愈肝龙胶囊联合抗病毒药物治疗基因1b型慢性丙型肝炎肝纤维化疗效观察

Clinical observation of Yuganlong capsule combined with Direct Antiviral Agents in treatment of liver fibrosis with Genotype 1b chronic hepatitis C

目的:观察愈肝龙胶囊联合以索磷布韦为基础的直接抗病毒药物(DAAs)治疗基因1b型慢性丙型肝炎肝纤维化的疗效。方法:82例基因1b型慢性丙型肝炎肝纤维化患者随机分为观察组42例和对照组40例,两组均给予以索磷布韦为基础的直接抗病毒药物治疗(索磷布韦+利巴韦林24周或索磷布韦+达拉他韦12周),观察组患者另加用愈肝龙胶囊治疗96周。比较两组患者病毒学应答情况,治疗前后肝脏瞬时弹性扫描仪(Fibroscan)、血清肝纤维化指标、肝肾功能及肝脏超声影像学指标。结果:两组患者HCV RNA转阴率及病毒学应答情况比较差异无统计学意义(P>0.05)。与对照组相比,观察组患者治疗后肝硬度测定值(LSM)、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)、谷丙转氨酶(ALT)、总胆红素(TBil)、门静脉内径结果均明显优于对照组,差异具有统计学意义(P<0.05)。结论:愈肝龙胶囊联合以索磷布韦为基础的DAA治疗基因1b型慢性丙型肝炎肝纤维化疗效优于单用以索磷布韦为基础的DAAs。

Objective:To observe the efficacy of Yuganlong Capsule combined with Direct Antiviral Agents(DAAs)based on Sofosbuvir in the treatment of chronic hepatitis C liver fibrosis.Methods:Prospective observation of 82 cases of liver fibrosis with genotype 1b HCV infections,42 cases were randomly divided into observation group and control group 40 cases,Both groups were treated with direct antiviral therapy on the basis of Sofosbuvir for 24 weeks(Sofosbuvir+Ribavirin OR Sofosbuvir+Daclatasvir),and patients in the observation group were additionally treated with yuganlong capsule for 96 weeks.The virological response of the two groups was observed and compared,and the Fibroscan liver hardness,serum fibrosis index,liver and kidney function,and liver ultrasound imaging were compared between the two groups at 96weeks.Results:There was no significant difference in HCV-RNA negative rate and virological response between the two groups(P>0.05).Compared with control group,the observation group of patients after treatment,Fibroscan value,HA,PCⅢ,ⅣC,ALT,TBIL and portal vein diameter results were significantly better than the control group,and the difference was statistically significant(P<0.05).Conclusion:The curative effect of yuganlong capsule combined with DAAs based on Sofosbuvir in the treatment of chronic hepatitis C liver fibrosis is better than that of DAAs based on Sofosbuvir alone.