Sugata F
Department of Gastroenterology, Showa University Fujigaoka Hospital.
Nihon Rinsho. 1993 Jul;51(7):1785-90.
In this paper the author describe present status and problems of Per oral cholesterol gallstone dissolution therapy by bile acid. 1) Both ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) decrease the cholesterol output in bile, but their action mechanism somewhat differs. 2) Clinical results of UDCA treatment in our hospital during past 17 years are as follows. Complete dissolution rate Approx. 20% Partial dissolution rate Approx. 20% 3) In the attempt to increase the complete dissolution rate, bedtime administration method (one time administration instead of 3 times, every day), combination therapy of UDCA and CDCA and UDCA plus simvastatin (HMG-CoA reductase inhibitor) were tried. The results of these trial were not superior compared with ordinary UDCA therapy (3 times after each meal administration). 4) The author concluded from the results that small size (< 1 cm in diameter), Ia in ultrasonographic classification, floating by oral cholecystography, and radiolucent gallstones are the most suited for bile acid dissolution therapy.
本文作者描述了经口服胆汁酸溶解胆固醇性胆结石疗法的现状与问题。1）熊去氧胆酸（UDCA）和鹅去氧胆酸（CDCA）均可降低胆汁中的胆固醇分泌量，但其作用机制略有不同。2）我院过去17年中UDCA治疗的临床结果如下。完全溶解率约20%，部分溶解率约20%。3）为提高完全溶解率，尝试了睡前给药法（每天1次给药而非3次）、UDCA与CDCA联合疗法以及UDCA加辛伐他汀（HMG-CoA还原酶抑制剂）疗法。这些试验结果并不优于普通UDCA疗法（每餐饭后给药3次）。4）作者从这些结果得出结论，直径小于1厘米、超声检查分类为Ia型、口服胆囊造影显示可漂浮且透X线的胆结石最适合胆汁酸溶解疗法。
