门冬氨酸鸟氨酸联合乳果糖治疗肝硬化并发肝性脑病疗效观察

目的观察门冬氨酸鸟氨酸(瑞甘)与乳果糖治疗肝硬化合并肝性脑病的临床疗效。方法将我院收治的肝硬化合并肝性脑病患者64例随机分为两组,治疗组32例,对照组32例。在基础治疗上,治疗组加用门冬氨酸鸟氨酸10 g,2次/d静滴;乳果糖10～20 g/次,3次/d,口服。保持2～3次/d软便(必要时可加量)。对照组给予精氨酸20 g/次,静滴,连用7 d。比较两组患者治疗前后的症状、体征、清醒时间、肝功能及血氨变化,总有效率及死亡率。肝性脑病分为Ⅰ、Ⅱ、Ⅲ、Ⅳ期[1,2],观察治疗前后的计分情况。结果治疗组与对照组比较,治疗组可明显改善患者症状、体征、缩短患者清醒时间,降低其血清转氨酶、胆红素、及血氨水平,提高总有效率,降低死亡率。对照组静滴精氨酸,因肝硬化患者鸟氨酸循环中所必需精氨酸酶、精氨酸合成酶活性下降,故疗效不佳。结论门冬氨酸鸟氨酸联合乳果糖是较为有效的治疗肝硬化合并肝性脑病的药物。

Efficacy of Ornithine Aspartate Combined with Lactulose in the Treatment of Liver Cirrhosis Complicated by Hepatic Encephalopathy

Objective To observe the clinical curative effect on ornithine aspartate （Ruigan） combined with lactu- lose for treatment of cirrhotic patients with hepatic encephalopathy. Methods 64 cases of such patients in our hospital were randomly divided into two groups, 32 cases in treatment group, 32 cases in the control group. In the base treatment, the treatment group was added with ornithine aspartate 10 g, 2 times a day ivgtt, lactulose 10 - 20 g one time, 3 times a day oral, keep the 2 - 3 times one day soft feces （ If necessary, it might be added weight） , the control group was given arginine 20 g one time intravenous drip, keep for 7 days. Comparison of two groups of patients before and after treatment of symptoms, signs, waking time, liver function and blood ammonia level, total efficiency and mortality. The scoring conditions were observed before and after treatment. Results It in the treatment group can significantly improve the patients symptoms and signs, shorten the patient awake time, reduce the serum transaminase, bilirubin, and ammonia levels, improve the total efficiency, reduce mortality. The control group were treated with intravenous drip of arginine, ornithine cycle due to liver cirrhosis patients required enzymes of arginine, arginine synthetase activity decreased, thus the curative effect is not good. Conclusion Ornithine aspartate combined with lactulose is more effective in the treatment of cirrhotic patients with hepatic encephalopathy.