复方甘草酸苷(美能)治疗活动性肝炎肝硬化的疗效观察  

One year and half treatment with Compound Glycyrrhizin in active cirrhosis resulting from chronic hepatitis B

作　　者：宋振民[1] 梁永广[1] 张文周[1] 

机构地区：[1]山东省聊城市人民医院,山东聊城252000

出　　处：《中国现代中药》2006年第1期22-24,共3页Modern Chinese Medicine

摘　　要：目的:观察活动性肝炎肝硬化患者复方甘草酸苷长程治疗的疗效及对停药后肝功能异常的对策探讨。方法:静脉注射复方甘草酸苷60mL,每日1次,连用18个月治疗活动性肝炎肝硬化患者58例。观察治疗前后的临床症状体征、生化指标、病毒学改变情况,停药后情况及对策探讨。结果:(1)35例(74.5%)患者治疗后病情缓解稳定,生化指标改善;Child-Pugh积分下降;肝功能恢复正常或好转。(2)HBVDNA下降>103拷贝/mL,HBeAg转阴率达33.3%(13/39)。(3)10例停药后,在3～6个月随访期间肝炎复发再次住院。停药后肝功能异常的治疗:2例用干扰素治疗1个月后出现黄疸、肝损害加重,立即停药保肝处理后缓解;8例患者未加任何抗病毒药物,经加强保肝、调节免疫等治疗后肝功能得到改善。结论:乙型肝炎后肝硬化患者伴有活动性病毒复制及肝炎时,长程复方甘草酸苷治疗可改善肝功能,阻止病情进展,提高生活质量,停药后肝炎活动不宜应用干扰素治疗。Objective： To study the therapy effect of long term Compound Glycyrrhizin treatment on active cirrhosis following chronic hepatitis B, and explore the method for abnormalities resulting from Compound Glycyrrhizin withdrawing. Method： 58 patients received Compound Glycyrrhizin 60mL orally everyday for 18 months. The changes were observed and wrote down, including clinical symptoms and signs, aminotransferase, virology indexes, and the abnormalities after Compound Glycyrrhizin withdrawing, then further to find out plans for the later. Results： （1）After Compound Glycyrrhizin treatment there were 35 patients whose situation stabilized life quality improved, Child-Pugh score declined, and liver function tuned better. （2）The level of HBV DNA decreased at least 10^3copies/mL, HBeAg of 33.3%patients （13/39）became negative. （3）Among the 10 patients who stopped Compound Glycyrrhizin of there own accord, and came again after 3 -6 months because of hepatitis B recurring, two were treated with interferon for one month, then turning to liver-protecting methods for deteriorating, the other eight only received liver-protecting and immune-regulating treatment, whose liver function improved. Conclusions： Long term treatment with Compound Glycyrrhizin for active cirrhosis following hepatitis B can improve liver function and life quality, prevent exacerbation. And it is not advisable at use interferon for hepatitis B relapsing after Compound Glycyrrhizin withdrawing.

关 键 词：慢性乙型肝炎 肝硬化 治疗学 复方甘草酸苷 美能 

分 类 号：R259.752[医药卫生—中西医结合]