@article{oai:soar-ir.repo.nii.ac.jp:00003934,
 author = {Tanaka,  Naoki and Horiuchi,  Akira and Yamaura,  Takahiro and Komatsu,  Michiharu and Yokoyama,  Takahide and Okaniwa,  Shinji and Nagaya,  Tadanobu and Yoshizawa,  Kaname and Kiyosawa,  Kendo and Aoyama,  Toshifumi and Tanaka,  Eiji},
 issue = {6},
 journal = {Journal of Gastroenterology},
 month = {Jun},
 note = {The original publication is available at www.springerlink.com, Background: Hepatoprotective therapies that include regular glycyrrhizin injection (GI) are beneficial for chronic hepatitis C patients, but are sometimes unable to normalize serum alanine aminotransferase (ALT) levels. Here, we evaluated whether the addition of minor bloodletting, named petit phlebotomy (PP), prior to each GI could further reduce serum ALT concentrations in such patients. Methods: Seventy-six HCV-infected patients receiving regular GI with persistently abnormal serum ALT levels were randomly divided into GI+PP or GI groups and monitored for 12 months. PP was performed before every GI to a total 60 ml of blood a week. The primary PP endpoint was serum ferritin levels of less than 20 ng/ml. PP was suspended upon reaching the endpoint, but was resumed as needed. The efficacy of the addition of PP was evaluated by measuring changes in serum ALT levels. Results: Two patients in each group dropped out because of apparition of hepatocellular carcinoma. The remainder completed the 12-month treatment with no serious adverse events. Serum ALT and ferritin levels were significantly decreased in the GI+PP group (from 67 + 34 to 44 + 14 U/l and from 163 + 127 to 25 + 21 ng/ml, respectively, both P<0.001), but these changes were not seen in the GI group. Although twenty patients in the GI+PP group had compensated cirrhosis, no significant reductions in serum albumin concentrations were observed. Conclusions: The addition of PP is effective and safe for improving serum aminotransferase levels in HCV-infected patients receiving regular GI, even in those with compensated cirrhosis., Article, Journal of Gastroenterology 44(6): 577-582(2009)},
 pages = {577--582},
 title = {Efficacy and safety of addition of minor bloodletting (petit phlebotomy) in hepatitis C virus-infected patients receiving regular glycyrrhizin injections},
 volume = {44},
 year = {2009}
}