Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the posttreatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3→5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.
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机译：在欧洲，据报道利福昔明可有效治疗肝性脑病（HE）。然而，尚不清楚利福昔明是否有效治疗韩国人的HE，因此我们进行了一项开放标签的前瞻性随机研究，以评估利福昔明与乳果糖在韩国患者中的疗效。入选了54例肝硬化和肝性脑病患者。在7天内，随机将32例患者接受利福昔明治疗，22例患者接受乳果糖治疗。在治疗之前和结束时，进行血氨的分级，拍打性震颤，精神状态，数字连接测试（NCT），并确定HE指标的估计值。利福昔明和乳果糖在大多数患者中均有效（分别为84.4％和95.4％，p = 0.315）。利福昔明和乳果糖显着改善了血液中的NH3，拍打性震颤，精神状态和NCT，利福昔明和乳果糖治疗组的这些措施的后处理水平相似，HE指数也是如此（利福昔明组（10.0→4.2， p ＝ 0.000）；乳果糖组（11.3→5.0，p ＝ 0.000）。一名接受利福昔明治疗的患者主诉腹痛，其易于控制。任一治疗组均无肾功能损害发作。利福昔明在治疗韩国肝性脑病患者中与乳果糖一样安全有效。
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