葛根素联合复方甘草酸单铵S治疗酒精性肝炎的疗效探讨

摘要

目的：探讨葛根素联合复方甘草酸单铵 S 治疗酒精性肝炎的临床疗效。方法选取2011年2月-2014年2月解放军97医院收治的92例酒精性肝炎患者，随机分为联合组和对照组各46例。对照组在常规治疗方案的基础上，加用复方甘草酸单铵 S治疗；联合组在对照组治疗方案的基础上，加用葛根素联合治疗。两组患者治疗20 d，对比其治疗前后的 TBil、ALT、AST、GGT、白蛋白（Alb）水平、Glasgow 酒精性肝炎（GAHS）评分及腹部超声，同时对比两组患者的临床疗效和不良反应。计量资料组间比较采用t 检验，计数资料组间比较采用卡方检验。结果治疗后两组患者的 GAHS 评分、TBil、ALT、AST 和 GGT 均显著低于治疗前，差异均有统计学意义（P 值均＜0．05）；联合组治疗后的 TBil 水平为（20．96±6．85）μmol /L，ALT 水平为（33．72±14．18）U /L，AST 水平为（38．69±6．38）U /L，均显著低于对照组，差异均有统计学意义（P 值均＜0．05）；联合组治疗后的显效率为63．04％，总有效率为93.48％，腹部超声的改善率44．44％，均显著高于对照组，差异均有统计学意义（P 值均＜0．05）；两组患者不良反应的对比，差异无统计学意义（P ＞0．05）。结论葛根素联合复方甘草酸单铵 S 可提高酒精性肝炎的临床疗效，保护患者的肝功能，且安全性较好，值得推广应用。%Objective To investigate the clinical efficacy of puerarin combined with compound ammonium glycyrrhetate S in the treatment of alcoholic hepatitis.Methods A total of 92 patients with alcoholic hepatitis who were admitted to our hospital from February 2011 to Febru-ary 2014 were recruited in this study and randomly divided into two groups.The control group (n =46)was treated with conventional thera-py combined with compound ammonium glycyrrhetate S.The test group (n =46)was treated with puerarin in addition to the regimen used in the control group.After 20 days of treatment,the levels of total bilirubin (TBil),alanine aminotransferase (ALT),aspartate aminotrans-ferase (AST),glutamyl transpeptidase (GGT),albumin (Alb),Glasgow alcoholic hepatitis score (GAHS),and abdominal ultrasound were measured and compared with the results before the treatment in both groups.The clinical efficacy and adverse reactions in the two groups were also compared.Results After the treatment,the GAHSs and levels of TBil,ALT,AST,and GGT in the two groups were all significantly lower than those before the treatment (all P <0.05).In the test group after the treatment,the levels of TBil (20.96 ±6.85μmol /L),ALT (33.72 ±14.18 U /L),and AST (38.69 ±6.38 U /L)were all significantly lower than those in the control group (all P <0.05).The marked response rate,overall response rate,and rate of improvement in abdominal ultrasound in the test group were 63.04%, 93.48%,and 44.44%,respectively,all significantly higher than those in the control group (all P <0.05).There was no significant differ-ence in adverse reactions between the two groups (P >0.05).Conclusion For patients with alcoholic hepatitis,the combined therapy with puerarin and compound ammonium glycyrrhetate S can improve the treatment outcome and protect the liver function,and it has high safety and holds promise for clinical application.