Okumura M, Tanikawa K, Chúman Y, Kóji T, Nakagawa S, Nakamura Y, Iino H, Yamasaki S, Hisatsugu T
Gastroenterol Jpn. 1977;12(6):469-75. doi: 10.1007/BF02781340.
Ursodeoxycholic acid (UDCA), 7beta hydroxy epimer of chenodeoxycholic acid (CDCA), has been used as a choleretica for 20 years in Japan. Recent report showing increased excretion of UDCA in bile after CDCA administration may suggest the possibility that UDCA has similar effects to CDCA on bile cholesterol unsaturation and on gallstone dissolution. The present paper describes the clinical usefulness of UDCA for gallstone patients during the past two years. Seventy-four gallstone patients with functioning gall-bladders, 19 men and 55 women with a mean age of 48 years, have been treated for 6 months or more. UDCA, supplied in tablets (Ursosan), was given 450 mg per day. The disappearance or the reduction of stone size or number, or both (dissolution effect) was recognized in 32 out of 74 patients (43%). In case of radiolucent stones, the overall effective rate was estimated for 24 of 46 patients (52%). There may be no significant difference in dissolution effect between CDCA and UDCA treatment, however, the merit of UDCA treatment seems to have its few side effects.
熊去氧胆酸（UDCA）是鹅去氧胆酸（CDCA）的7β-羟基差向异构体，在日本作为利胆药已使用了20年。最近的报告显示，给予CDCA后胆汁中UDCA的排泄增加，这可能提示UDCA在胆汁胆固醇不饱和以及胆结石溶解方面可能具有与CDCA相似的作用。本文描述了过去两年中UDCA对胆结石患者的临床效用。74例胆囊功能正常的胆结石患者，其中男性19例，女性55例，平均年龄48岁，接受了6个月或更长时间的治疗。提供的熊去氧胆酸片剂（优思弗），每天服用450毫克。74例患者中有32例（43%）结石消失或结石大小或数量减少，或两者兼有（溶解效果）。对于透X线结石，46例患者中有24例（52%）的总体有效率得到评估。CDCA和UDCA治疗在溶解效果上可能没有显著差异，然而，UDCA治疗的优点似乎是副作用较少。
