苦参素联合胸腺肽α1治疗失代偿期肝硬化的抗病毒疗效观察

Antiviral efficacy of oxymatrine and thymosin alpha 1 in treatment of decompensated cirrhosis

目的探讨苦参素联合胸腺肽α1治疗失代偿期肝硬化的抗病毒疗效。方法将42例失代偿期丙型肝炎肝硬化患者按照随机数字表分成2组,对照组(n=21)给予保肝、白蛋白基础治疗,观察组(n=21)在基础治疗之上加用苦参素、胸腺肽α1治疗,疗程48周。比较2组患者治疗前后临床症状改善、Child-Pugh评分、血生化指标、HCV-RNA(hepatitis C virus-RNA)变化情况。结果对照组65.0%患者乏力消失,62.5%患者腹胀消失,50%患者腹水消失Child-Pugh评分由治疗前的(9.7±1.4)分降至治疗后的(8.3±0.7)分,观察组85.7%患者乏力消失,87.5%患者腹胀消失,88.3%患者腹水消失Child-Pugh评分由治疗前的(9.8±1.6)分降至治疗后的(5.7±0.6)分,2组临床症状改善、Child-Pugh评分差异均具有统计学意义(P<0.05);观察组患者血生化指标改善与对照组相比有统计学意义(P<0.05);对照组治疗前后HCV-RNA无显著变化,观察组治疗前后HCV-RNA有显著性差异(P<0.05)。结论苦参素联合胸腺肽α1治疗失代偿期丙型肝炎肝硬化有效降低HCV-RNA水平,延缓肝硬化进展。

Objective To evaluate the antiviral efficacy of oxymatrine and thymosin alpha 1 in treatment of decompensated cirrhosis. Methods 41 cases with decompensated cirrhosis of hepatitis C were randomly divided into two groups according to the random number table method. Control group(n= 21) were received basic treatment of protecting liver and albumin support therapy. Observation group(n = 21) were added oxymatrine and thymosin alpha1 on the basis of basical therapy. The course of treatment was 48 weeks. Improvement of clinical symptoms,serum biochemical indexes,hepatitis C virus-RNA and Child- Pugh scores were observed and compared in two groups. Results 65. 0% patients in control group had fatigue disappears,62. 5% had bloating disappeared,50% had ascites disappeared and Child-Pugh score was from(9. 7 ± 1. 4) score to(8. 3 ± 0. 7) score; 85. 7%patients in observation group had fatigue disappears,87. 5% had bloating disappeared,88. 3% had ascites disappeared and Child-Pugh score was from(9.8 ±1.6) score to(5.7 ±0.6) score. The differences of clinical symptoms improvement and Child-Pugh scores between two groups were statistical significant(P < 0. 05). Serum biochemical indexes in observation group were improved more than control group( P < 0. 05). Compared with before treatment,HCV-RNA level had little change in control group after treatment,while had significant change in observation group(P < 0. 05). Conclusion Oxymatrine and thymosin alpha1 in treatment of decompensated cirrhosis of hepatitis C can effectively reduce the HCV- RNA level,and delay the progress of cirrhosis.