Efficacy Of Lactulose In Patients With Minimal Hepatic Encephalopathy

Background and ObjectiveMinimal hepatic encephalopathy has not the clinical behaviors and mental disorders as hepatic encephalopathy, so it isn't easily be found in daily life.However, the patients prone to accidents when engaged in aerial work or driving. The incidence of MHE in patients with cirrhosis in China is 38.8 to 85.0%, comparing with 30% to 84% in foreign countries. We attach importance to MHE,not only it has high incidence,but also it has great influence on the patient's daily work and the quality of life.The patients with MHE look like normal, but the operating capacity and emergency response capabilities were decreased. Currently, there is no "gold standard" for MHE diagnosis. Number connection test is considered the most valuable diagnostic indicators. The treatment of MHE mainly includes working, eating, eliminating incentives, drugs, etc. MHE drug therapy is the main research object of this study. At present, the pathogenesis of MHE is unclear, there are various theories.One of the theories recognized by most experts and clinical practitioners are ammonia poisoning theory. Reducing the blood ammonia is an effective means of clinical treatment. Lactulose used in the clinical treatment of clinical hepatic encephalopathy is very common.However, in the treatment of MHE and the efficacy remains controversial. The main purpose of this study is to survey the clinical curative effect of lactulose and guide further treatment.Material and Methods86 patients with cirrhosis and MHE,who came to the department of infectious diseases of the first affiliated hospital of Zhengzhou University,were collected in 2009.8-2010.8, including 47 male patients and 39 women patients,which aged 33.2-67.5 years.51 cases of liver cirrhosis after hepatitis B,27 cases of liver cirrhosis after hepatitis C,5 cases after mixed infection of hepatitis B and C,3 cases of alcoholic cirrhosis. Randomized patients will be divided into two groups:treatment group 46 cases and control group 40 cases.Patients of treatment group was given oral lactulose, 10-20ml, tid, po, to maintain soft stools of patients 1-3 times / day. Treatment continued for 4 weeks.ResultsComparing with control group,both the NCT-A and blood ammonia concentration were decreased after treatment in treatment group,which was statistically significant (P<0.05). NCT-A:the markedly effective was 16 cases, excellent rate 34.78%, effective 20 cases, effective rate 43.48%;the total effective rate was 78.26%. Blood ammonia concentration:the markedly effective was 23 cases, excellent rate 50%,effective 17 cases, effective rate 36.96%, the total effective rate was 86.96%.ConclusionThe NCT and blood ammonia concentration of patients given lactulose were decreased, showing that lactulose has the exact effect. No serious adverse reactions were observed in this study. It is worthy of promotion.