以索磷布韦为基础的直接抗病毒药物联合肝爽颗粒对慢性HCV感染的临床疗效  

Clinical efficacy of sofosbuvir-based direct-acting antivirals combined with Ganshuang granules in the treatment of chronic HCV infection

作　　者：管敏 陆爽 张先明 GUAN Min;LU Shuang;ZHANG Xianming(Department of Infectious Diseases,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院感染科,贵州贵阳550004 [2]贵州医科大学附属医院呼吸与危重症医学科,贵州贵阳550004

出　　处：《贵州医科大学学报》2025年第3期450-455,共6页Journal of Guizhou Medical University

基　　金：贵州省卫健委科技基金(gzwkj2021-090)。

摘　　要：目的观察以索磷布韦为基础的直接抗病毒药物(direct-acting antivirals,DAAs)联合肝爽颗粒治疗慢性丙型肝炎病毒(hepatitis C virus,HCV)感染的临床疗效。方法慢性HCV感染者108例,按照治疗方法不同分为以索磷布韦为基础的DAAs+肝爽颗粒组(联合用药组,n=53)及单独使用以索磷布韦为基础的DAAs组(单药组,n=55),DAAs用药12周,肝爽颗粒用药4周;于治疗4周、治疗结束及停药12周时,检测两组患者肝功能ALT、AST、GGT、ALB、CHE等指标及检测第4周快速病毒学应答率(early virologic response rate,EVR)、治疗结束时病毒学应答率(end-of-treatment virologic response,ETVR)及停药12周时持续病毒学应答率(sustained virologic response at 12 weeks,SVR12)。结果与治疗前相比,单药组和联合用药组的ALT、AST、GGT在治疗第4周、治疗结束及停药12周时均较治疗前下降,差异有统计学意义(P<0.05);与单药组相比,联合用药组的ALT、AST在治疗第4周时较单药组下降更明显,差异有统计学意义(P<0.05),联合用药组的ALT、AST的复常率在治疗第4周时较单药组更高,差异有统计学意义(P<0.05);单药组的EVR为85.5%、ETVR为100.0%、SVR12为98.2%,联合用药组的EVR为94.3%、ETVR为100.0%、SVR12为100.0%,两组的EVR、ETVR、SVR12相比较,差异均无统计学意义(P>0.05)。结论以索磷布韦为基础的DAAs联合4周肝爽颗粒的治疗慢性HCV感染的方案在抗病毒治疗4周时的ALT、AST的复常率优于单用以索磷布韦为基础的治疗方案。Objective To observe the clinical efficacy of sofosbuvir-based direct-acting antivirals(DAAs)combined with Ganshuang granules in treating patients with chronic hepatitis C virus(HCV)infection.Methods total of 108 chronic HCV-infected patients were enrolled and divided into two groups according to the treatment regimen:a combination group(sofosbuvir-based DAAs+Ganshuang Granules,n=53)and a monotherapy group(sofosbuvir-based DAAs alone,n=55).DAAs were administered for 12 weeks,while Ganshuang Granules were given for 4 weeks.Liver function parameters[alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),albumin(ALB),and cholinesterase(CHE)]were measured at week 4 of treatment,at the end of treatment,and at 12 weeks after treatment cessation.In addition,the early virologic response rate at week 4(EVR),the end-of-treatment virologic response(ETVR),and the sustained virologic response at 12 weeks post-treatment(SVR12)were evaluated.Results Compared with baseline,both the monotherapy and combination groups showed significant decreases in ALT,AST,and GGT at week 4,at the end of treatment,and at 12 weeks post-treatment(P<0.05).At week 4,compared with the monotherapy group,the combination group exhibited a significantly greater reduction in ALT and AST levels(P<0.05)and a significantly higher normalization rate of ALT and AST(P<0.05).In the monotherapy group,the EVR was 85.5%,ETVR was 100.0%,and SVR12 was 98.2%,whereas in the combination group,the EVR was 94.3%,ETVR was 100.0%,and SVR12 was 100.0%.No statistically significant differences were observed between the groups for EVR,ETVR,or SVR12(P>0.05).Conclusion The regimen of sofosbuvir-based DAAs combined with 4 weeks of Ganshuang granules in treatment of chronic HCV infection yields a superior rate of ALT and AST normalization at 4 weeks of antiviral therapy compared with sofosbuvir-based DAAs alone.

关 键 词：肝炎病毒 丙型 慢性 索磷布韦 肝爽颗粒 抗病毒疗效 药物相互作用 

分 类 号：R512.63[医药卫生—内科学]