乳果糖治疗亚临床肝性脑病的临床及实验研究

目的 :为探讨乳果糖 (苏威制药 ,杜必克 )治疗亚临床肝性脑病 (Subclinicalhepaticen cephalopathy ,SHE)的疗效及其机理。 方法 :观察了 30例肝炎后肝硬化 (代偿期 )SHE患者治疗前后临床症状、体征、肝功能、血氨、数字连接试验、画线试验等指标变化。结果 :乳果糖不仅可改善临床症状、体征、而且明显降低血氨和数字连接试验的时间以及画线试验的时间及错误次数 (P <0 .0 5)。以四氯化碳 (CCL4 )和苯巴比妥染毒造成大鼠肝硬化模型 ,通过观察血清血氨 ,肝脏病理及Y型电迷宫试验。乳果糖可降低血氨 ,改善肝脏病理 ,而且使大鼠Y型电迷宫试验错误次数明显低于模型对照组。结论 :乳果糖治疗亚临床肝性脑病疗效确切 ,其机制可以是通过降低血氨和通过排便而清除内毒素等减轻肝脏炎症而起作用。

Clinical and experimental study on the treatment of subclinical hepatic encephalopathy by lactulose

Objective:To investigate the therapeutic effect and its mechanisms on the treatment of Subclinical hepatic encephalopathy (SHE) by Lactulose (Suwei pharmacy,Dubike).Method: We observed the change of clinical symptoms, signs, hepatic function, blood ammonia, test of connecting numbers and test of drawing line and other indexes before and after treatment on 30 cases of SHPEresulting from hepatocirrhosis (compensatery phase)following up hepatitis.Results:It showed that Lactulose could not only improve the clinical symptoms and signs, but also significantly decrease the blood ammonia, time of number-connecting test, and time and error times of drawing-line test (P<0.05). CCL 4 and phenobarbital were used to form the hepatocirrhosis model in rats.Conclusion: Through observing the blood ammonia, hepatic pathologic change and test of Y-type electric maze, it is showed that Lactulose could decrease blood ammonia, ameliorate hepatic pathologic state , and the error times of Y-type electric maze test were also significantly lower than model group. The therapeutic effect of Lactulose on treatment of SHE was certain, and the mechanism may be it exert its function through decreasing blood ammonia and defecation to remove endotoxin to relieve hepatic infiammation.