CAJ | 학술논문

目的探讨门冬氨酸鸟氨酸颗粒剂(门鸟)治疗血清高γ-谷氨酰转移酶(GGT)慢性肝病至24周的临床效果.方法对200例慢性肝病患者根据治疗12周后血清GGT结果分为三组,采取不同的治疗剂量:Ⅰ组(血清G-GT恢复正常),将Ⅰ组继续随机分为原剂量巩固组和减量巩固组,原剂量巩固组维持初始剂量治疗至24周,减量巩固组减量治疗至24周(治疗组减量至3 g/d;对照组减量至50 mg/d);Ⅱ组(血清GGT下降但未恢复正常),患者均维持初始剂量治疗至24周;Ⅲ组(血清GGT未下降或不降反弹),患者均维持初始剂量治疗至24周.检测肝功能,比较分析各组患者血清GGT正常率.计数资料采用x2检验.结果 Ⅰ组患者治疗24周后,治疗组中的原剂量巩固组GGT正常率(90.9％)明显高于减量巩固组(52.2％),差异有统计学意义(x2=8.213,P＜0.05);Ⅱ组和Ⅲ组在治疗24周后,治疗组血清GGT正常率均明显高于对照组,差异有统计学意义(P＜0.05).全部患者在治疗24周后,治疗组GGT正常率高达78.6％,对照组仅为55.0％,差异有统计学意义(x2=11.452,P＜ 0.05).对GGT恢复正常的患者停药,停药2周后治疗组血清GGT水平正常率达92.7％,仅3例有明显反弹,而对照组血清GGT水平正常率为66.7‰差异有统计学意义(x2=14.964,P＜ 0.05).结论建议对血清GGT短期恢复正常的患者按原疗程巩固治疗24周.门鸟较复方甘草酸苷效果更为明显,门鸟长程效果明显,且停药后不易反弹,安全性高.
목적 탐토문동안산조안산과립제(문조)치료혈청고γ-곡안선전이매(GGT)만성간병지24주적림상효과.방법 대200례만성간병환자근거치료12주후혈청GGT결과분위삼조,채취불동적치료제량:Ⅰ조(혈청G-GT회복정상),장Ⅰ조계속수궤분위원제량공고조화감량공고조,원제량공고조유지초시제량치료지24주,감량공고조감량치료지24주(치료조감량지3 g/d;대조조감량지50 mg/d);Ⅱ조(혈청GGT하강단미회복정상),환자균유지초시제량치료지24주;Ⅲ조(혈청GGT미하강혹불강반탄),환자균유지초시제량치료지24주.검측간공능,비교분석각조환자혈청GGT정상솔.계수자료채용x2검험.결과 Ⅰ조환자치료24주후,치료조중적원제량공고조GGT정상솔(90.9％)명현고우감량공고조(52.2％),차이유통계학의의(x2=8.213,P＜0.05);Ⅱ조화Ⅲ조재치료24주후,치료조혈청GGT정상솔균명현고우대조조,차이유통계학의의(P＜0.05).전부환자재치료24주후,치료조GGT정상솔고체78.6％,대조조부위55.0％,차이유통계학의의(x2=11.452,P＜ 0.05).대GGT회복정상적환자정약,정약2주후치료조혈청GGT수평정상솔체92.7％,부3례유명현반탄,이대조조혈청GGT수평정상솔위66.7‰차이유통계학의의(x2=14.964,P＜ 0.05).결론 건의대혈청GGT단기회복정상적환자안원료정공고치료24주.문조교복방감초산감효과경위명현,문조장정효과명현,차정약후불역반탄,안전성고.
Objective To explore the clinical effect of L-ornithine L-aspartate (LOLA) granules in treating chronic liver disease in patients with high-level serum gamma-glutamyltransferase (γ-GT) using a 24-week treatment course.Methods Two-hundred patients with chronic liver disease and abovenormal γ-GT were given a 12-week course of LOLA granules (9 g/d) and then classified into the following three groups according to the change in serum γ-GT:group Ⅰ:patients with γ-GT level returned to normal;group Ⅱ:patients with serum γ-GT level that was reduced during the treatment; group Ⅲ:patients with serum γ-GT level that did not decrease or that increased to a higher level than at start of treatment.After the 12-week treatment course,the patients in group Ⅰ were divided into three subgroups for receipt of a control drug (compound glycyrrhizin,50mg/d) or an additional 12-week course ofγ-GT at a reduced dose (LOLA granules 3 g/d) or at the original dose; groups Ⅱ and Ⅲ were maintained on the initial dose for an additional 12 weeks.The groups were reassessed at the end of the second 12-week course (at the end of week 24 of the study's observation period).Count data were compared using the x2 test and measurement data were compared using the t-test.Results In group Ⅰ,the serum γ-GT level was 90.9％ at the end of the first 12-week course and dropped to a mean level of 52.2％ for both of the subgroups that received the reduced and original dose after the additional 12 weeks of LOLA granules treatment; the difference from week 12 to week 24 was significant (x2 =8.213,P ＜ 0.05).The 24-week change in serum γ-GT levels for the group Ⅰ reduced and original dose subgroups vs.the control subgroup were also significantly different from those seen in groups Ⅱ and Ⅲ (P ＜ 0.05).The percentage of patients in group Ⅰ who achieved normallevel serum γ-GT after 24 weeks of treatment (78.6％) was significantly higher than that for the control group (vs.55.0％,x2 =11.452,P ＜ 0.05).When the patients in group 1 who had received the 12 additional weeks of LOLA granules treatment were measured again at two weeks after the treatments had been discontinued (end of week 26),the percentage of patients with normal serum γ-GT level was 92.7％,with only three cases showing obviously abnormal levels; in contrast,the group Ⅰ patients in the control group of the second 12-week study period had on 66.7％ of patients with normal-level serum γ-GT.The difference in change between the treated groups (both reduced and original dose) and the control group was significant (x2 =14.964,P ＜ 0.05).Conclusion Patients whose serumγ-GT levels returned to normal after receipt of LOLA granules for 12 weeks benefitted from an additional 12 weeks of consolidation treatment,and those given the treatment at the original dose benefitted most.Compared with the compound glycyrrhizin,LOLA granules provided a better maintenance of resolved γ-GT level.Therefore,the effect of LOLA appears to be reliable and stable as well as safe for clinical use.