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[摘要]
目的 研究复方丹参片联合胸腺法新治疗失代偿期丙型肝炎肝硬化的临床疗效。方法 选取2013年10月-2014年5月中国石油天然气集团公司中心医院和首都医科大学附属北京佑安医院收治的失代偿期丙型肝硬化患者120例,随机分为对照组和治疗组,每组各60例。对照组静脉注射注射用胸腺法新,1.6 mg/次,2次/周;治疗组在对照组基础上口服复方丹参片,3片/次,3次/d。两组患者均持续治疗12个月。评价两组患者临床效果,同时比较两组患者治疗前后肝功能指标、肝纤维化指标、丙型肝炎病毒RNA(HCV-RNA)水平、Child-Pugh评分和乙型肝炎E抗原(HBeAg)转阴率变化。结果 治疗12个月后,两组患者总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)水平均显著下降,白蛋白(ALB)水平显著上升,同组比较差异具有统计学意义(P<0.05);且治疗组患者血浆TBiL、ALT和ALB下降水平显著优于对照组(P<0.05)。治疗12个月后,两组患者透明质酸(HA)、Ⅲ型前胶原(PCIII)和层黏连蛋白(LN)水平均显著下降(P<0.05);且治疗组患者HA、PCIII和LN水平显著比对照组低(P<0.05)。治疗12个月后,治疗组患者HCV-RNA显著低于治疗前,治疗组治疗前后比较差异具有统计学意义(P<0.05);且低于治疗12个月后对照组,两组比较差异有统计学意义(P<0.05)。治疗12个月后,治疗组患者Child-Pugh评分显著降低,两组HBeAg转阴率显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者Child-Pugh评分和HBeAg转阴率改善情况明显优于对照组(P<0.05)。结论 复方丹参片联合胸腺法新治疗失代偿期肝硬化患者临床效果良好,肝纤维化指标、肝功能以及病毒学指标均得到了显著改善,缓解了患者的临床症状。
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[Abstract]
Objective To study the clinical effect of Compound Danshen Tablets combined with Thymalfasin for injection in treatment of decompensated hepatitis C cirrhosis. Methods Patients (120 cases) with decompensated hepatitis C cirrhosis in CNPC Central Hospital and Beijing You'an Hospital, Capital Medical University from October 2013 to May 2014 were divided into control and treatment groups, and each group had 60 cases. Patients in the control group were iv administered with Thymalfasin for injection, 1.6 mg/time, twice one week. Patients in the treatment group were po administered with Compound Danshen Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 12 months. After treatment, the clinical efficacy was evaluated, liver function and fibrosis indexes, HCV-RNA level, Child-Pugh score and HBeAg negative conversion rate in two groups before and after treatment were compared. Results After treatment for 12 months, TBiL and ALT levels in two groups were significantly decreased, but ALB level was increased, the difference was statistically significant in the same group (P<0.05). And the TBiL, ALT, and ALB levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment for 12 months, the HA, PCIII, and LN levels in two groups were significantly decreased (P<0.05). And the HA, PCIII, and LN levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment for 12 months, HCV-RNA level in the treatment was significantly decreased, and which was lower than that in the control group after treatment, and there were differences in the treatment group and between two groups after treatment (P<0.05). After treatment for 12 months, Child-Pugh score in the treatment group was significantly decreased, HBeAg negative conversion rate in two groups was significantly increased, and the difference was statistically significant in the same group (P<0.05). The Child-Pugh score and HBeAg negative conversion rate in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Compound Danshen Tablets combined with Thymalfasin for injection has a good clinical effect in treatment of decompensated hepatitis C cirrhosis, can significantly improve liver fibrosis, liver function and virology indicators, and relieve the clinical symptoms.
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