丙肝合剂联合干扰素、利巴韦林治疗丙肝肝硬化代偿期的临床观察

发布时间：2018-01-16 13:29

本文关键词：丙肝合剂联合干扰素、利巴韦林治疗丙肝肝硬化代偿期的临床观察　出处：《陕西中医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的：对2a型丙肝肝硬化代偿期气虚血瘀淤毒型患者在聚乙二醇化干扰素a-2b及利巴韦林常规抗病毒治疗基础上，联合运用丙肝合剂，通过临床观察，探讨该病中西医联合用药可行性，为进一步推广使用打下理论依据。方法：HCV-RNA阳性的60例2a型丙型肝炎后肝硬化代偿期患者，中医辨证属气虚血瘀淤毒型，随机分成治疗组30例给予皮下注射聚乙二醇化干扰素a-2b（佩乐能）每周1次，80ug，口服利巴韦林900mg/日，并使用丙肝合剂联合，对照组30例仅使用聚乙二醇化干扰素a-2b、利巴韦林，用法同治疗组，且白细胞下降低于4×109/L时给予口服鲨肝醇及维生素B4联合用药，，每组疗程均为24周，治疗结束后24周随访一次，观察患者临床症状、体征、血常规、实验室生化检查、HCV-RNA转阴率等相关指标的变化。结果：对2a型丙型肝炎后肝硬化代偿期患者的治疗中，治疗组患者血清HCV-RNA快速应答及结束时应答上与对照组无明显差异（P0.05），无统计学意义。两组在早期应答及持续应答上治疗组优于对照组（P0.05），有统计学意义。治疗组在改善患者临床症状、血常规、生化指标及影像学检查（B超）上相比对照组有较好效果（P0.05），结果有统计学意义。结论：丙肝合剂与聚乙二醇化干扰素a-2b（佩乐能）、利巴韦林联合使用时对改善中医辩证为气虚血瘀淤毒型丙型肝炎后肝硬化代偿期2a型患者的症状、生化指标、影像学改善等方面具有明显优势。
[Abstract]:Objective: based on the routine antiviral therapy of pegylated interferon a-2b and ribavirin, the patients with type 2a liver cirrhosis in compensatory stage of Qi deficiency and blood stasis were treated with hepatitis C mixture, and the clinical observation was carried out. To explore the feasibility of combined use of traditional Chinese and western medicine, lay a theoretical basis for the further promotion of the use. Methods 60 patients with type 2a hepatitis C posthepatitic cirrhosis who were positive for HCV-RNA were treated with TCM syndrome differentiation as qi deficiency and blood stasis toxin. Patients in the treatment group were randomly divided into two groups: 30 patients in the treatment group were given subcutaneous injection of PEG-IFNa-2b (Perlergic) once a week, orally ribavirin 900mg / d, combined with Hepatitis C mixture. 30 patients in the control group were treated with only pegylated interferon a-2b and ribavirin in the same way as the treatment group, and the leukopenia was less than 4 脳 109 / L. Each course of treatment was 24 weeks, followed up 24 weeks after the end of the treatment, to observe the clinical symptoms, signs, blood routine, laboratory biochemical examination of HCV-RNA negative rate and other related indicators. Results: there was no significant difference in serum HCV-RNA response between the treatment group and the control group (P 0.05). There was no statistical significance. The treatment group was better than the control group in early response and continuous response, which had statistical significance. The treatment group was improving the clinical symptoms and blood routine. Compared with the control group, the biochemical index and imaging examination (B ultrasound) had better effect (P 0.05), and the results were statistically significant. Conclusion: the mixture of Hepatitis C and PEG-IFNa-2b (Perlergic). Ribavirin combined with ribavirin has obvious advantages in improving the symptoms, biochemical indexes and imaging improvement of patients with hepatitis C in the compensatory stage of liver cirrhosis due to deficiency of qi and blood stasis and stasis of blood stasis in traditional Chinese medicine.
【学位授予单位】：陕西中医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.63

【参考文献】