Leuschner U
Medizinische Klinik II, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main.
Praxis (Bern 1994). 1998 Nov 11;87(46):1532-6.
For the medical treatment of cholestasis plant alkaloids, phenobarbital and S-adenosyl-L-methionine (SAMe) have been used. Although the mode of action of these substances is understood in part, the treatment of patients was unsuccessful. In contrast, ursodeoxycholic acid, a physiologically occurring bile acid in man, was successful. The daily dosage of ursodeoxycholic acid is 10-15 mg/kg bodyweight. Best results have been obtained in primary biliary cirrhosis where symptoms improved markedly, the cholestasis-indicating enzymes and immunoglobulin M decreased significantly. After long-term therapy even liver histology improved. Recently it has been shown that ursodeoxycholic acid prolongs the interval to liver transplantation. Ursodeoxycholic acid has to be taken lifelong, because interruption of therapy, even after long periods of continued treatment will induce a rebound of cholestasis. Ursodeoxycholic acid therapy is without side effects. In patients with primary sclerosing cholangitis ursodeoxycholic acid prolongs life expectancy only in combination with endoscopic bile duct dilatation.
对于胆汁淤积症的医学治疗，曾使用过植物生物碱、苯巴比妥和S-腺苷-L-蛋氨酸（SAMe）。尽管这些物质的作用方式已部分为人所知，但对患者的治疗并不成功。相比之下，熊去氧胆酸，一种人体生理存在的胆汁酸，治疗取得了成功。熊去氧胆酸的日剂量为10 - 15毫克/千克体重。在原发性胆汁性肝硬化中取得了最佳效果，症状明显改善，提示胆汁淤积的酶和免疫球蛋白M显著下降。长期治疗后甚至肝脏组织学也有所改善。最近有研究表明，熊去氧胆酸可延长肝移植的间隔时间。熊去氧胆酸必须终身服用，因为即使经过长时间持续治疗后中断治疗，也会导致胆汁淤积反弹。熊去氧胆酸治疗无副作用。在原发性硬化性胆管炎患者中，熊去氧胆酸仅与内镜下胆管扩张联合使用时可延长预期寿命。
