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目的观察康氏抗纤方联合聚乙二醇化干扰素α-2a(PEG-IFNα-2a)、利巴韦林对慢性丙型肝炎(CHC)患者抗病毒治疗应答及生活质量的影响。方法选择CHC患者64例,随机分为治疗组33例与对照组31例。对照组给予PEG-IFNα-2a注射液180μg/次,皮下注射,每周1次;利巴韦林0.3 g/次,口服,每天3次。治疗组在对照组基础上口服康氏抗纤方,每日1剂。两组均治疗24周。观察两组患者治疗前后肝组织病理、肝纤维化瞬时弹性测定值、血清丙氨酸氨基转氨酶(ALT)水平、丙肝病毒定量(HCV RNA)及慢性肝病问卷(CLDQ)积分的变化。结果两组患者病毒学应答与生化应答比较差异无统计学意义(P>0.05)。治疗后两组肝脏炎症及纤维化程度均较本组治疗前显著改善(P<0.05);治疗组改善肝纤维化程度方面显著优于对照组(P<0.05);治疗组治疗后肝纤维化瞬时弹性测定值改善程度显著优于对照组(P<0.05)。治疗组治疗后CLDQ各项积分与治疗前比较均明显提高(P<0.01),而对照组仅在系统症状、活动能力和情感方面得分明显提高(P<0.05),治疗组治疗后在腹部症状、困乏、情感、焦虑方面积分改善程度明显优于对照组(P<0.01)。结论康氏抗纤方联合PEG-IFNα-2a、利巴韦林治疗CHC在抗病毒治疗应答的同时,具有显著改善肝纤维化的程度及提高患者生活质量的作用。
Objective To observe the effect of Kangshe Kangxian Decoction combined with pegylated interferon alfa-2a (PEG-IFNα-2a) and ribavirin on antiviral therapy response and quality of life in patients with chronic hepatitis C (CHC). Methods Sixty-four CHC patients were randomly divided into treatment group (n = 33) and control group (n = 31). Control group was given PEG-IFNα-2a injection of 180μg / subcutaneous injection once a week; ribavirin 0.3g / times orally three times a day. Treatment group in the control group oral Kang’s anti-fibrosis, a day. Both groups were treated for 24 weeks. The changes of liver histopathology, transient elasticity of liver fibrosis, serum ALT level, HCV RNA and CLDQ score were observed before and after treatment. Results There was no significant difference in virological response and biochemical response between the two groups (P> 0.05). The liver inflammation and fibrosis of the two groups were significantly improved after treatment (P <0.05), and the treatment group was significantly better than the control group in improving the degree of liver fibrosis (P <0.05). After treatment, the liver fibrosis The instantaneous elasticity measured value improved significantly better than the control group (P <0.05). After treatment, the scores of CLDQ in treatment group were significantly higher than those before treatment (P <0.01), while those in control group only increased significantly in symptom, activity ability and emotion (P <0.05) , Drowsiness, emotion, anxiety aspect of the improvement is obviously better than the control group (P <0.01). Conclusions Kangshe Kangxian Decoction combined with PEG-IFNα-2a and ribavirin can significantly improve the degree of hepatic fibrosis and improve the quality of life of patients while treating CHC with antiviral therapy.