温经托毒方联合聚乙二醇干扰素α-2a和利巴韦林治疗慢性丙型肝炎的临床研究  

Clinical study of Wenjing Tuodu Prescription combined with Peginterferon α-2a and Ribavirin in the treatment of chronic hepatitis C

作　　者：吴艺锋 吴容芳 WU Yi-feng;WU Rong-fang(Department of Infectious Diseases, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine,Guangzhou 528000, China;Department of Nephropathy, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou 528000, China)

机构地区：[1]广东省中西医结合医院感染科,广东广州528000 [2]广东省中西医结合医院肾病科,广东广州528000

出　　处：《中国当代医药》2018年第33期26-29,共4页China Modern Medicine

摘　　要：目的综合分析温经托毒方联合聚乙二醇干扰素α-2a和利巴韦林治疗慢性丙型肝炎的临床效果。方法选取2016年9月～2017年8月本院收治的28例慢性丙型肝炎患者,按照入院顺序随机分为实验组与对照组,各14例。实验组采用温经托毒方联合聚乙二醇干扰素α-2a和利巴韦林治疗方法,对照组采用聚乙二醇干扰素α-2a和利巴韦林治疗方法。比较两组患者治疗前、治疗12周、治疗48周以及停药后8周的丙型肝炎病毒(HCV)RNA转阴率、血清T淋巴细胞亚群(CD3^+、CD4^+、CD8^+以及CD4^+/CD8^+比值)以及治疗前、治疗48周的肝纤维化指标(透明质酸、层粘连蛋白、Ⅲ型前胶原肽、Ⅳ型胶原)、肝脏硬度测量(LSM)值、中医证候积分。结果两组治疗12周、治疗48周以及停药后8周的HCV RNA转阴率比较,差异无统计学意义(P>0.05)。两组治疗前的中医证候积分比较,差异无统计学意义(P>0.05)。两组患者治疗48周后的中医证候积分均较治疗前升高(P<0.05),但实验组的中医证候积分升高幅度低于对照组(P<0.05)。两组患者治疗前的CD3^+、CD4^+、CD8^+以及CD4^+/CD8^+值比较,差异无统计学意义(P>0.05)。实验组治疗后48周以及停药后8周的CD3^+、CD4^+、CD8^+、CD4^+/CD8^+所占比例显著高于对照组(P<0.05)。两组患者治疗前的肝纤维化指标比较,差异无统计学意义(P>0.05)。两组患者治疗后48周的肝纤维化指标比较,差异有统计学意义(P<0.05)。两组治疗前的LSM值比较,差异无统计学意义(P>0.05)。两组治疗后的LSM值均低于治疗前(P<0.05),实验组治疗后的LSM值显著低于对照组(P<0.05)。结论温经托毒方联合聚乙二醇干扰素α-2a和利巴韦林治疗慢性丙型肝炎的临床效果显著。Objective To comprehensively analyze the clinical effect of Wenjing Tuodu Prescription combined with Peginterferon α-2 a and Ribavirin in the treatment of chronic hepatitis C. Methods From September 2016 to August2017, 30 patients with chronic hepatitis C admitted to our hospital were randomly divided into the experimental group and the control group according to on the sequence of admission to the hospital, 14 cases in each group. The experimental group was treated with Wenjing Tuodu Prescription combined with Peginterferon α-2 a and Ribavirin, and The control group was treated with Peginterferon α-2 a and Ribavirin. The negative conversion rate of(HCV) RNA before treatment, 12 weeks after treatment, 48 weeks after treatment, and 8 weeks after drug discontinuing, the serum lymphocyte subsets including CD3^+, CD4^+, CD8^+and CD4^+/CD8^+ratio, the indexes of liver fibrosis such as hyaluronic acid,laminin, Ⅲ procollagen peptide, and Ⅳ collagen before treatment and 48 weeks after therapy, liver stiffness measurement(LSM), and scores of traditional Chinese medicine(TCM) pattern were analyzed in the two groups. Results There was no significant difference in HCV RNA negative conversion rate at 12 weeks after treatment, 48 weeks after treatment and 8 weeks after drug withdrawal between the two group(P>0.05). Before treatment, there was no significant difference in the TCM syndrome score between the two groups(P >0.05). After 48 weeks of treatment, TCM syndrome scores of the two groups were significantly increased than those before treatment(P<0.05), but the increase range in the experimental group was less than that in the control group(P<0.05). Before treatment, there was no significant difference in CD3^+, CD4^+, CD8^+and CD4^+/CD8^+ratio between the two groups(P>0.05). After 48 weeks and 8 weeks of drug discontinuing, the proportions of CD3^+, CD4^+, CD8^+and CD4^+/CD8^+ratio in the experimental group were all significantly higher than those in the control group(P<0.05). No statistical difference was displayed

关 键 词：温经托毒方 聚乙二醇干扰素Α-2A 利巴韦林 慢性丙型肝炎 

分 类 号：R512.63[医药卫生—内科学]