Analysis of clinical effects and prognosis of patients with early-mid stage chronic severe hepatitis B treated with integrated traditional and western medicine
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摘要: 目的通过对214例早中期慢性乙型重型肝炎患者中西医结合治疗的临床研究,探讨中西医结合治疗方案疗效以及相关因素对预后的影响。方法所有病例均采用常规中西医结合治疗措施,包括保肝、退黄、抗病毒、对症支持及中医辩证治疗,对其治疗前后相关指标及预后进行统计分析。结果 214例早中期慢性乙型重型肝炎患者治疗总有效率63.1%,无效率36.9%;治疗前后自身对比,TBil、DBil、ALT、AST、PAT、Chol、TG、HBV DNA等指标均有明显改善(P<0.05)。抗病毒药物使用、电解质紊乱、肝肾综合征和治疗后重型肝炎分期为预后的强影响因素(P<0.05)。抗病毒药物中恩替卡韦组及拉米夫定组有效率较高(P<0.05)。结论中西医结合治疗慢性乙型重型肝炎早、中期患者可以取得良好的治疗效果,合并电解质紊乱、肝肾综合征的患者预后较差,选择恩替卡韦或拉米夫定可能会提高有效率。Abstract: Objective Clinical analysis of 214 cases of early-mid stage chronic severe hepatitis B was performed to explore the effects of integrated treatment and the prognosis of related factors.Methods All the cases were treated with routine integrated traditional and western medicine, including hepatocytes protection, jaundice-relieving, antivirus, support and other symptomatic treatments.Results The total effective rate was 63.1% from 214 cases of chronic severe hepatitis B and ineffective rate was 36.9%.It shows that there are significant improvements in serum total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, prothrombin activity, total cholesterol, triglycerides, HBV DNA and other indicators between pretreatment and treatment outcome (P<0.05) .The significant prognostic factors involve the use of different anti-virus drug, electrolyte disturbances, hepatorenal syndrome and the chronic severe hepatitis B stage after treatment (P<0.05) .Among different groups of various antiviral drugs, entecavir group and lamivudine group appears to be more effective (P<0.05) .Conclusion Integrated traditional and western medicine treatment can achieve good therapeutic effects for early-mid stage chronic severe hepatitis B patients.The prognosis of patients with electrolyte disturbances or hepatorenal syndrome is worse.Better effects may be obtained by using antiviral drugs such as entecavir or lamivudine.
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Key words:
- hepatitis B /
- chronic
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