单用异甘草酸镁与联合激素治疗慢性乙型重型肝炎的疗效对比

Compare of the efficacy and safety of the single-using magnesium isoglycyrrhizinate and combined-using with hormone in the treatment of chronic severe hepatitis B

目的比较单用异甘草酸镁与联合激素(地塞米松)治疗慢性乙型重型肝炎的疗效及安全性。方法回顾性分析158例慢性乙型重型肝炎患者临床资料,所有患者均采用内科综合治疗,其中采取异甘草酸镁注射液治疗(A组)48例,异甘草酸镁注射液联合激素治疗(B组)41例及未使用异甘草酸镁注射液及地塞米松(对照组)69例,观察治疗前和治疗4周后的谷草转氨酶(AST)、总胆红素(TB)、白蛋白(ALB)、凝血酶原时间(PT)、终末期肝病模型MELD评分等相关指标,并进行比较,同时观察治疗中的不良反应。结果治疗4周后,异甘草酸镁治疗组比对照组更有效降低AST、TB水平,改善凝血功能,降低MELD评分(P<0.05);异甘草酸镁治疗组与联合激素治疗组相关指标改善差异无统计学意义(P>0.05)。异甘草酸镁治疗组未发现不良反应,联合激素治疗组引起血压、血糖升高及出血等不良反应几率增大。结论单用异甘草酸镁治疗慢性乙型重型肝炎能达到联合激素治疗同样的疗效,但可避免激素的相关不良反应。

Objective To .compare efficacy and safety of the magnesium isoglycyrrhizinate （MI） and the combined-using MI with hormone in the treatment of chronic severe hepatitis B （CSHB）. Methods 158 CSHB were analyzed retrospectively, and all of them received comprehensive medical treatment. Of all, 48 cases in treatment group A received intravenous MI, 41 cases in treatment group B received combined-using MI with dexamethasone, the rest 69 cases in control group did not received MI nor dexamethasone. Clinical data including aspartate aminotransferase （AST）, total bilirubin （TB）, albumin （ALB）, prothrombin time （PT） and model for end-stage liver disease （MELD） before and after 4 weeks of the medication were collected and compared for any side effect during the therapy was recorded as well. Results （!）After 4 weeks treatment, group A showed a more effectively reduction of the AST and TB levels, improved blood clotting function, and lower MELD score when compared with the control group （P〈0.05）; （~）The differences of the improvements of the clinical indicators between group A and group B were not significant （P〉O.05）.Group A found no adverse reactions, however, patients in group B had a slight tendency of the elevation of blood pressure, serum glucose and hemorrhage. Conclusion The treatment effects of MI parallels with that of combined-using M! with hormone, however, it prevents hormone related side：effects.