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Pharmacotherapy for Hepatic encephalopathy: view of Evidence-Based Medicine | OMICS International | Abstract
ISSN: 2167-0889

Journal of Liver
Open Access

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Research Article

Pharmacotherapy for Hepatic encephalopathy: view of Evidence-Based Medicine

Ming-Hua Zheng1*, Dan-Qin Sun1, Qian Jiang2, Ke-Qing Shi1, Ai-Min Wu3 and Yong-Ping Chen1*
1Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China
2Department of Pharmacy, the Second people’s Hospital of Sichuan Province, Sichuan provincial Cancer Hospital, Chengdu 610041, China
3Information Service Department, Library of Wenzhou Medical College, Wenzhou 325000, China
Corresponding Authors : Ming-Hua Zheng
Department of Infection and Liver Diseases, Liver Research Center
The First Affiliated Hospital of Wenzhou Medical College
No.2 Fuxue lane, Wenzhou, Zhejiang, China
Tel: (86) 577-88078232
Fax: (86) 577-88078262
E-mail: [email protected]
  Yong-Ping Chen
Department of Infection and Liver Diseases, Liver Research Center
The First Affiliated Hospital of Wenzhou Medical College
No.2 Fuxue lane, Wenzhou, Zhejiang, China
Tel: (86) 577-88078232
Fax: (86) 577-88078262
E-mail: [email protected]
Received October 20, 2011; Accepted December 15, 2011; Published December 18, 2011
Citation: Zheng MH, Sun DQ, Jiang Q, Shi KQ, Wu AM, et al. (2011) Pharmacotherapy for Hepatic encephalopathy: view of Evidence-Based Medicine. J Liver 1:102. doi:
Copyright: © 2011 Zheng MH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Hepatic encephalopathy (HE) refers to a complex and reversible neuro-psychiatric syndrome that results from complications of acute or chronic hepatic failure, particularly alcoholic cirrhosis. It will lead to frequent life disruptions, poor quality of life and extensive use of health care resources. We conducted the review of several agents based on randomized controlled trials (RCTs) of high-quality Jadad scores (≥3) to provide effective information for clinical practice. Rifaximin appears at least to be as effective as conventional treatments, but not superior to them. L-Ornithine-L-aspartate appears to be a safe and effective treatment of chronic HE when compared with a placebo regime. Other treatments include non-absorbable disaccharides (NAD) and benzodiazepine receptor antagonists. In spite of the variability in the improvement of HE, NAD and non-absorbed antibiotics such as rifaximin offer a favorable benefit–risk ratio in the improvement of HE. Further RCTs with power calculation and a multi-centre approach with adequate population number are needed to resolve the heterogeneous results

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