愈肝逍遥散联合干扰素α、利巴韦林治疗慢性丙型肝炎肝郁脾虚证43例

Forty Three Cases with Chronic Hepatitis C Due to Liver Depression and Spleen Deficiency Treated with Yugan Xiaoyao Powder Combined with Interferonα and Ribavirin

目的:观察愈肝逍遥散联合干扰素α、利巴韦林治疗慢性丙型肝炎肝郁脾虚证的疗效。方法:选择2011年1月—2015年3月在江苏省丹阳市人民医院感染科住院或肝病门诊就诊的慢性丙型肝炎肝郁脾虚证患者86例,按照随机数字表法分为对照组和治疗组,每组43例。治疗组给予愈肝逍遥散联合干扰素α、利巴韦林治疗,对照组给予多烯磷脂酰胆碱胶囊联合干扰素α、利巴韦林治疗。结果:治疗组治疗后中医证候积分优于对照组(P<0.01);治疗组有效率88.37%,对照组有效率62.79%,治疗组优于对照组(P<0.05);停药6个月后,治疗组有效率79.07%,复发率4.65%,对照组有效率46.52%,复发率20.93%,治疗组均优于对照组(P<0.05或P<0.01);治疗组治疗后肝脏B型超声直方图灰阶值优于治疗前(P<0.05),但与对照组治疗后比较,无统计学意义(P>0.05);治疗组治疗后TC、HDL-C水平优于对照组(P<0.05);治疗组治疗后抗HCV阴转率、HCV RNA病毒载量下降率和HCV RNA阴转率优于对照组(P<0.05);治疗组治疗后TBIL、ALT、AST水平优于对照组(P<0.05);治疗组治疗后肝纤维化指标均优于对照组(P<0.01)。结论:愈肝逍遥散联合干扰素α、利巴韦林治疗慢性丙型肝炎肝郁脾虚证疗效显著,副作用少、安全度高,复发率低。

Objective：To observe the clinical effects of Yugan Xiaoyao Powder combined with Interferonct and Ribavirin on chronic hepatitis C due to liver depression and spleen deficiency. Methods：Totally 86 patients with ehronic hepatitis C due to liver depres- sion and spleen deficiency treated in tile Infections Department of Jiangsu Provineial Danyang hospital between January 2011 and March 2015 were randomized into control group and treatment group, with 43 cases in each group. Treatment group were treated with Yugan Xiaoyao Powder combined with Interferonctand Ribavirin while control group were given Phosphatidylcholine Capsules combined with Interferonc and Ribavirin. Results ： After treatment, the TCM symptom scores in treatment group were better than these in control group （P 〈0.01 ）. The effective rate was 88.37% in treatment group and 62.79% in control group;treatment group were better than control group （t7 〈 0.05）. Six months after drug withdraw, the efteetive rate was 79.07% in treatment group and 46.52% in control group;the recurrence rate was 4.65% in treatment group and 20.93% in control group;treatment group were better than control group（ P 〈 0.05 or P 〈 0.01 ）. According to the liver B-mode ultrasounic histogram, the gray-scale values in both groups were better than these before treatment group （ P 〈 0.05）, but the difference between the two groups had no statistical significance （ P 〉 0.05 ）. The levels of TC and HDL-C in treatment group were better than these in control group （ P 〈 0.05）. The anti-HCV negative conversion rate, viral load scale of deerease rate and the HCV RNA negative conversion rate in treatment group were better than these in control group （P 〈 0.05 ）. After treatment, the levels of TBIL, ALT and AST in treatment group were better than these in control group （P 〈 0.05 ）. The hepatic fibrosis index in treatment group was better than that in control group （ P 〈 0.01 ）. Conclusion ： Yugan Xiaoyao Powder combined with Interferon a and Ribavirin has remarkable therapeu- tic eftcts on chronic hepatitis C due to liver depression and spleen deficiency,which is of high safety and little side effects and low recurrenee rate.