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[目的]探讨PEG IFNα-2a联合利巴韦林加芪参二莲汤对慢性丙型肝炎(chronic hepatitis C,CHC)患者肝功能、HCV RNA及外周血单个核细胞(Peripheral blood mononuclear cell,PBMC)的影响。[方法]选取于2010年4月~2015年10月入我院肝病科诊治的慢性丙型肝炎患者100例,均为HCV RNA阳性1b型,随机等分为实验组和对照组,其中,对照组予PEG IFNα-2a联合利巴韦林治疗,实验组予PEG IFNα-2a联合利巴韦林加芪参二莲汤治疗,2组患者均治疗48周,治疗结束后,随访24周,收集2组患者的肝功能、HCV RNA及PBMC,进行治疗前后对比和组间对比,分析是否有差异。[结果]在病毒学应答方面,治疗组EVR、ETVR、随访SVR分别为76%、86%、84%,对照组分别为34%、50%、30%,实验组病毒学应答明显优于对照组,且差异具有统计学意义(P<0.01);与治疗前比较,2组患者治疗后ALT、TBiL均显著下降,且差异有统计学意义(P<0.05),治疗结束后,对比同时段2组患者的ALT和TBiL,实验组明显优于对照组,且差异有统计学意义(P<0.01);与治疗前比较,2组患者治疗后IL-10均显著下降,且差异具有统计学意义(P<0.05),治疗结束后,对比同时段2组患者IL-10,实验组明显优于对照组,且差异具有统计学意义(P<0.01),随访24周后对比,实验组仍优于对照组(P<0.01);对比2组患者治疗前后IL-12,差异无统计学意义(P>0.05),随访24周后组间对比显示,实验组优于同时段对照组,差异具有统计学意义(P<0.01)。[结论]相比于单用干扰素联合利巴韦林,PEG IFNα-2a联合利巴韦林加芪参二莲汤对1b型丙型肝炎患者能更好改善患者肝功能、抑制HCV RNA复制,对患者而言有着更好的疗效和预后。
[Objective] To investigate the effects of PEG IFNα-2a combined with ribavirin and qi-shen-xianlian decoction on liver function, HCV RNA and Peripheral blood mononuclear cell (PBMC) in patients with chronic hepatitis C (CHC) )Impact. [Methods] A total of 100 patients with chronic hepatitis C who were admitted to our hospital from April 2010 to October 2015 were enrolled in this study. All of them were HCV RNA positive type 1b and were randomly divided into experimental group and control group. Among them, Group was treated with PEG IFNα-2a combined with ribavirin. The experimental group was treated with PEG IFNα-2a plus ribavirin and Qidingshenlian Decoction. The patients in both groups were treated for 48 weeks. After the treatment, they were followed up for 24 weeks. Two groups of patients with liver function, HCV RNA and PBMC, before and after treatment comparison and comparison between groups to analyze whether there are differences. [Results] In terms of virological response, the EVR, ETVR and follow-up SVR in the treatment group were 76%, 86% and 84% respectively, while the control group were 34%, 50% and 30% respectively. The virological response in the experimental group was significantly better than that in the control group (P <0.01). Compared with those before treatment, the ALT and TBiL of the two groups were significantly decreased after treatment (P <0.05), and the difference was statistically significant (P <0.05). After the treatment, The levels of ALT and TBiL in the two groups were significantly better than those in the control group (P <0.01). Compared with before treatment, the levels of IL-10 in both groups were significantly decreased, and the difference was statistically significant (P <0.05). After the treatment, comparing the IL-10 in two groups at the same time, the experimental group was obviously superior to the control group (P <0.01), and the difference was statistically significant Compared with the control group (P <0.01). There was no significant difference between the two groups before and after treatment (P> 0.05). After 24 weeks of follow-up, comparison between the two groups showed that the experimental group was superior to the control group in the same period, With statistical significance (P <0.01). [Conclusion] PEG IFNα-2a combined with ribavirin plus Qidingsiaolian decoction could improve liver function and inhibit the replication of HCV RNA in patients with type 1b hepatitis C compared with interferon alone and ribavirin , For patients with better efficacy and prognosis.