胸腺肽α1联合宣通化瘀汤治疗急性病毒性黄疸型甲型肝炎的临床研究

Clinical study of thymosinα1 combined with Xuantong Huayu decoction in the treatment of acute viral icteric hepatitis A

目的:研究胸腺肽α1联合宣通化瘀汤治疗急性病毒性黄疸型甲型肝炎(AVJH-A)的临床疗效。方法:选择2016年1月至2018年6月就诊的AVJH-A患者158例,依据随机数字表法将158例AVJH-A患者分为联合组(n=79)和胸腺肽α1组(n=79),胸腺肽α1组给予胸腺肽α1治疗,联合组在胸腺肽α1组治疗基础上联合宣通化瘀汤治疗。比较两组治疗前后血清直接胆红素(DBil)、总胆红素(TBil)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)与碱性磷酸酶(ALP)等血清学指标,CD 4+、CD 8+、CD 4+/CD 8+等细胞免疫指标,中医证候积分、不良反应及临床疗效。结果:治疗后,联合组DBil、TBil、AST、ALT、ALP均低于胸腺肽α1组,CD 4+、CD 4+/CD 8+大于胸腺肽α1组,CD 8+低于胸腺肽α1组,各中医症状积分均低于胸腺肽α1组(P<0.05)。联合组总有效率(92.41%)高于胸腺肽α1组(79.75%)(P<0.05)。两组均无不良反应。结论:胸腺肽α1联合宣通化瘀汤治疗AVJH-A可有效改善患者血清学、细胞免疫学指标及中医证候积分,疗效显著,安全可靠。

Objective:to study the clinical efficacy of thymosinα1 combined with Xuantong Huayu Decoction in the treatment of acute viral icteric hepatitis A(AVJH-A).Methods:158 patients with AVJH-A in our hospital from January 2016 to June 2018 were selected and randomly divided into combination group(n=79)and thymosinα1 group(n=79).Thymosinα1 group was treated with thymosinα1,and the combination group was treated with Xuantong Huayu Decoction on the basis of thymosinα1 group.The serum direct bilirubin(DBil),total bilirubin(TBil),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and alkaline phosphatase(ALP)were compared between the two groups before and after treatment,and the cellular immune indexes such as CD 4+,CD 8+,CD 4+/CD 8+were also compared.Results:After treatment,DBil,TBil,AST,ALT and ALP in the combined group were lower than those in the thymosinα1 group,CD 4+,CD 4+/CD 8+were higher than those in the thymosinα1 group,CD 8+was lower than those in the thymosinα1 group,and the TCM symptom scores in the combined group were lower than those in the thymosinα1 group(P<0.05).The total effective rate of combined group was higher than that of thymosinα1 group(92.41%vs 79.75%,P<0.05).There were no adverse reactions in both groups;Conclusion:Thymosinα1 combined with Xuantong Huayu Decoction in the treatment of AVJH-A can effectively improve the serological,cellular immunologic indexes and TCM syndrome score of the patients.