联合应用复方甘草酸苷与恩替卡韦对慢性重型乙型肝炎的临床疗效

Clinical curative effect of combined compound glycyrrhizin and entecavir in treatment of chronic severe hepatitis

目的分析并评价联合使用复方甘草酸苷与恩替卡韦对慢性重型乙型肝炎患者的临床疗效。方法选择江苏镇江解放军第三五九医院自2007年至2009年期间收治的慢性重型乙型肝炎患者36例作为观察组;选择2004年至2006年期间收治的慢性重型乙型肝炎32例作为对照组。对照组患者采取复方甘草酸苷(20ml/支)加综合治疗;观察组给予复方甘草酸苷(20ml/支)加恩替卡韦(0.5 mg/片)加综合治疗。结果两组患者经治疗后,在主要临床症状改善、TB及凝血酶原活动度、疸酶分离、并发症、抢救成功率、病死率以及住院时间方面比较,两组之间差异均显著(P<0.01或P<0.05),均具有统计学意义;随访或治疗2年后,观察组HBV-DNA与HBeAg转阴率均明显高于对照组,两组之间比较差异均显著(P<0.01),均具有统计学意义;2年后通过B超和/或肝组织活检证实肝硬变者,观察组明显少于对照组,两组比较差异显著(P<0.01),具有统计学意义。结论恩替卡韦在治疗慢性重型乙型肝炎患者方面具有较高的安全性,其与复方甘草酸苷联合使用能够发挥协同作用,提高临床疗效和抢救成功率,长期服用能够有效抑制病毒复制,延缓肝硬变进程。

Objective To analyze and evaluate the clinical efficacy of compound glycyrrhizin combined with entecavir in treatment of chronic severe hepatitis patients. Methods In our hospital from 2007 - 2009 years from chronic severe hepatitis patients 36 cases as the observation group ; 2004 - 2006 during the years in our hospital of chronic severe hepa- titis B 32 cases as control group. The control group patients taken compound glycyrrhizin （20ml/a） ＋ comprehensive treatment; Observation group were treated with glycyrrhizin （20ml/a） ＋ entecavir （0. 5mg/piece） and comprehensive treatment. Results Two groups of patients after treatment, the main clinical symptoms improved, TB and prothrombin activity, jaundice, enzyme separation complications, success rate, death rate and length of hospital stay compared, the difference between the two groups was significant （P 〈 0. 01 or P 〈 0. 05 ）, were statistically significant ; Follow - up or treatment for 2 years, the observation group HBV - DNA and HBeAg negative rate were significantly higher than those in the control group, two groups were significant differences （P 〈 0. 01 ）, were statistically significant; 2 years later by B ultrasound and / or liver cirrhosis biopsy confirmed, the observation group was less than that in the control group, the difference between the two groups is significant （P 〈 0. 01 ）, with statistical significance. Conclusion Entecavir in the treatment of chronic severe hepatitis B patients with high safety, with compound glycyrrhizin combined use can play a synergistic role, improve clinical curative effect and the success rate of rescue, long - term use can effectively suppress viral replication, delaying the process of liver cirrhosis.