PEG-IFNα-2a和利巴韦林联合自拟中药复方治疗慢性丙型肝炎的临床疗效

发布时间：2018-06-21 16:10

  本文选题：聚乙二醇干扰素α-a + 利巴韦林　； 参考：《重庆医学》2017年32期

【摘要】：目的研究聚乙二醇干扰素α-2a(PEG-IFNα-2a)和利巴韦林联合自拟中药复方治疗肝肾阴虚夹湿热型慢性丙型肝炎(CHC)患者的临床疗效。方法将该院确诊的59例肝肾阴虚夹湿热型CHC患者按随机数字表法分为对照组(29例)和联合组(30例),对照组患者给予PEG-IFNα-2a注射液和利巴韦林治疗,联合组患者在此基础上加用自拟中药复方进行治疗,比较两组患者治疗前后中医症状分级量化积分差异、肝功能改善情况、丙型肝炎病毒(HCV)RNA阴转率、炎症因子、临床疗效的总有效率及不良反应的发生情况。结果联合组患者治疗后胁肋疼痛、腰膝酸软、腕腹胀闷、舌红苔黄、头昏身重、失眠多梦的中医症状分级量化积分均低于对照组(P0.05),其他中医症状分级量化积分差异无统计学意义(P0.05)。联合组患者治疗48周后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)改善情况优于对照组(P0.05),但两组清蛋白(ALB)、谷氨酰转肽酶(GGT)差异无统计学意义(P0.05)。联合组患者在治疗36、48周时的HCV RNA阴转率要高于对照组(P0.05),但在治疗12、24周及随访24周时差异无统计学意义(P0.05)。联合组患者治疗48周后炎症因子IL-21、IL-6、TNF-α指标水平低于对照组(P0.05)。联合组的临床疗效的总有效率要优于对照组(93.33%vs.72.41%,P0.05)。两组治疗中发生的不良反应差异无统计学意义(P0.05)。结论采用PEG-IFNα-2a(PEG-IFNα-2α)、利巴韦林联合自拟中药复方治疗CHC,能明显改善患者的临床症状和肝功能指标,提高HCV RNA阴转率,降低炎症因子水平
[Abstract]:Objective to study the clinical effect of PEG-IFN 伪 -2a) and ribavirin in the treatment of chronic hepatitis C with liver and kidney yin deficiency and dampness heat. Methods 59 CHC patients with liver and kidney yin deficiency and damp-heat type were randomly divided into control group (n = 29) and combined group (n = 30). The control group was treated with PEG-IFN 伪 -2a injection and ribavirin. On this basis, the patients in the combined group were treated with self-made traditional Chinese medicine compound. The difference of TCM symptom grading and quantitative score, the improvement of liver function, the negative rate of HCV RNA, and the inflammatory factor were compared between the two groups before and after treatment. Total effective rate of clinical efficacy and occurrence of adverse reactions. Results after treatment, the patients in the combined group suffered from rib pain, sore waist and knee, abdominal distention of the wrist, yellow tongue, dizzying weight. The scores of TCM symptom classification and quantification of insomnia and dreams were lower than that of the control group (P 0.05), but there was no significant difference in other Chinese medicine symptom classification and quantification scores (P 0.05). The improvement of alanine aminotransferase (alt), aspartate transaminase (AST) and total bilirubin (TBIL) in the combined group was better than that in the control group (P 0.05) after 48 weeks of treatment, but there was no significant difference between the two groups in the level of serum albumin and glutamyl transpeptidase (GGTs). The negative conversion rate of HCV RNA in the combined group was higher than that in the control group at 36-48 weeks, but there was no significant difference between the two groups at the 12th week and the follow up at the 24th week. After 48 weeks of treatment, the level of IL-21 and IL-6 TNF- 伪 in the combined group was lower than that in the control group (P 0.05). The total effective rate of the combined group was better than that of the control group (93.33 vs.72.41). There was no significant difference in adverse reactions between the two groups (P 0.05). Conclusion the treatment of CHCs with PEG-IFN- 伪 -2a- PEG-IFN- 伪 -2 伪 and ribavirin combined with traditional Chinese medicine can obviously improve the clinical symptoms and liver function, increase the negative conversion rate of HCV RNA, and decrease the level of inflammatory factors.
【作者单位】： 贵州省黔南州人民医院感染科;
【分类号】：R512.63
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本文编号：2049406