摘要
目的探讨不同剂量复方甘草酸苷联合恩替卡韦对慢性乙型肝炎(慢性乙肝)患者的临床效果及对血钾、血钠及血醛固酮的影响。方法选取收治的慢性乙肝患者219例,采用随机数字表法分为对照组(50例)、A组(56例)、B组(57例)及C组(56例),所有患者均给予恩替卡韦治疗,在此基础上,A组、B组及C组分别给予复方甘草酸苷40、60、80 mL进行治疗。比较4组血钾、血钠、血醛固酮水平、肝功能指标、症状和体征改善率及不良反应发生率。结果与对照组比较,A组、B组及C组总有效率显著升高(P<0.05)。与对照组比较,A组、B组及C组乙型肝炎e抗原(HBeAg)阴转率、乙肝病毒脱氧核糖核酸(HBV-DNA)阴转率显著升高(P<0.05)。治疗前后,4组血钾、血钠和血醛固酮水平比较差异无统计学意义;治疗后同一时期,4组血钾、血钠、血醛固酮水平比较差异无统计学意义。治疗后,4组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆红素(TBIL)水平均较治疗前降低,白蛋白水平较治疗前升高(P<0.05);与对照组比较,A组、B组及C组TBIL水平显著降低,白蛋白水平显著升高。与对照组和A组比较,B组和C组肝肿大、乏力、食欲不振、肝区不适改善率及不良反应发生率均显著升高。结论以3周为截点,不同剂量复方甘草酸苷联合恩替卡韦对慢性乙肝患者血钠、血钾、血醛固酮水平及肝功能指标的影响与谷胱甘肽无差异,但60 mL复方甘草酸苷联合恩替卡韦治疗慢性乙肝不仅可改善患者的症状及体征,还可降低不良反应发生率。
Objective To investigate the clinical effect of different doses of compound glycyrrhizin combined with entecavir on serum potassium,sodium and aldosterone in patients with chronic hepatitis B.Methods 219 patients with chronic hepatitis B were selected and randomly divided into control group(50 cases),group A(56 cases),group B(57 cases)and group C(56 cases).All patients were treated with entecavir.On this basis,group A,group B and group C were treated with compound glycyrrhizin 40,60 and 80 mL,respectively.The levels of serum potassium,sodium,aldosterone and liver function,improvement rate of symptoms and signs and the incidence of adverse reactions were compared among the 4 groups.Results Compared with the control group,the total efficiency of A,B and C groups increased significantly(P<0.05).Compared with the control group,the negative conversion rates of HBeAg and HBV-DNA in group A,B and C were increased significantly(P<0.05).Before and after treatment,there was no significant difference in serum potassium,sodium and aldosterone levels among the groups.After treatment,the level of alanine aminotransferase(ALT),aspartic transaminase(AST)and total bilirubin(TBIL)of the 4 groups was lower on average than before treatment,and the albumin level was higher than before treatment(P<0.05).Compared with control group,the total bilirubin level in group A,B and C decreased significantly and albumin levels increased significantly.Compared with the control group and group A,the improvement rate and adverse reaction rate of hepatomegaly,fatigue,loss of appetite and liver discomfort in group B and group C were increased significantly.Conclusion At the end of 3 weeks,the effects of different doses of compound glycyrrhizic acid and entecavir on the levels of blood sodium,potassium,aldosterone and liver function in patients with chronic hepatitis B were not different from that of glutathione.However,60 mL compound glycyrrhizin combined with entecavir can not only improve the symptoms and signs of patients,but also reduce the incidence of adverse reactions.
作者
陈科帆
熊域皎
焦家欢
方平安
袁术生
CHEN Kefan;XIONG Yujiao;JIAO Jiahuan;FANG Ping′an;YUAN Shusheng(Department of Infectious Diseases,People′s Hospital of Leshan,Leshan 614000,China)
出处
《西北药学杂志》
CAS
2021年第6期985-988,共4页
Northwest Pharmaceutical Journal
基金
2017年四川省医学会感染性肝病专项科研课题(编号:2017SZJA07)。
关键词
复方甘草酸苷
恩替卡韦
慢性乙型肝炎
血钾
血钠
血醛固酮
compound glycyrrhizin
entecavir
chronic hepatitis B
blood potassium
blood sodium
serum aldosterone
作者简介
陈科帆,男,副主任医师;通信作者:袁术生,男,主任医师。
