝硬化患者,随机平均分为观察组与对照组,两组都予以甘利欣、还原型谷胱甘肽、门冬氨酸钾镁、钙剂治疗,在此基础上,观察组给予UDCA胶囊治疗,对照组给予注射用丁二磺酸SAM治疗,均连续治疗观察3个月。结果治疗后,观察组的总有效率(97.5%)显著高于对照组(85.0%)(P<0.05)。治疗后,观察组的血清ALT与AST值分别为(32.87±12.10)U/L和(33.20±14.20)U/L,明显低于对照组的(51.39±13.09)U/L和(51.49±14.22)U/L(P<0.05)。治疗后两组的CD4+值明显低于治疗前,且观察组明显低于对照组(P<0.05),而治疗前后两组的CD8+值均无明显变化(P>0.05)。结论 UDCA辅助治疗原发性胆汁性肝硬化,能减轻肝脏的损害,提高治疗有效率,疗效明显优于SAM,其作用机制可能与提高患者的细胞免疫功能有关。

Objective To compare the curative effects between ursodeoxycholic acid （UDCA） and S-adenosyl methionine （SAM） in the treatment of biliary cirrhosis.Methods A prospective study was made on 80 patients with primary biliary cirrhosis, who were divided randomly into an observation group and a control group, and the two groups were administered with Diammonium Glycyrrhizinate, reduced glutathione, Potassium Aspartate magnesium, and calcium; on the basis of this, the observation group was additionally administered with UDCA capsule and the control group with SAM-B injection. Both groups were treated and observed for three consecutive months. divided randomly into an observation group and a control group, and the two groups were administered with Diammonium Glycyrrhizinate, reduced glutathione, Potassium Aspartate magnesium, and calcium; on the basis of this, the observation group was additionally administered with UDCA capsule and the control group with SAM-B injection. Both groups were treated and observed for three consecutive months.Results After the treatment, the total effective rate in the observation group （97.5%） was significantly higher than that in the control group （85%） （P 〈 0.05）; the serum ALT and AST values in the observation group were （32.87±12.10）U/L and （33.20±14.20）U/L, respectively, significantly lower than those in the control group （51.39±13.09）U/L and （51.49±14.22）U/L（P 〈 0.05）. The CD4＋ values in both groups were significantly lower than those before the treatment; the CD4＋ value in the observation group were significantly lower than those in the control group （P 〈 0.05）, whereas the CD8＋ values in both groups before and after the treatment were not significantly changed （P 〉 0.05）.Conclusion As an adjuvant medicine in the treatment of primary biliary cirrhosis, UDCAcan reduce the damage to the liver, improve the efficiency of treatment, and has better curative effect than SAM; its mechanism is probably related to the improvement of the cellular immune function of patients.