De Binay K, Dutta Deep, Pal Subrata K, Gangopadhyay Subhabrata, Das Baksi Sumanta, Pani Adyapad
Department of Medicine, Medical College Calcutta, India.
Can J Gastroenterol. 2010 Mar;24(3):183-8. doi: 10.1155/2010/349076.
Increased nitric oxide production in cirrhosis has been commonly implicated in the genesis of hepatopulmonary syndrome (HPS). Initial studies suggested that garlic, a constituent of the daily diet, may have a role in the treatment of HPS by altering nitric oxide production.
To evaluate the effects of oral garlic supplementation on arterial blood gas parameters, and overall morbidity and mortality in patients with HPS.
Twenty-one and 20 HPS patients were randomly assigned to receive either oral garlic supplementation or placebo, respectively, and were evaluated monthly over a period of nine to 18 months.
After nine months, garlic supplementation was associated with a 24.66% increase in baseline arterial oxygen levels (83.05 mmHg versus 66.62 mmHg; P<0.001), compared with only a 7.37% increase (68.75 mmHg versus 64.05 mmHg; P=0.02) among subjects in the placebo group. There was also a 28.35% decrease in alveolar-arterial oxygen gradient (21.35 mmHg versus 29.77 mmHg; P<0.001) among patients with HPS who received garlic, in contrast with only a 10.73% decrease (29.11 mmHg versus 32.61 mmHg; P=0.12) among those in the placebo group. After nine months, the arterial oxygen level was significantly higher (83.05 mmHg versus 68.75 mmHg; P<0.001) and the alveolar-arterial oxygen gradient was significantly lower (21.35 mmHg versus 29.11 mmHg; P<0.001) among patients receiving garlic compared with those receiving placebo. Reversal of HPS was observed in 14 of 21 patients (66.67%) on garlic supplementation (intent-to-treat analysis) and in one of 20 patients (5%) on placebo. Two of 21 patients undergoing garlic supplementation died during follow-up in contrast to seven of 20 patients who were on placebo.
Garlic supplementation may be beneficial in patients with HPS for the reversal of intrapulmonary shunts as well as reducing hypoxemia and mortality.
肝硬化患者体内一氧化氮生成增加通常被认为与肝肺综合征（HPS）的发生有关。早期研究表明，大蒜作为日常饮食的组成部分，可能通过改变一氧化氮生成在HPS治疗中发挥作用。
评估口服补充大蒜对HPS患者动脉血气参数以及总体发病率和死亡率的影响。
21例和20例HPS患者分别被随机分配接受口服大蒜补充剂或安慰剂，并在9至18个月的时间里每月进行评估。
9个月后，补充大蒜的患者基线动脉血氧水平增加了24.66%（从66.62 mmHg升至83.05 mmHg；P<0.001），而安慰剂组患者仅增加了7.37%（从64.05 mmHg升至68.75 mmHg；P=0.02）。接受大蒜治疗的HPS患者肺泡-动脉血氧梯度下降了28.35%（从29.77 mmHg降至21.35 mmHg；P<0.001），相比之下，安慰剂组仅下降了10.73%（从32.61 mmHg降至29.11 mmHg；P=0.12）。9个月后，接受大蒜治疗的患者动脉血氧水平显著高于接受安慰剂的患者（83.05 mmHg对68.75 mmHg；P<0.001），肺泡-动脉血氧梯度显著低于接受安慰剂的患者（21.35 mmHg对29.11 mmHg；P<0.001）。在接受大蒜补充剂治疗的21例患者中，有14例（66.67%）观察到HPS逆转（意向性分析），而接受安慰剂治疗的20例患者中有1例（5%）逆转。接受大蒜补充剂治疗的21例患者中有2例在随访期间死亡，而接受安慰剂治疗的20例患者中有7例死亡。
补充大蒜可能对HPS患者有益，可逆转肺内分流，减少低氧血症和死亡率。
