摘要
目的:探讨熊去氧胆酸(ursodeoxycholic acid ,UDCA)联合茵栀黄口服液治疗婴儿肝炎综合征(IHS)的疗效。方法46例IHS患儿随机分为治疗组26例(男17例,女9例;平均年龄2.35个月)与对照组20例(男10例,女10例;平均年龄2.05个月)。两组病例均予美能降转氨酶及基础治疗。对照组单用茵栀黄口服液退黄治疗,治疗组在此基础上加用UDCA 10~25 mg/Kg/d,分2次服用,连续应用14 d为1个疗程,部分用2疗程。监测两组患儿治疗前后血清总胆红素(TB)、结合胆红素(DB)、谷丙转氨酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)水平。结果与治疗前比较,治疗后各组患儿血清及胆汁中 TB、DB、ALT、γ-GT、TBA均显著降低,差异有统计学意义(P<0.01)。治疗后,与对照组比较,治疗组血清TB、DB、γ-GT、TBA均有明显下降,差异有显著性(P<0.05),血清 ALT升高,差异有统计学意义(P<0.05)。与对照组比较,治疗组的总有效率升高,差异有统计学意义(P<0.05)。结论 UDCA联合茵栀黄口服液能降低血清胆红素及内源性胆汁酸水平,可促进胆红素、TBA排泄,具有明显的利胆、退黄的疗效。
Objective To investigate the curative ef ect of ursodeoxycholic acid(UDCA)combing with Yinzhihuang oral liquid in the treatment of infantile hepatitis syndrome(IHS).Method A total of 46 patinets with IHS were randomly divided into a treatment group of 26 cases(male 17 cases,female 9 cases;mean age 2.35 months)and the control group of 20 cases(male 10 cases,female 10 cases;mean age 2.05 months).Two groups were both treated with Compound Glycyrrhizin to reduce transaminase and basic treatment.The control group was only treated with Yinzhihuang oral liquid,treatment group was added UDCA 10~25 mg/(kg/d)basing on this,pointing 2 times to take,continuous application of 14d for 1 course of treatment,part with 2 courses of treatment.Monitoring of the level of serum total bilirubin(TB),direct bilirubin(DB),alanine aminotransferase(ALT),gamma glutamyl transpeptidase(γ-GT)and total bile acid(TBA)of the two groups.Result Compared with prior treatment,the level of TB,DB,ALT,γ-GT and TBA were both dramatic decline of post reatment,the dif erence was statistical y significant(P<0.01).After treatment,the serum level of total bil irubin(TB),DB,γ-GT and TBA were significantly decreased,in the treatment group than the control group(P<0.05),the serum level of ALT was significant increased in the treatment group.t(P<0.05).Compared to two groups,the total ef ective rate of treatment group was bet er than that in control group,the dif erence was statistical y significant(P<0.05).Conclusion UDCA combined with Yinzhihuang oral liquid can reduce serum bilirubin and endogenous bile acid,also it can promote the excretion of bilirubin,TBA and the obvious cholagogic ef ect.
作者
孙蓓蓓
封东进
张锐锋
王光猛
SUN Bei-bei;FENG Dong-jin;ZHANG Rui-feng;WANG Guang-meng(Xuzhou Children's Hospital Department of Gastroenterology,Xuzhou Jiangsu 221000,China)
关键词
熊去氧胆酸
茵栀黄口服液
婴儿肝炎综合征
Ursodeoxycholic Acid
Yinzhihuang oral liquid
Infantile hepatitis syndrome
