文章摘要
赵琳,陈建杰,聂红明,凌琪华,陈逸云,叶青艳,申宏.难治性丙型肝炎HCV基因型临床特征及芪术冲剂抗病毒疗效观察[J].南京中医药大学学报,2014,30(5):422-424.
难治性丙型肝炎HCV基因型临床特征及芪术冲剂抗病毒疗效观察
Clinical Characteristics of HCV Genotype of Refractory Hepatitis C and its Effect on Antiviral Function of Qizhu Granule
投稿时间:2014-05-09  修订日期:2014-06-20
DOI:
中文关键词: 难治性  丙型肝炎  芪术冲剂  基因型
英文关键词: refractory diseases  hepatitis C  Qizhu Granules  genotype
基金项目:
作者单位
赵琳,陈建杰*,聂红明,凌琪华,陈逸云,叶青艳,申宏 上海中医药大学附属曙光医院上海 
200021 
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中文摘要:
      目的 探讨难治性丙型肝炎HCV基因型临床特征及芪术冲剂抗病毒疗效观察。方法 将入组的204例难治性丙型肝炎患者采用SANGER测序法进行病毒基因型分析,并按1∶1比例随机分为治疗组和对照组,治疗组予芪术冲剂(治疗过程中的兼夹证进行固定药物和固定剂量的随证加味)治疗,对照组予安慰剂,治疗疗程均为48周。在第0周(治疗前)、第4周、第12周、第24周、第48周(治疗后)、第72周检测HCV RNA定量。结果 在完成48周治疗的182例病例中,173例检测得基因型,其中1b型为129例,占74.6%,非1b型占26.4%。1b型和非1b型患者在性别、BMI指数及血清ALT、AST基础水平上差异无统计学意义(P>0.05),但1b型患者的病程要长于非1b型,年龄要大于非1b型,HCV RNA基础水平要高于非1b型,差别有统计学意义(P<0.05)。芪术冲剂治疗组中非1b型患者的持续病毒学应答(SVR)率为42.86%,而1b型患者的SVR率仅为9.09%,两者差异有统计学意义(P<0.05)。结论 HCV基因非1b型患者对芪术冲剂有更好的抗病毒应答,HCV基因型对中药复方抗病毒学应答存在影响。
英文摘要:
      OBJECTIVE To investigate clinical characteristics of HCV genotypes of refractory hepatitis C and its effect on antiviral function of Qizhu Granule. METHODS After virus genotypes were analyzed by SANGER sequencing before the treatment, 204 patients with refractory hepatitis C were randomly and equally divided into the treatment group (Qizhu Granules) and the control group (placebo group). Two groups received 48-week treatments. The patients' HCV RNA level was monitored before treatment and during the 4th, 12th, 24th, 48th treatment, as well as 4 weeks after the treatment. RESULTS 182 patients finally received 48-week treatment and completed the study.173 cases were detected with their genotypes, including 129 case of genotype 1b for 74.6%, and 44 cases of non-1b type for 26.4%. No significant difference was found between genotype 1b and non-genotype 1b patients in gender, BMI index and serum ALT and AST level (P>0.05). Patients infected by genotype 1b virus had longer disease courses and were older than non-genotype 1b patients on average. RNA level of HCV of genotype 1b patients was higher than that of non-1b type with significant differences. SVR in the treatment group of non-genotype 1b patients was 42.86%, while that of genotype 1b was only 9.09% with statistically significance. CONCLUSION Non-1b genotype patients have better antiviral effects and HCV genotype is an important factor affecting the antiviral effect of Qizhu granules.
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