本文關鍵詞：丙肝合劑聯(lián)合干擾素、利巴韋林治療丙肝肝硬化代償期的臨床觀察　出處：《陜西中醫(yī)學院》2014年碩士論文　論文類型：學位論文

  更多相關文章： 肝硬化代償期 氣虛血瘀淤毒型 丙肝合劑

【摘要】：目的：對2a型丙肝肝硬化代償期氣虛血瘀淤毒型患者在聚乙二醇化干擾素a-2b及利巴韋林常規(guī)抗病毒治療基礎上，聯(lián)合運用丙肝合劑，通過臨床觀察，探討該病中西醫(yī)聯(lián)合用藥可行性，為進一步推廣使用打下理論依據。 方法：HCV-RNA陽性的60例2a型丙型肝炎后肝硬化代償期患者，中醫(yī)辨證屬氣虛血瘀淤毒型，隨機分成治療組30例給予皮下注射聚乙二醇化干擾素a-2b（佩樂能）每周1次，80ug，口服利巴韋林900mg/日，并使用丙肝合劑聯(lián)合，對照組30例僅使用聚乙二醇化干擾素a-2b、利巴韋林，用法同治療組，且白細胞下降低于4×109/L時給予口服鯊肝醇及維生素B4聯(lián)合用藥，，每組療程均為24周，治療結束后24周隨訪一次，觀察患者臨床癥狀、體征、血常規(guī)、實驗室生化檢查、HCV-RNA轉陰率等相關指標的變化。 結果：對2a型丙型肝炎后肝硬化代償期患者的治療中，治療組患者血清HCV-RNA快速應答及結束時應答上與對照組無明顯差異（P0.05），無統(tǒng)計學意義。兩組在早期應答及持續(xù)應答上治療組優(yōu)于對照組（P0.05），有統(tǒng)計學意義。治療組在改善患者臨床癥狀、血常規(guī)、生化指標及影像學檢查（B超）上相比對照組有較好效果（P0.05），結果有統(tǒng)計學意義。 結論：丙肝合劑與聚乙二醇化干擾素a-2b（佩樂能）、利巴韋林聯(lián)合使用時對改善中醫(yī)辯證為氣虛血瘀淤毒型丙型肝炎后肝硬化代償期2a型患者的癥狀、生化指標、影像學改善等方面具有明顯優(yōu)勢。
[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.
【學位授予單位】：陜西中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R512.63

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