van Rossum T G, Vulto A G, de Man R A, Brouwer J T, Schalm S W
Department of Hepatogastroenterology, Erasmus University Hospital, Rotterdam, The Netherlands.
Aliment Pharmacol Ther. 1998 Mar;12(3):199-205. doi: 10.1046/j.1365-2036.1998.00309.x.
Chronic hepatitis C is a slowly progressive liver disease that may evolve into cirrhosis with its potential complications of liver failure or hepatocellular carcinoma. Current therapy with alpha-interferon is directed at viral clearance, but sustained response is only achieved in 20-40% of patients without cirrhosis, and less than 20% in patients with cirrhosis who have the greatest need for therapy. Treatment for those who do not respond to anti-viral therapy is highly desirable. In Japan glycyrrhizin has been used for more than 20 years as treatment for chronic hepatitis. In randomized controlled trials, glycyrrhizin induced a significant reduction of serum aminotransferases and an improvement in liver histology compared to placebo. Recently, these short-term effects have been amplified by a well-conducted retrospective study suggesting that long-term usage of glycyrrhizin prevents development of hepatocellular carcinoma in chronic hepatitis C. The mechanism by which glycyrrhizin improves liver biochemistry and histology are undefined. Metabolism, pharmacokinetics, side-effects, and anti-viral and hepatoprotective effects of glycyrrhizin are discussed.
慢性丙型肝炎是一种进展缓慢的肝脏疾病，可能会发展为肝硬化，并伴有肝衰竭或肝细胞癌等潜在并发症。目前使用α干扰素的治疗旨在清除病毒，但只有20%至40%的非肝硬化患者能实现持续应答，而最需要治疗的肝硬化患者中，这一比例不到20%。对于那些对抗病毒治疗无反应的患者，非常需要有效的治疗方法。在日本，甘草酸已用于治疗慢性肝炎20多年。在随机对照试验中，与安慰剂相比，甘草酸可显著降低血清转氨酶，并改善肝脏组织学。最近，一项精心开展的回顾性研究进一步证实了这些短期效果，表明长期使用甘草酸可预防慢性丙型肝炎患者肝细胞癌的发生。甘草酸改善肝脏生化指标和组织学的机制尚不清楚。本文将讨论甘草酸的代谢、药代动力学、副作用以及抗病毒和肝脏保护作用。
