A comparative study of high-or low-dose terlipressin therapy in patients with cirrhosis and type 1 hepatorenal syndrome / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To perform an analysis and comparative study of the clinical data for patients with cirrhosis and type 1 hepatorenal syndrome (HRS) who received treatment with terlipressin using high-or low-dose regimens.</p><p><b>METHODS</b>A total of 56 patients with cirrhosis and type 1 HRS who presented for treatment to the Wuhan Medical Treatment Center and Taizhou Central Hospital between March 2010 and October 2012 were enrolled in the study. The patients were randomly assigned to the terlipressin treatment groups for receipt of the high-dose regimen (1 mg/6-8 h;n =27) or low-dose regimen (1 mg/12 h;n =29). All patients were assessed for 24-hour urine volume, serum blood urea nitrogen (BUN) and creatinine (Cr) levels, therapeutic effect and prognosis, and adverse reactions. Measurements were made before and after the treatment, and on post-treatment days 3, 7 and 14. Inter-group differences were assessed by statistical analyses.</p><p><b>RESULTS</b>The high-dose group showed an increase in 24-hour urine volumes from post-treatment day 3 (1112 ± 262 ml) to day 7 (1938 ± 312 ml), and the volumes on both days were significantly better than those of the low-dose group (day 3:986 ± 162 ml and day 7:1760 ± 300 ml, t =1.500, 1.830, P=0.038, 0.041). The high-dose group also showed a significantly better decreases in serum BUN levels (35.1 ± 8.6 to 30.2 ± 6.3 mmol/L vs.low-dose group: 43.2 ± 10.9 to 35.1 ± 7.6 mmol/L, t =3.200, 5.901, P =0.043, 0.047) and in serum Cr values (219.0 ± 35.1 to 128.2 ± 41.6 vs.low-dose group: 230.3 ± 82.1 to 151.5 ± 38.7, t =2.997, 5.765, P =0.036, 0.046).On post-treatment day 14 the 24-hour urine volume of patients in the high-dose group decreased (to 720+/-136 ml), but the difference from that of the low-dose group was not significant (vs. 620 ± 164 ml, t =1.855, P =0.069). The serum BUN level increased in the high-dose group (to 54.4 ± 15.0 mmol/L), which was statistically different from that in the low-dose group (vs .57.7 ± 17.3 mmol/L, t=5.166, P =0.022); the same trend was seen for the serum Cr value (397.8 ± 127.4 mumol/L vs. 480.3 ± 179.8 mumol/L, t =5.638, P =0.047). No statistically significant differences were observed for the groups in regard to significant efficiency, efficiency or 2-week survival rate (x2 =2.314, 1.767, 0.678, P =0.128, 0.128, 0.410 respectively), but the total efficiency was significantly different between the two groups (x² =5.793, P =0.016). In addition, no serious adverse reactions (including precordial pain, myocardial infarction or intestinal necrosis) were observed in either group.</p><p><b>CONCLUSION</b>Terlipressin therapy at both high and low dosages can lead to significant beneficial effects within as little as 3 days after the treatment; however, the high-dose appears to produce a better lasting efficacy (at day 14 after the treatment). The difference in doses does not appear to markedly affect significant efficiency, efficiency, nor the 2-week survival rate.</p>

A clinical effect of oxy matrine and salvia miltiorrhiz on hepatic fibyosis / 中国基层医药

Objective To study the influence of oxy matrine combined with salvia mltiorrhiz on the hepatic fibrosis markers.Methods 60 patients with abnomal prameters of fibrosis level were randomly divided into two groups,30 patients of treatment group treated by salvia miltiorrhiz and oxy matrine,the control group was given liver protectiont treatment,then observed the changes of hepatic fibrosis markers:HA,LN,PCⅢ,and ⅣC.Results A significant decrease of HA,LN,PCⅢ,and ⅣC were observed in the patients treated with oxy matrine and salvia miltiorrhiz(P

Lamivudine Alone or in Combination with Bicyclol to Treat Chronic Viral Hepatitis B:A Clinical Study / 中华医院感染学杂志

OBJECTIVE To survey the therapeutic effect of lamivudine alone or in combination with bicyclol on chronical viral hepatitis B.METHODS Ninety patients with chronic viral hepatitis B were divided into 3 groups: A,B and C.Patients of group A(n=30) were given each 100mg lamivudine po qd,and 25 mg(bicyclol) po,tid,and the course of treatment lasted 72 weeks.Patients of group B(n=30) were subjected to(lamivudine) treatment alone at the same dosage as that of patients in group A.Patients of group C(n=30) were treated with(conventional) hepatinica and symptomatic therapeutic measures,serving as controls.Changes in serum HBV DNA and liver functions and YMDD mutant were dynamically monitored.RESULTS At the end of the 24,48 and 72 weeks of treatment,the rates of sera to turn negative for HBV DNA were 90.0%,(86.7%,) and(83.3%),(respectively),in patients of group A,and 86.7%,83.3%,and 76.7%,respectively,in patients of group B.The rates of sera to turn negative for HBV DNA,in patients of groups A and B were significantly higher than those in patients of group C(P0.05);at the end of 72 weeks,the rates of YMDD mutant were 16.7% in group A and 36.7% in group B,the rates in group A were significantly higher than in group B((P