目的：观察探讨PEG IFN （聚乙二醇干扰素）α-2a联合利巴韦林的基础上，加用芪参二莲汤治疗慢性丙型病毒性肝炎（CHC）的临床疗效。方法：选取我院2011年5月-2012年1月HCV RNA 阳性的1b型CHC患者62例随机分为两组，治疗组30例，采用PEG IFNα-2a联合利巴韦林加芪参二莲汤治疗，对照组32例应用PEG IFNα-2a联合利巴韦林治疗，疗程48周，疗程结束后随访24周。并观察治疗前、后两组患者肝功能、 HCV RNA及PBMC变化。结果：治疗组 EVR 为76.67％， ETVR 为86.67％，随访 SVR 为83.33％；对照组分别为34.37％、50.00％、31.32％。两组病毒学应答比较，治疗组EVR、 ETVR、 SVR较对照组疗效显著，其差异均具有统计学意义（ P＜0.05）。两组患者治疗48周后， ALT、 TBil与本组治疗前比较，差异均具有统计学意义（P＜0.05），其中治疗组ALT与同组治疗前比较，差异具有显著意义（ P＜0.01）；两组患者治疗48周后，两组间同时段ALT及TBil比较，治疗组更优于对照组，差异均具有统计学意义（ P＜0.05）。两组患者治疗48周后IL-10水平较本组治疗前均有所降低，差异均有统计学意义（P＜0.05）；两组间治疗后48周同时段相比较，治疗组患者改善优于对照组，差异有统计学意义（P＜0.05），随访24周，两组间比较，差异仍具有统计学意义（P＜0.05）。治疗48后两组患者IL-12水平较本组治疗前比较差异均无统计学意义（P＞0.05），但随访24周显示，治疗组IL-12水平较同时段对照组比较，差异有统计学意义（P＜0.05）。结论：芪参二莲汤加PEG IFN α-2a联合利巴韦林治疗1b型CHC疗效显著，明显优于单用干扰素联合利巴韦林的临床疗效。不仅可以显著抑制HCV RNA复制，改善肝功能，而且可以减轻不良反应，预后良好稳定，值得临床推广。%Objective: To discuss the clinical efficacy of Qishen Erlian combined with pegylated interferon α-2a plus ribavi-rin in the treatment of chronic hepatitis C genotype 1b patients.Methods: Sixty-two HCV RNA 1b chronic hepatitis C positive patients in our hospital during May 2011 to January 2012 were randomly divided into two groups, the treatment group (n=30), which were treated with Shenqi Erlian combined with PEG IFNα-2a plus ribavirin, the control group (n=32) were treated with PEG IFNα-2a and ribavirin for 48 weeks.To observed the liver function , HCV-RNA and PBMC change before and after treat-ment, and also followed up for 24 weeks.Results: In the treatment group , EVR was 76.67%, ETVR was 86.67%, SVR was 83.33%;EVR was 34.37%, ETVR was 50.00%and SVR was 31.32%in control group , effect was significant compared with the control group at virological response , the differences were statistically significant ( P<0.05 ) .After 48 weeks′treatment , ALT, TBil was significant declined compared with the same group pre-treatment, the differences were statistically significant (P <0.05), and ALT declined more significant in treatment group , the difference was significant (P<0.01) ;compared with the control group after 48 weeks′treatment, the treatment group was better than the control group , the differences were statistically significant ( P<0.05 ) .Both groups of patients after 48 weeks of treatment , IL-10 levels were decreased compared with pre-treatment, the differences were statistically significant (P<0.05);compared with the control group after 48 weeks′treatment, the treatment group was better than the control group , the differences were statistically significant ( P <0.05 ) , followed up for 24 weeks between the two groups , the difference was still statistically significant (P<0.05) .There was no statistically signifi-cant difference at IL-12 after 48 weeks′treatment (P>0.05), compared with the control group, the level of IL-12 in treatment group was higher than the control group at follow-up of 24 weeks.the difference was statistically significance ( P<0.05) .Con-clusion: The clinical efficacy of Qishen Erlian combined with pegylated interferon α-2a plus ribavirin was better than pegylated interferon α-2a with ribavirin significantly.Not only can significantly inhibit HCV RNA replication , improve liver function , and can reduce the adverse reaction , worthy of promotion.
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