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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 observe the clinical efficacy of adefovir dipivoxil and diammonium glycyrrhizinate in the treatment of HBeAg-positive chronic hepatitis B patients. Methods Patients with HBeAg-positive chronic hepatitis B were divided into group A (n = 46) and group B (n = 39). Group A was treated with adefovir dipivoxil and diammonium glycyrrhizinate. Group B was treated with adefovir Ester capsule treatment. The changes of hepatic symptoms, alanine aminotransferase (ALT) and HBVDNA in the two groups at the end of the 12th and the 24th week of treatment were observed. Results The symptoms of fatigue, loss of appetite and discomfort of liver in group A were relieved at the end of 12th week. ALT decreased significantly compared with that in group B (P <0.01). ALT of patients in group A was still stable (P <0.01) at 24 weekend, but symptoms of fatigue, loss of appetite and discomfort in liver were significantly relieved in patients in groups A and B (P> 0.05). HBV DNA levels in the blood of patients in groups A and B at 12 and 24 weeks after treatment were significantly decreased, with no significant difference (P> 0.05). Conclusions adefovir dipivoxil capsules combined with diammonium glycyrrhizinate in patients with HBeAg-positive chronic hepatitis B can rapidly control liver inflammation and necrosis, improve clinical symptoms, reduce serum ALT level and rapidly reduce liver damage Tissue inflammatory damage, easier to achieve long-term improvement of liver function, the purpose of stabilizing hepatitis.