本文選題：聚乙二醇干擾素α-a + 利巴韋林　； 參考：《重慶醫(yī)學(xué)》2017年32期

【摘要】：目的研究聚乙二醇干擾素α-2a(PEG-IFNα-2a)和利巴韋林聯(lián)合自擬中藥復(fù)方治療肝腎陰虛夾濕熱型慢性丙型肝炎(CHC)患者的臨床療效。方法將該院確診的59例肝腎陰虛夾濕熱型CHC患者按隨機數(shù)字表法分為對照組(29例)和聯(lián)合組(30例),對照組患者給予PEG-IFNα-2a注射液和利巴韋林治療,聯(lián)合組患者在此基礎(chǔ)上加用自擬中藥復(fù)方進(jìn)行治療,比較兩組患者治療前后中醫(yī)癥狀分級量化積分差異、肝功能改善情況、丙型肝炎病毒(HCV)RNA陰轉(zhuǎn)率、炎癥因子、臨床療效的總有效率及不良反應(yīng)的發(fā)生情況。結(jié)果聯(lián)合組患者治療后脅肋疼痛、腰膝酸軟、腕腹脹悶、舌紅苔黃、頭昏身重、失眠多夢的中醫(yī)癥狀分級量化積分均低于對照組(P0.05),其他中醫(yī)癥狀分級量化積分差異無統(tǒng)計學(xué)意義(P0.05)。聯(lián)合組患者治療48周后丙氨酸轉(zhuǎn)氨酶(ALT)、天冬氨酸轉(zhuǎn)氨酶(AST)、總膽紅素(TBIL)改善情況優(yōu)于對照組(P0.05),但兩組清蛋白(ALB)、谷氨酰轉(zhuǎn)肽酶(GGT)差異無統(tǒng)計學(xué)意義(P0.05)。聯(lián)合組患者在治療36、48周時的HCV RNA陰轉(zhuǎn)率要高于對照組(P0.05),但在治療12、24周及隨訪24周時差異無統(tǒng)計學(xué)意義(P0.05)。聯(lián)合組患者治療48周后炎癥因子IL-21、IL-6、TNF-α指標(biāo)水平低于對照組(P0.05)。聯(lián)合組的臨床療效的總有效率要優(yōu)于對照組(93.33%vs.72.41%,P0.05)。兩組治療中發(fā)生的不良反應(yīng)差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論采用PEG-IFNα-2a(PEG-IFNα-2α)、利巴韋林聯(lián)合自擬中藥復(fù)方治療CHC,能明顯改善患者的臨床癥狀和肝功能指標(biāo),提高HCV RNA陰轉(zhuǎn)率,降低炎癥因子水平
[Abstract]:Objective to study the clinical effect of PEG-IFN 偽 -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 偽 -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- 偽 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- 偽 -2a- PEG-IFN- 偽 -2 偽 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.
【作者單位】： 貴州省黔南州人民醫(yī)院感染科;
【分類號】：R512.63
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本文編號：2049406