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研究

摘要

Objective To evaluate the efficacy of combined Adefovir dipivoxil and Diammonium Glycyrrhizinate for treatment of HbeAg-positive chronic hepatitis B. Methods Fourty-six cases with HbeAg-positive chronic hepatitis B who were heated with Adofovir dipivoxil and Diammonium Glycyrrhizinate (Treatment group) were enrolled, together with 39 cases with HbeAg-positive chronic hepatitis B who were treated with Adefovir dipivoxil alone(Control group). Symptoms, ALT level and HBV-DNA were observed at the end of 12 th and 24 th week. Results The remission of symptom of Hypodynamia, Anorexia, Hepatic region compl, and the decrease of the level of ALT on treatment group were more significant than those of control group at the end of 12 th week( P < 0.01). The decrease of ALT level was more significant (P <0.01)than that of control group at the end of 24 th week. But the remission of symptom of Hypodynamia, Anorexia, Hepatic region were not significant between the 2 groups (P>0.05). The level of HBV-DNA of beth groups significantly decreased at the end of 12 th and 24 th week. But the decrease of the level of HBV-DNA in treatment group were less significant than that on control group (P > 0.05 ). Condusion The efficacy of combined Adefovir dipivoxil and Diammonium glycyrrthzinate is higher than that of Adefovir dipivoxil alone.%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 85例HBeAg阳性慢性乙型肝炎患者中结合患者的治疗意愿选择46例作为治疗组,应用阿德福韦酯胶囊联合注射用甘草酸二铵治疗;39例为对照组,单用阿德福韦酯胶囊治疗.观察治疗12周末和24周末2组患者肝病症状、丙氨酸转氨酶(ALT)和HBVDNA的变化.结果 12周末时治疗组患者乏力、食欲不振和肝区不适等症状明显缓解,ALT明显下降,与对照组相比,差异有统计学意义(P<0.01).24周末时治疗组ALT较对照组仍持续稳定(P<0.01),2组乏力、食欲不振和肝区不适等症状都明显缓解.治疗12周末和24周末时2组患者HBVDNA在血中的水平都明显下降,差异无统计学意义(P>0.05).结论 联合应用阿德福韦酯胶囊和注射用甘草酸二铵治疗HBeAg阳性慢性乙型肝炎患者,与单用阿德福韦酯胶囊治疗的HBeAg阳性慢性乙型肝炎患者相比较,能够在抗HBV治疗的同时较快控制肝组织炎症、坏死,改善患者的临床症状,降低血清ALT,增强了患者治疗疾病的信心和治疗的依从性,可达到长期改善肝功能、稳定肝炎病情的目的 .