聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎患者中医证型的变化

Effect of pegylated interferon combined with ribavirin treatment on the changes of TCM syndrome in patients with chronic hepatitis C

目的观察慢性丙型肝炎患者予聚乙二醇干扰素联合利巴韦林抗病毒治疗前后中医证型的变化。方法采用前瞻性研究方法,对54例慢性丙型肝炎患者应用聚乙二醇干扰素联合利巴韦林治疗,收集患者治疗前后的中医证候资料,并进行统计学分析。结果 54例患者治疗前后中医症状乏力、脘闷腹胀、烦燥易怒、情绪郁闷、寐差、面色萎黄、面色晦暗及舌边尖齿痕与舌质瘀点瘀斑发生率较前增多,差异有统计学意义(P<0.05)。治疗前中医证型分布规律为正虚邪恋证>肝郁脾虚证>肝肾阴虚证>湿热中阻证>脾肾阳虚证>瘀血阻络证;治疗后中医证型分布规律为肝郁脾虚证>正虚邪恋证>瘀血阻络证>脾肾阳虚证>湿热中阻证=肝肾阴虚证;治疗后肝郁脾虚证及瘀血阻络证患者比治疗前明显增多,差异有统计学意义(P<0.05)。结论聚乙二醇干扰素联合利巴韦林抗病毒治疗可对中医证型分布规律产生影响,主要表现为肝郁脾虚证及瘀血阻络证的增多。

Objective To observe the effect of pegylated interferon combined with ribavirin treatment on the changes of TCM syndrome in patients with chronic hepatitis C. Method A prospective study was conducted of fifty-four cases with chronic hepatitis C who received a treatment of pegylated interferon combined with ribavirin, the patients＇information of TCM syndrome before and after the treatment were collected and analyzed. Results The change of TCM symptom score in 54 cases before and after the treatment had significant difference（P〈0.05）. The symptoms of weakness, b]toating, depression, poor sleep, sallow complexion, dim complexion, Tongue edge, steeth marks, lingual petechia and ecchymosis were increased obviously after treatment. The distribution law of TCM syndrome in chronic hepatitis C before the treatment was syndrome of heahhy-qi deficiency and pathogen-factor lingering 〉syndrome of liver-depression and spleen-deficiency〉yin-deficiency of liver-kidney syndrome〉syndrome of dampness-heat obstructing the middle energizer〉 yang-deficiency of spleen-kidney syndrome〉syndrome of stasis-blood obstructing the collaterals; while after the treatment syndrome of liver-depression and spleen-deficiency 〉syndrome of healthy-qi deficiency and pathogen-factor lingering 〉 syndrome of stasis-blood obstructing the collaterals 〉yang-defieiency of spleen-kidney syndrome〉syndrome of dampnessheat obstructing the middle energizer=yin-deficiency of liver-kidney syndrome; the syndrome of liver-depression and spleen-deficiency and the syndrome of stasis-blood obstructing the collaterals were significantly increased after the treatment（P〈0.05）. Conclusion The antiviral treatment of pegylated interferon combined with ribavirin has an effect on distribution law of TCM syndrome, manifesting the increase of the liver-depression and spleen-deficiency syndrome and stasis-blood obstructing the collaterals syndrome.