甘草酸二铵联合富马酸丙酚替诺福韦治疗恩替卡韦应答不佳慢性乙型病毒性肝炎的疗效  

Clinical efficacy of diammonium glycyrrhizinateenteric coated capsules combined with tenofovir alafenamide fumarate in the treatment of chronic viral hepatitis B with suboptimal response to entecavir

作　　者：刘柏林 谢宁 高世定 熊勰 章丽艳 曹雯雯 LIU Bolin;XIE Ning;GAO Shiding;XIONG Xie;ZHANG Liyan;CAO Wenwen(Department of Infections Diseases,the 908th Hospital of the Joint Logistics Support Force,Nanchang 330000,China;Department of Oncology,the 908th Hospital of the Joint Logistics Support Force,Nanchang 330000,China;Department of General Surgery,the 908th Hospital of the Joint Logistics Support Force,Nanchang 330000,China;Department of Neurosurgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]联勤保障部队第908医院感染科,南昌330000 [2]联勤保障部队第908医院肿瘤科,南昌330000 [3]联勤保障部队第908医院普外科,南昌330000 [4]南昌大学第一附属医院神经外科,南昌330006

出　　处：《临床药物治疗杂志》2025年第3期68-73,共6页Clinical Medication Journal

基　　金：江西省卫生健康委科技计划项目(202311390)。

摘　　要：目的探究甘草酸二铵肠溶胶囊联合富马酸丙酚替诺福韦治疗恩替卡韦应答不佳慢性乙型病毒性肝炎(CHB)的疗效。方法选取联勤保障部队第908医院2022年3月至2024年4月诊治的恩替卡韦应答不佳的CHB患者,随机分为观察组和对照组。对照组采用富马酸丙酚替诺福韦治疗,观察组在此基础上联用甘草酸二铵肠溶胶囊治疗。比较两组临床疗效、肝功能、炎症细胞因子水平、肝纤维化、氧化应激指标水平、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量、乙型肝炎病毒表面抗原(HBsAg)水平、HBV-DNA转阴率和ALT复常率,记录不良反应发生情况。结果共纳入患者120例,观察组与对照组各60例。干预12周、24周,观察组总胆红素、ALT、AST均低于对照组(P<0.05),透明质酸酶、层黏连蛋白、IV型胶原水平均低于对照组(P<0.05),IL-2、干扰素γ水平均高于对照组(P<0.05),IL-4水平均低于对照组(P<0.05),丙二醛水平均低于对照组(P<0.05),谷胱甘肽过氧化物酶、超氧化物歧化酶水平均高于对照组(P<0.05),总有效率93.33%高于对照组的71.67%(P<0.05),HBV-DNA载量、HBsAg水平均低于对照组(P<0.05),HBV-DNA转阴率、ALT复常率均高于对照组(P<0.05)。结论对于恩替卡韦应答不佳的CHB患者,采用甘草酸二铵肠溶胶囊联合富马酸丙酚替诺福韦治疗,患者HBV-DNA转阴率高,疗效佳且安全性高。Objective To investigate the efficacy of enteric-coated diammonium glycyrrhizinatecapsule combined with tenofovir alafenamidefumarate in the treatment of chronic viral hepatitis B(CHB)patients with suboptimal response to entecavir,and the effects of cytokines,oxidative stress and HBV negative conversion rate.Methods A total of 120 CHB patients with poor response to entecavir treated in the 908 Hospital of the Joint Logistics Support Force from March 2022 to April 2024 were selected and randomly divided into an observation group and a control group,with 60 patients in both the observation group and the control group.The control group was treated with tenofovir alafenamide fumarate alone,while the observation group received additional diammonium glycyrrhizinate enteric-coated capsules.The clinical efficacy,liver function,liver fibrosis,inflammatory cytokines levels,oxidative stress index levels hepatitis B virus deoxyribonucleic acid(HBV-DNA)load,HBsAg level,were compared between the two groups,HBV-DNA negative conversion rate and ALT normality rate were recorded,and the occurrence of adverse reactions were recorded.Results After 12 and 24 weeks of intervention,the observation group showed significantly lower levels of total bilirubin,ALT,AST,hyaluronidase,laminin,type IV collagen,IL-4,and malondialdehyde compared to the control group(all P<0.05).The observation group also exhibited higher levels of IL-2,interferon-γ,glutathione peroxidase,and superoxide dismutase(all P<0.05).The total clinical efficacy rate in the observation group(93.33%)was significantly higher than that in the control group(71.67%)(P<0.05).Additionally,the observation group had lower HBV-DNA load and HBsAg levels,as well as higher HBV-DNA negative conversion rate and ALT normalization rate(all P<0.05).Conclusion For CHB patients with poor response to entecavir,the combination of enteric-coated diammonium glycyrrhizinate capsule and tenofovir alafenamide fumarate for treatment has a high HBV-DNA negative conversion rate,excellent efficacy,and g

关 键 词：甘草酸二铵肠溶胶囊 富马酸丙酚替诺福韦 慢性乙型肝炎 疗效 

分 类 号：R978.7[医药卫生—药品] R512.6[医药卫生—药学] R373.2