Cacciatore L, Antoniello S, Russo M
Clin Ter. 1989 Nov 30;131(4):225-32.
Alcohol abuse is widespread and alcoholic liver disease represents a major medical and social problem. The spectrum of alcoholic liver injury is currently grouped into three clinical forms: fatty liver, alcoholic hepatitis and cirrhosis. The rational management of alcoholic liver disease can be divided in non-specific therapy and in specific treatment. The most important aspect of non-specific therapy is cessation of alcohol consumption: the abstinence diminishes symptoms and improves signs, and significantly increases survival. As to specific treatment, a number of controlled clinical trials of various forms of therapy have been carried out. Steatosis is spontaneously reversible after cessation of alcohol consumption, and therefore no treatment is necessary. For hepatitis, a number of protocols have been studied with both low and high doses of corticosteroids, cyanidanol, penicillamine, synthetic thyroid antagonists, hormones, and amino acids. Results have been negative, disappointing, or contradictory. In cirrhosis, corticosteroids and colchicine have been used: the former were ineffective while clinical and histological improvement as well as reduced mortality were obtained with the latter. Especially interesting results were registered after treatment with polyunsaturated phosphatidylcholine which has been used for steatosis, acute hepatitis and cirrhosis with good clinical, histological, and biohumoral findings.
酒精滥用很普遍，酒精性肝病是一个主要的医学和社会问题。目前，酒精性肝损伤的范围分为三种临床形式：脂肪肝、酒精性肝炎和肝硬化。酒精性肝病的合理治疗可分为非特异性治疗和特异性治疗。非特异性治疗最重要的方面是戒酒：戒酒可减轻症状、改善体征，并显著提高生存率。至于特异性治疗，已经开展了许多关于各种治疗形式的对照临床试验。戒酒之后，脂肪变性可自发逆转，因此无需治疗。对于肝炎，已经研究了多种使用低剂量和高剂量皮质类固醇、花青素、青霉胺、合成甲状腺拮抗剂、激素和氨基酸的方案。结果均为阴性、令人失望或相互矛盾。对于肝硬化，曾使用过皮质类固醇和秋水仙碱：前者无效，而后者则取得了临床和组织学改善以及死亡率降低的效果。用多不饱和磷脂酰胆碱治疗后取得了特别有趣的结果，该药物已用于治疗脂肪变性、急性肝炎和肝硬化，取得了良好的临床、组织学和生物体液方面的效果。
