中西医结合治疗早中期慢性乙型重型肝炎154例临床分析  

Clinical analysis of 154 patients with early-mid stage chronic severe hepatitis B treated by integrated traditional and western medicine

作　　者：王立福[1] 李筠[1] 杨慧银[1] 周双男[1] 白云峰[1] 张晓峰[1] 李丰衣[1] 何卫平[1] 陈菊梅[1] 

机构地区：[1]中国人民解放军第302医院感染科,北京100039

出　　处：《中西医结合肝病杂志》2010年第4期197-199,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家"十一五"传染病重大专项课题资助(No.2008ZX10005-007);军队"十一五"中医药研发推广专项重大临床攻关项目资助(No.2006231001)

摘　　要：目的:通过对154例早中期慢性乙型重型肝炎中西医结合治疗的临床分析,探讨有关治疗方案及选择使用不同的核苷类抗病毒药物对预后的影响。方法:所有病例均采用常规中西医结合保肝、退黄、抗病毒、支持、对症等治疗,部分病例应用人工肝治疗。结果:154例慢性乙型重型肝炎患者总有效率64.3%,在院病死率1.3%,无效率34.4%;治疗前后自身对比,血清总胆红素(TBil)、直接胆红素(DBil)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胆碱酯酶(Che)、凝血酶原活动度(PTA)、总胆固醇(TC)、甘油三酯(TG)等指标均有明显改善(P<0.05)。抗病毒药物当中恩替卡韦及拉米夫定组有效率较高。结论:慢性乙型重型肝炎早期、中期患者,中西医结合治疗可以取得良好的治疗效果,选择单一快速起效的恩替卡韦或拉米夫定可能会提高有效率。Objective：Clinical analysis of 154 cases of early-mid stage chronic severe hepatitis B to explore effective treatment and the effects on prognosis of different nucleoside analogue choices.Methods：All cases were treated by routine integrated traditional and western medicine liver protection,jaundice-relieving,antivirus,support and other symptomatic treatment,some cases were applied artificial liver treatment.Results：The total effective rate is 64.3% from 154 cases of chronic severe hepatitis B,fatality rate in hospital is 1.3%,invalid rate is 34.4% It shows that there are significant improvements in serum total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,cholinesterase,prothrombin activity,total cholesterol,triglycerides and other indicators after treatment,and P〈0.05.Among different groups of various antiviral drugs,entecavir group and lamivudine group appears to be more effective.Conclusion：Integrated traditional and western medicine treatment can achieve good therapeutic effects for early-mid stage chronic severe hepatitis B patients,and better effects may be obtained by selecting a rapid onset medicine such as entecavir of lamivudine.

关 键 词：重型肝炎 中西医结合 抗病毒 

分 类 号：R512.62[医药卫生—内科学]