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【目的】观察健脾补肾、益气补血法联合聚乙二醇干扰素α-2a和利巴韦林治疗慢性丙型病毒性肝炎的临床疗效。【方法】将62例慢性丙型病毒性肝炎患者随机分为治疗组32例与对照组30例。对照组给予西医标准化治疗方案治疗,即皮下注射聚乙二醇干扰素α-2a及口服利巴韦林片,治疗组在西医标准化治疗方案基础上联合健脾补肾、益气补血方(由黄芪、熟地黄、黄精、仙鹤草、鸡血藤、甘草等中药免煎颗粒剂及花生衣煎剂组成)治疗,每日1剂,2组疗程均为48周。比较2组治疗前后中医证候积分变化情况及治疗后12周、24周、36周、48周及停药后24周丙型肝炎病毒(HCV)RNA转阴率情况。【结果】(1)治疗后,2组中医证候积分均较治疗前升高(P<0.05),但治疗组的升高幅度低于对照组(P<0.05)。(2)治疗组在治疗12周、24周、36周后及停药后24周的HCVRNA转阴率均有优于对照组的趋势,但差异均无统计学意义(P>0.05);治疗组治疗48周后的HCVRNA转阴率与对照组相仿,差异无统计学意义(P>0.05)。(3)随访24周后,女性复发率有高于男性趋势,但差异无统计学意义(P>0.05)。【结论】中药健脾补肾、益气补血方联合聚乙二醇干扰素α-2a和利巴韦林治疗慢性丙型病毒性肝炎能有效改善患者临床症状,提高临床疗效,减轻西药副作用,达到增效减毒的效果,同时能降低患者停药后的复发率。
【Objective】 To observe the clinical effects of invigorating the spleen and invigorating the kidney and invigorating the qi and invigorating the blood on the treatment of chronic hepatitis C with peginterferon alfa-2a and ribavirin. 【Methods】 Sixty-two patients with chronic hepatitis C were randomly divided into treatment group (n = 32) and control group (n = 30). The control group was treated with western medicine standardization treatment regimen, that is, subcutaneous injection of pegylated interferon alfa-2a and oral ribavirin tablets. The treatment group was treated on the basis of standardized western medicine treatment by combining spleen and kidney, , Rehmannia, Polygonatum, Agrimony, Millettia, licorice and other Chinese medicine-free granules and decoction of peanut decoction) treatment, 1 day, 2 courses of treatment for 48 weeks. The changes of TCM syndrome scores before and after treatment were compared between the two groups. The negative rates of hepatitis C virus (HCV) RNA in 12 weeks, 24 weeks, 36 weeks, 48 weeks and 24 weeks after treatment were compared. 【Results】 (1) After treatment, the TCM syndrome scores of two groups were significantly higher than those before treatment (P <0.05), but the increase of treatment group was lower than that of the control group (P <0.05). (2) The HCV RNA negative rates in the treatment group at 12 weeks, 24 weeks, 36 weeks and 24 weeks after treatment were superior to those in the control group, but the difference was not statistically significant (P> 0.05); treatment After 48 weeks of treatment, the rate of HCV RNA negative conversion was similar to that of the control group, with no significant difference (P> 0.05). (3) After 24 weeks of follow-up, the recurrence rate of women was higher than that of men, but the difference was not statistically significant (P> 0.05). 【Conclusion】 The Chinese herbs of spleen and kidney, Yiqi Buxue Recipe combined with peginterferon alfa-2a and ribavirin in the treatment of chronic hepatitis C can effectively improve the clinical symptoms, improve the clinical curative effect, relieve the side effects of western medicine and achieve Synergistic and attenuated effect, while reducing the recurrence rate after stopping patients.