辨证论治联合抗病毒药物治疗丙型肝炎临床观察

Combination of Chinese traditional and western medicine in treating 32 patients with chronic hepatitis C

目的:探讨中药辨证论治联合西医抗病毒药物治疗慢性丙型肝炎(CHC)的临床疗效。方法:将62例CHC患者随机分成治疗组(32例)和对照组(30例),对照组采用聚乙二醇干扰素α-2a(派罗欣)180μg皮下注射,1次/周,利巴韦林1 000 mg/d口服,疗程48周;治疗组在对照组用药基础上加用中药辨证治疗24周,1剂/d,分2次口服,然后停用中药,总疗程为48周。观察两组患者治疗24周后不良反应、肝纤维化指标、临床表现、HCV RNA的改变情况。结果:治疗24周后,治疗组患者不良反应、肝纤维化指标、临床表现与对照组相比,差异有统计学意义(P<0.05);HCV RNA转阴率较对照组高,但差异无统计学意义(P>0.05)。结论:采用中药辨证论治联合西药抗病毒治疗CHC可减少抗病毒药物的不良反应,有利于疗程的顺利进行,并可延缓患者肝脏纤维化进展、显著改善临床症状,值得临床推广应用。

Objective： To explore the chinical effect of Chinese herb medicine combined with western medicine of antiviral therapy for treating chronic hepatitis C. Methods： Sixty-two patients with chronic hepatitis C were randomly divided into the treatment group （32 cases） and control group （30 cases） ; The control group using peginterferon alpha -2a （Pegasys） 180μg subcutaneous injection, 1 time a week, ribavirin 1000 mg/d by oral use. The treatment course was 48 weeks; Based on the con- trol group, the treatment group was added with Chinese medicine for 24 weeks, daily 1 agent, in 2 oral; Then deactivates the traditional Chinese medicine; The treatment com＇se was also 48 weeks; The changes of adverse reactions, indexes of hepatic fi- brosis, clinical manifestations, HCV RNA were observed ＇after 24 weeks, treatment in both groups. Results ： The improvement of adve^e reactions, indexes of hepatic fibrosis, clinical performance of treatment group were statistically significant compared with the control group （ P 〈 0. 05 ） . HCV RNA negative rate was increased compared to the control group, but the difference was not statistically significant （ P 〉 0. 05 ） . Conclusion ： The use of traditional Chinese medicine combined with antiviral therapy for chronic hepatitis C may reduce the antiviral drug adverse reaction, use of full coupe smoothly, and can delay the progress of liver fibrosis, significantly improve the clinical symptoms. It is worthy of clinical application.