联合用药治疗HBeAg阳性慢性乙型肝炎的临床观察

Clinical observation of the treatment of patients with HbeAg-positive chronic hepatitis B using adefovir dipivoxil combined with diammonium glycyrrhizinate

目的观察阿德福韦酯联合甘草酸二铵治疗HBeAg阳性慢性乙型肝炎的临床疗效。方法将HBeAg阳性慢性乙型肝炎患者分为A组(46例)和B组(39例),A组应用阿德福韦酯胶囊联合注射甘草酸二铵治疗,B组单用阿德福韦酯胶囊治疗。观察治疗12周末和24周末两组患者肝病症状、丙氨酸氨基转移酶(ALT)和HBVDNA的变化。结果 12周末时A组患者乏力、食欲不振和肝区不适等症状明显缓解,ALT显著下降,与B组相比差异有统计学意义(P<0.01)。24周末时A组患者ALT仍较B组患者稳定(P<0.01),A、B两组患者的乏力、食欲不振和肝区不适等症状均明显缓解(P>0.05)。治疗12周末和24周末时A、B两组患者血中HBV DNA水平均明显下降,差异无统计学意义(P>0.05)。结论阿德福韦酯胶囊联用甘草酸二铵治疗HBeAg阳性慢性乙型肝炎患者,能够在抗HBV治疗的同时迅速控制肝组织炎症坏死、改善患者的临床症状、降低血清ALT水平,迅速减轻肝组织炎症损伤程度,较易达到长期改善肝功能、稳定肝炎病情的目的 。

Objective To evaluate the efficacy of adefovir dipivoxil and diammonium glycyrrhizinate in treating HbeAg-positive chronic hepatitis B.Methods Changes in symptoms,ALT levels,and HBV DNA were observed at the end of 12th and 24th week in 46 patients with HbeAg-positive chronic hepatitis B who were treated with adefovir dipivoxil and diammonium glycyrrhizinate（Group A）.The same was done in 39 patients with HbeAg-positive chronic hepatitis B who were treated with adefovir dipivoxil alone（Group B）.Results The amelioration of symptoms of weakness,loss of appetite,and discomfort in the hepatic region and decreased levels of ALT in Group A were more significant than in Group B at the end of week 12（P0.01）.The difference in the decreased levels of ALT was more significant（P0.01） than those levels in Group B at the end of week 24,but the amelioration of symptoms of weakness,loss of appetite,and discomfort in the hepatic region was not（P0.05）.The level of HBV DNA in both Group A and Group B significantly decreased at the end of week 12 and week 24,but the decreased level of HBV DNA in Group A was less significant than that in Group B（P0.05）.Conclusion Adefovir dipivoxil and diammonium glycyrrhizinate have higher efficacy than adefovir dipivoxil alone.