苦参素联合胸腺肽α-1治疗失代偿期肝硬化的抗病毒效果分析

摘要

目的 研究分析苦参素联合胸腺肽α-1治疗失代偿期肝硬化的方法及效果.方法 选取本院100例失代偿期丙型肝炎肝硬化患者,随机平均分为对照组与治疗组.对照组予以白蛋白、保肝基础治疗,治疗组予以苦参素联合胸腺肽α-1治疗.对比2组血生化指标、临床症状改善效果、HCV-RNA(hepatitis C virus-RNA)水平及Child-Pugh评分、不良反应.结果 治疗48周治疗组平均谷丙转氨酶[(45.3±10.9) U/L]、平均总胆红素[(30.1±2.5)μmol/L]、白蛋白水平[(36.7±2.9) g/L]、平均PT[(13.8±2.9)s],治疗24、48周谷丙转氨酶、总胆红素、白蛋白水平、PT均优于对照组(P＜0.05).治疗组治疗48周平均HCV-RNA水平[(3.01±0.28) loglOIU/ml]明显优于治疗前,且优于同期对照组(P＜0.05).治疗组治疗后乏力消失(88％)、腹胀消失(92％)、腹水消失(92％),各项症状改善率显著高于对照组(P＜0.05);治疗48周治疗组平均Child-Pugh评分[(5.5±0.1)分]优于同期对照组(P＜0.05).两组均有良好的耐受力,未见治疗相关的上消化道出血、肝性脑病、急性肝衰竭、肾功能受损等事件.结论 苦参素联合胸腺肽α-1治疗失代偿期肝硬化患者能显著抑制病毒增殖,延缓病情进展,全面改善各项指标,不良反应少,安全有效,值得推广应用.%Objective To study the method and effect of oxymatrine combined with thymosin alpha-1 in the treatment ofdecompensated cirrhosis.Methods 100 patients with decompensated hepatitis C cirrhosis were selected from our hospital and randomly divided into a control group and a treatment group.The control group were treated with albumin and liver protection therapy and the treatment group with oxymatrine and thymosin alpha-1.The blood biochemical indexes,improvement effect of clinical symptoms,HCV-RNA (hepatitis C vimsRNA) level,child Pugh score,and adverse reactions were compared between these two groups.Results after 48 weeks' treatment,the mean alanine aminotransferase was (45.3 ± 10.9) U / L,the average total bilirubin (30.1 ±2.5) mol / L,the serum albumin level (36.7 ± 2.9) g / L,and the average PT (13.8 ± 2.9) s in the treatment group;after 24 and 48 weeks' treatment,the above indicators were better in the treatment group than in the control group (P ＜ 0.05).After 48 weeks' treatment,the average HCV-RNA level was (3.01 + 0.28) loglOIU/ml in the treatment group,which was significantly better than that before the treatment and than that in the control group (P ＜ 0.05).After the treatment,the disappearance rates of fatigue,abdominal distention,and ascites were 88％,92％,and 92％ in the treatment group.The symptom improvement rate was significantly higher in the treatment group than in the control group (P ＜ 0.05).After 48 weeks' treatment,the average child Pugh score was (5.5 ± 0.1) in the treatment group,which was better than that in the control group (P ＜ 0.05).Both groups had good tolerance.No treatment-related upper gastrointestinal bleeding,hepatic encephalopathy,acute liver failure,renal function damage,etc.occurred in both groups.Conclusions Oxymatrine combined with thymosin alpha-1 in the treatment of decompensated cirrhosis patients can significantly inhibit the proliferation of virus,delay the progress of the disease,comprehensively improve the indicators,has few adverse reactions,and is safe and effective,so it is worth being generalized.