Investigation of optimum Plan of Glucocorticoids in the Treatment of Patients With Early Severe Hepatitis

Objective To observe the clinical efficacy of different administration ways of glucocorticoids in the treatment of patients with early stage of severe hepatitis and to investigate optimum plan. Methods 68 patients with early stage of severe hepatitis were randomly divided into three groups.27 cases in treatment group A were administrated low dose dexamethasone 5mg in an interval of 48~72 hours to synthetic treatment.21 patients in treatment group B received the synthetic treatment plus 10mg dexamethasone every day for a week,then the dose of dexamethasone began to reduce gradually untill total bilirubin obviously decreased,while 20 cases in control group only received the synthetic treatment.The changes of clinical symptoms,the serum total bilirubin(TBil) and the prothrombin time(PT) in the three groups were observed before and after therapy.The side effect and complication of each group were monitored. Results After 6 weeks treatment,compared with control group,the two treatment groups can significantly decrease the level of TBil and PT(P0.05),and improve the clinical symptoms.The success rate of two treatment groups surpass the control group(P0.05).The complications of secondary infection,alimentary tract hemorrhage,hepatorenal syndrome(HRS),hepatic encephalopathy(HE) occur in control group and treatment group B more than that in treatment group A(P0.05).In-hospital time become shorter in treatment group A than in other groups. Conclusion The administration of low dose clycocorticosteroid to the early severe hepatitis had obvious effect,short course of disease and slighter side-effect.