丙肝（专业版）
丙肝是一种感染了丙型肝炎病毒（HCV）的的病毒性肝炎。早期感染HCV的人症状轻微且进展缓慢，易被忽视或误诊。而一旦症状出现，肝损伤已经很严重，不能逆转。
其他名称：丙肝病毒感染，丙型肝炎
英文名称：HCV，Hepatitis C，Hep C
患有肝炎的产妇在生产时可以将病毒传染给婴儿。丙肝病毒不是通过食物或水传播的。
症状可能包括如下：
调整饮食和生活方式
营养与草本综合干预
以下是基于循证医学和循证营养学有关文献综合的结果。
有助于防控丙肝的营养和草本补充剂，主要包括如下：
一、肝谷胱甘肽与氧化应激：
谷胱甘肽是一种肝脏细胞解毒剂，有助于防止自由基的损伤1。而且，谷胱甘肽耗竭在HCV感染患者中很常见2。以下天然化合物可能有助于提高肝脏谷胱甘肽水平。
1.N-乙酰半胱氨酸（NAC）：
NAC作为强大的抗氧化剂可以减少自由基并提高谷胱甘肽水平3。在医院环境中，静脉和口服NAC用于治疗对乙酰氨基酚（或扑热息痛）中毒。在非扑热息痛中毒引起的急性肝功能衰竭儿童中，接受NAC与住院时间更短、肝脏恢复率更高以及移植后存活率更好有关4。在一项早期试验中，在干扰素中添加NAC可以提高慢性丙型肝炎患者白细胞中的谷胱甘肽水平，并使41%的干扰素无应答者的ALT水平正常化5。虽然最近的临床试验无法证实NAC在慢性丙型肝炎中的治疗作用，但已经证明NAC具有很好的耐受性6,7。
2.S-腺苷-L-蛋氨酸（SAMe）：
SAMe是许多甲基化反应的甲基供体，其抗抑郁特性已被研究8。 SAMe还调节谷胱甘肽合成9。在既往抗病毒治疗无效的HCV感染患者中，在聚乙二醇干扰素加利巴韦林（PEG-IFN/RBV）方案中添加SAMe可改善早期病毒反应10。在另一项试验中，SAMe和三甲基甘氨酸（另一种甲基供体）与PEG-IFN/RBV一起给慢性丙型肝炎患者。该治疗导致59%的受试者出现早期病毒学应答（EVR），而PEG-IFN/RBV单独治疗之前仅获得14%的EVR11。
3.硫辛酸：
这种自由基清除剂有助于修复氧化应激引起的损伤，并支持谷胱甘肽和维生素E等重要抗氧化剂的再生12。在动物中，已经发现硫辛酸可以预防脂肪肝疾病13。在人体试验中，含有硫辛酸的抗氧化剂混合物的给药被证明可以有利地调节肝酶、HCV RNA水平，以及HCV患者的肝活检评分14,15。
4.乳清蛋白：
乳清蛋白可提高谷胱甘肽水平并改善免疫系统功能16。在肝炎动物模型中，补充乳清蛋白可减轻化学诱导的肝酶升高17。此外，一项临床研究发现，口服乳清蛋白可降低病毒载量，减少炎症，降低ALT水平，并对代偿性慢性HCV感染患者产生其他有益作用16。
5.硒：
硒是谷胱甘肽过氧化物酶的重要成分，它是一种保护细胞免受自由基损伤的酶。研究发现，丙型或乙型肝炎患者的血清硒浓度低于健康人18。此外，硒缺乏被认为会导致HCV相关慢性肝病患者的胰岛素抵抗；在肝细胞癌患者中观察到硒水平降低19,20。
6.谷胱甘肽：
1989年的一项研究发现，口服谷胱甘肽可提高血浆谷胱甘肽水平21。临床前试验发现，口服还原型谷胱甘肽可提高肺、肝和肾脏等组织中的谷胱甘肽水平22-26。
二、降低肝铁负荷：
1.乳铁蛋白：
乳铁蛋白是一种铁结合糖蛋白，作为肝炎患者血清铁超负荷的辅助治疗可能是有益的。乳铁蛋白是一种强效抗氧化剂、抗病毒药物和游离铁清除剂。此外，它直接参与自然杀伤细胞活性的上调，使其成为免疫功能的天然介质27。作为一种免疫介质，乳铁蛋白可能与干扰素协同作用，以降低病毒载量28。在一项针对慢性丙型肝炎患者的研究中，单独使用乳铁蛋白可显著降低丙型肝炎病毒核糖核酸滴度，并提高干扰素和利巴韦林后续治疗的疗效29。
2.绿茶：
绿茶中的表没食子儿茶素-3-没食子酸盐（EGCG）已被发现通过阻断病毒进入靶细胞，以阻断HCV感染的第一步。此外，EGCG抑制了HCV的细胞间传播。无论测试的基因型如何，都能观察到这二种效果。这些发现对预防肝移植患者再次感染丙型肝炎病毒具有重要意义30。此外，绿茶已被证明可抑制肠细胞中的铁吸收31，以及肝组织中的铁积聚32，过多铁可能导致过度氧化应激。
3.钙：钙抑制铁的吸收33；服用600mg元素钙可使铁的吸收减少60%34。
三、其他支持：
1.水飞蓟：
来源于水飞蓟的水飞蓟素及其主要活性成分水飞蓟宾（Silibinin）都有助于肝脏避免毒性损伤，并在损伤后再生。
水飞蓟素：几项研究的结果表明，水飞蓟素在肝脏中具有潜在的抗病毒35、抗氧化36、抗炎35,37和抗纤维化38作用。它还可以改善HCV患者的肝酶水平39。
在最近的一项细胞培养研究中，水飞蓟素抑制HCV进入细胞，抑制病毒RNA和蛋白质的表达，并减少HCV的细胞间传播40。一项涉及1145名HCV感染者的临床研究表明，使用水飞蓟素的患者肝脏相关症状较少，生活质量评分较高41。剂量大于700mg可能改善水飞蓟素的生物利用度；研究发现，每天口服2100mg是安全且耐受性良好的42。
水飞蓟宾：其抗氧化、抗纤维和代谢作用已在大量研究中得到证实43,44。水飞蓟宾也具有抗病毒能力45,46。
口服水飞蓟宾治疗活动性慢性丙型肝炎的临床疗效尚未明确43,47。然而，在一项试验中，静脉注射水飞蓟宾有效地治疗了少数患者肝移植后的HCV再次感染48，并在另一个试验中帮助85%的对标准护理无反应的患者达到无法检测到的丙型肝炎RNA水平49。同样，除了PEG-IFN/RBV治疗外，给予高剂量的静脉注射水飞蓟宾降低了先前对治疗无反应的HCV感染患者的病毒载量46；每天1400mg的水飞蓟宾静脉注射连续14天，成功地在一名57岁的肝移植患者中诱导了SVR50。
一项医学文献综述发现，每天剂量高达10,000mg的水飞蓟宾植物体没有显著副作用，与其他药物也没有明显相互作用43。
2.磷脂酰胆碱：
聚乙烯磷脂酰胆碱（PPC）是必需磷脂的主要成分51。除了改善HCV患者的肝酶外52，PPC还能补充SAMe水平，SAMe是强效抗氧化剂谷胱甘肽的前体53。PPC可保护肝脏免受损伤51，并改善肝功能52,54。在动物研究中，它已证明具有抗氧化、细胞保护、抗炎和抗纤维化作用，抑制氧化应激和酒精性肝病的发展51,52。多项双盲安慰剂对照临床试验表明，必需磷脂可改善人类慢性肝炎55。
3.五味子：
五味子中的浆果含有保护肝脏的活性成分。五味子及其提取物传统上在中日医学中占有重要地位56，和五味子已被用于治疗化学性和病毒性肝炎57。一项研究表明，含有五味子的日本草药组合的效果表明，五味子果实可以抑制HCV感染58。五味子的种子提取物似乎具有肝脏解毒能力，种子提取物的成分被认为具有抗癌、抗炎、肝脏保护、抗艾滋病毒HIV和免疫调节作用59。
4.甘草：
已知甘草根提取物（Glycyrrhizin，甘草甜素）对HCV具有抗病毒作用60。在日本丙型肝炎患者中，长期使用甘草甜素被证明有助于预防炎症、肝硬化和肝细胞癌61,62。还观察到甘草甜素的广泛抗炎活性63和抗氧化能力64。在标准PEG-IFN/RBV治疗中添加含有维生素C、甘草甜素和其他抗氧化剂的营养补充剂，可显著提高慢性HCV患者的生化和组织学改善率65,66。在慢性HCV患者中，使用该混合物治疗后，氧化应激和免疫参数显着改善65。
一种名为Stronger Neo-Minophagen C（SNMC）的制剂含有甘草甜素作为活性成分，在日本用于治疗慢性肝炎已有30多年，SNMC已被发现可以预防脂肪肝疾病67，并通过恢复耗尽的谷胱甘肽水平来保护肝细胞免受四氯化碳诱导的氧化应激68。
不过，摄入大量甘草可能产生的副作用是高血压69。因此，应该定期监测血压。
5.维生素D：
在HCV患者中观察到维生素D水平下降70,71。在慢性HCV感染患者中，低水平血清维生素D与慢性HCV感染患者的严重纤维化以及PEG-IFN/RBV治疗的低SVR相关71。已发现补充维生素D可增强HCV对PEG-IFN/RBV治疗的反应72。在最近一项涉及接受PEG-IFN/RBV治疗的HCV基因型2-3患者的研究中，口服补充维生素D可显著改善病毒反应。治疗24周后，95%的治疗组（维生素D）HCV RNA阴性，而对照组为77%73。
6.锌和肌肽锌：
锌具有抑制HCV的能力74。据报道，在接受干扰素治疗的患者中，锌的补充提高了HCV根除率75，减少了胃肠道紊乱和脱发，并改善了慢性HCV患者的指甲健康。它还可以提高患者对IFN-α-2a和利巴韦林的耐受性76。
由锌和L-肌肽组成的螯合化合物（肌肽锌）可以诱导肝脏的抗氧化功能，从而减少肝细胞损伤77。已经发现，补充螯合肌肽锌可以减轻慢性HCV感染或肝硬化患者的肝损伤程度，并改善其长期预后78。在HCV相关的慢性肝病患者中，它似乎通过减少铁过载对肝脏具有抗炎作用79。此外，在PEG-IFN/RBV联合治疗中加入肌肽锌时，观察到的胃肠道副作用较少80。
7.咖啡与绿原酸：
最近的一项研究表明，患有晚期HCV相关慢性肝病的患者，每天喝3杯或更多咖啡对PEG-IFN/RBV治疗的反应是不喝咖啡的患者的3倍；这些患者先前对干扰素治疗无反应81。已发表的研究报告表明，饮用咖啡与肝硬化82,83、肝细胞癌84,85、HCV感染的肝病进展86以及血清ALT活性降低之间存在关联87。
人口研究表明，饮用咖啡可以降低患临床意义重大的慢性肝病的风险88。这些影响可能部分归因于绿原酸的抗病毒活性，绿原酸是一种咖啡多酚，在高温烘焙加工的咖啡中损失多，在绿咖啡提取物中含量特别高89。
8.姜黄素：
姜黄素具有抗氧化、抗炎、抗真菌、抗菌和抗增殖能力90-92。此外，研究发现姜黄素对多种病毒具有抗病毒活性，包括HIV93、流感病毒94和柯萨奇病毒95。姜黄素与IFN-α联合治疗对HCV复制具有“深远的抑制作用”。作者得出结论，姜黄素可能是一种有价值的新型抗HCV药物96。姜黄素也被证明可以预防肝癌97。
9.槲皮素：
槲皮素是一种存在于水果、蔬菜、葡萄酒和茶中的类黄酮，具有抗氧化和抗炎特性。研究表明，槲皮素还具有抗高血压、抗菌、抗纤维化、抗动脉粥样硬化和抗增殖的特性98。槲皮素还被发现可以减少HCV的产生99,100。
10.L-肉碱：
慢性HCV患者接受PEG-IFN/RBV加上氨基酸L-肉碱或PEG-IFM/RBV单独治疗12个月。与非L肉碱组的25%相比，50%的L肉碱组观察到持续病毒学反应显著改善101。补充L肉碱的PEG-IFN/RBV治疗也与慢性丙型肝炎患者的精神和身体疲劳减轻以及健康相关的生活质量改善有关。后一种结果可能会提高患者对PEG-IFN/RBV治疗的依从性102。
更多可点击其个性化的综合干预方案如下：
以及参阅本网如下专文的相关内容：
医疗干预
常规治疗包括如下：
丙肝通常采用综合治疗，包括：
如果不能控制病情，慢性丙肝可导致肝硬化、肝衰竭等严重并发症。
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美国梅奥诊所
www.mayoclinic.org
美国肝脏基金会
http://www.liverfoundation.org
美国国际肝炎基金会
http://www.hepfi.org
加拿大肝脏基金会
http://www.liver.ca
加拿大卫生部
http://www.hc-sc.gc.ca
免责声明和安全信息
英文名称：HCV，Hepatitis C，Hep C
定义
丙肝是一种感染了丙型肝炎病毒（HCV）的的病毒性肝炎。早期感染HCV的人症状轻微且进展缓慢，易被忽视或误诊。而一旦症状出现，肝损伤已经很严重，不能逆转。约有80％感染HCV的人可发生慢性感染，并面临肝硬化、肝衰竭和肝癌等并发症的风险。病因
丙肝是由丙肝病毒（HCV）引起的。丙肝病毒是通过接触被感染者的血液传播的。患有肝炎的产妇在生产时可以将病毒传染给婴儿。丙肝病毒不是通过食物或水传播的。
风险因素
可能增加患丙肝的风险因素，包括如下：- 共用牙刷、剃须刀、指甲钳、或其他个人卫生用品
- 频繁接触丙肝病毒者，如医疗服务人员
- 纹身
- 性伙伴感染
- 长期肾透析治疗
- 被HCV感染的注射针头，如医务人员误用。
症状
大多数丙肝患者早期没有症状。但随着时间的推移，这种疾病会导致严重的肝损伤。症状可能包括如下：
- 疲劳
- 没有食欲
- 皮肤易出血、易擦伤
- 皮肤出现蜘蛛状血管
- 思维混乱、嗜睡和言语不清
- 恶心、呕吐
- 眼睛和皮肤呈现黄色（黄疸）
- 尿深色、浅色大便，便溏
- 腹痛、肿胀
- 痒、皮疹
- 关节疼痛
- 腿肿胀
- 虚弱
- 严重疲劳
- 食欲不振
并发症
丙肝的并发症包括：- 肝硬化
- 肝功能衰竭
- 肝癌
疗法
综合选项可包括如下：调整饮食和生活方式
- 健康、均衡饮食，包括水果、蔬菜和全谷类食物
- 不要饮酒、吸烟
- 经常锻炼、改善体质
- 良好休息、睡眠充足
营养与草本综合干预
以下是基于循证医学和循证营养学有关文献综合的结果。
有助于防控丙肝的营养和草本补充剂，主要包括如下：
一、肝谷胱甘肽与氧化应激：
谷胱甘肽是一种肝脏细胞解毒剂，有助于防止自由基的损伤1。而且，谷胱甘肽耗竭在HCV感染患者中很常见2。以下天然化合物可能有助于提高肝脏谷胱甘肽水平。
1.N-乙酰半胱氨酸（NAC）：
NAC作为强大的抗氧化剂可以减少自由基并提高谷胱甘肽水平3。在医院环境中，静脉和口服NAC用于治疗对乙酰氨基酚（或扑热息痛）中毒。在非扑热息痛中毒引起的急性肝功能衰竭儿童中，接受NAC与住院时间更短、肝脏恢复率更高以及移植后存活率更好有关4。在一项早期试验中，在干扰素中添加NAC可以提高慢性丙型肝炎患者白细胞中的谷胱甘肽水平，并使41%的干扰素无应答者的ALT水平正常化5。虽然最近的临床试验无法证实NAC在慢性丙型肝炎中的治疗作用，但已经证明NAC具有很好的耐受性6,7。
2.S-腺苷-L-蛋氨酸（SAMe）：
SAMe是许多甲基化反应的甲基供体，其抗抑郁特性已被研究8。 SAMe还调节谷胱甘肽合成9。在既往抗病毒治疗无效的HCV感染患者中，在聚乙二醇干扰素加利巴韦林（PEG-IFN/RBV）方案中添加SAMe可改善早期病毒反应10。在另一项试验中，SAMe和三甲基甘氨酸（另一种甲基供体）与PEG-IFN/RBV一起给慢性丙型肝炎患者。该治疗导致59%的受试者出现早期病毒学应答（EVR），而PEG-IFN/RBV单独治疗之前仅获得14%的EVR11。
3.硫辛酸：
这种自由基清除剂有助于修复氧化应激引起的损伤，并支持谷胱甘肽和维生素E等重要抗氧化剂的再生12。在动物中，已经发现硫辛酸可以预防脂肪肝疾病13。在人体试验中，含有硫辛酸的抗氧化剂混合物的给药被证明可以有利地调节肝酶、HCV RNA水平，以及HCV患者的肝活检评分14,15。
4.乳清蛋白：
乳清蛋白可提高谷胱甘肽水平并改善免疫系统功能16。在肝炎动物模型中，补充乳清蛋白可减轻化学诱导的肝酶升高17。此外，一项临床研究发现，口服乳清蛋白可降低病毒载量，减少炎症，降低ALT水平，并对代偿性慢性HCV感染患者产生其他有益作用16。
5.硒：
硒是谷胱甘肽过氧化物酶的重要成分，它是一种保护细胞免受自由基损伤的酶。研究发现，丙型或乙型肝炎患者的血清硒浓度低于健康人18。此外，硒缺乏被认为会导致HCV相关慢性肝病患者的胰岛素抵抗；在肝细胞癌患者中观察到硒水平降低19,20。
6.谷胱甘肽：
1989年的一项研究发现，口服谷胱甘肽可提高血浆谷胱甘肽水平21。临床前试验发现，口服还原型谷胱甘肽可提高肺、肝和肾脏等组织中的谷胱甘肽水平22-26。
二、降低肝铁负荷：
1.乳铁蛋白：
乳铁蛋白是一种铁结合糖蛋白，作为肝炎患者血清铁超负荷的辅助治疗可能是有益的。乳铁蛋白是一种强效抗氧化剂、抗病毒药物和游离铁清除剂。此外，它直接参与自然杀伤细胞活性的上调，使其成为免疫功能的天然介质27。作为一种免疫介质，乳铁蛋白可能与干扰素协同作用，以降低病毒载量28。在一项针对慢性丙型肝炎患者的研究中，单独使用乳铁蛋白可显著降低丙型肝炎病毒核糖核酸滴度，并提高干扰素和利巴韦林后续治疗的疗效29。
2.绿茶：
绿茶中的表没食子儿茶素-3-没食子酸盐（EGCG）已被发现通过阻断病毒进入靶细胞，以阻断HCV感染的第一步。此外，EGCG抑制了HCV的细胞间传播。无论测试的基因型如何，都能观察到这二种效果。这些发现对预防肝移植患者再次感染丙型肝炎病毒具有重要意义30。此外，绿茶已被证明可抑制肠细胞中的铁吸收31，以及肝组织中的铁积聚32，过多铁可能导致过度氧化应激。
3.钙：钙抑制铁的吸收33；服用600mg元素钙可使铁的吸收减少60%34。
三、其他支持：
1.水飞蓟：
来源于水飞蓟的水飞蓟素及其主要活性成分水飞蓟宾（Silibinin）都有助于肝脏避免毒性损伤，并在损伤后再生。
水飞蓟素：几项研究的结果表明，水飞蓟素在肝脏中具有潜在的抗病毒35、抗氧化36、抗炎35,37和抗纤维化38作用。它还可以改善HCV患者的肝酶水平39。
在最近的一项细胞培养研究中，水飞蓟素抑制HCV进入细胞，抑制病毒RNA和蛋白质的表达，并减少HCV的细胞间传播40。一项涉及1145名HCV感染者的临床研究表明，使用水飞蓟素的患者肝脏相关症状较少，生活质量评分较高41。剂量大于700mg可能改善水飞蓟素的生物利用度；研究发现，每天口服2100mg是安全且耐受性良好的42。
水飞蓟宾：其抗氧化、抗纤维和代谢作用已在大量研究中得到证实43,44。水飞蓟宾也具有抗病毒能力45,46。
口服水飞蓟宾治疗活动性慢性丙型肝炎的临床疗效尚未明确43,47。然而，在一项试验中，静脉注射水飞蓟宾有效地治疗了少数患者肝移植后的HCV再次感染48，并在另一个试验中帮助85%的对标准护理无反应的患者达到无法检测到的丙型肝炎RNA水平49。同样，除了PEG-IFN/RBV治疗外，给予高剂量的静脉注射水飞蓟宾降低了先前对治疗无反应的HCV感染患者的病毒载量46；每天1400mg的水飞蓟宾静脉注射连续14天，成功地在一名57岁的肝移植患者中诱导了SVR50。
一项医学文献综述发现，每天剂量高达10,000mg的水飞蓟宾植物体没有显著副作用，与其他药物也没有明显相互作用43。
2.磷脂酰胆碱：
聚乙烯磷脂酰胆碱（PPC）是必需磷脂的主要成分51。除了改善HCV患者的肝酶外52，PPC还能补充SAMe水平，SAMe是强效抗氧化剂谷胱甘肽的前体53。PPC可保护肝脏免受损伤51，并改善肝功能52,54。在动物研究中，它已证明具有抗氧化、细胞保护、抗炎和抗纤维化作用，抑制氧化应激和酒精性肝病的发展51,52。多项双盲安慰剂对照临床试验表明，必需磷脂可改善人类慢性肝炎55。
3.五味子：
五味子中的浆果含有保护肝脏的活性成分。五味子及其提取物传统上在中日医学中占有重要地位56，和五味子已被用于治疗化学性和病毒性肝炎57。一项研究表明，含有五味子的日本草药组合的效果表明，五味子果实可以抑制HCV感染58。五味子的种子提取物似乎具有肝脏解毒能力，种子提取物的成分被认为具有抗癌、抗炎、肝脏保护、抗艾滋病毒HIV和免疫调节作用59。
4.甘草：
已知甘草根提取物（Glycyrrhizin，甘草甜素）对HCV具有抗病毒作用60。在日本丙型肝炎患者中，长期使用甘草甜素被证明有助于预防炎症、肝硬化和肝细胞癌61,62。还观察到甘草甜素的广泛抗炎活性63和抗氧化能力64。在标准PEG-IFN/RBV治疗中添加含有维生素C、甘草甜素和其他抗氧化剂的营养补充剂，可显著提高慢性HCV患者的生化和组织学改善率65,66。在慢性HCV患者中，使用该混合物治疗后，氧化应激和免疫参数显着改善65。
一种名为Stronger Neo-Minophagen C（SNMC）的制剂含有甘草甜素作为活性成分，在日本用于治疗慢性肝炎已有30多年，SNMC已被发现可以预防脂肪肝疾病67，并通过恢复耗尽的谷胱甘肽水平来保护肝细胞免受四氯化碳诱导的氧化应激68。
不过，摄入大量甘草可能产生的副作用是高血压69。因此，应该定期监测血压。
5.维生素D：
在HCV患者中观察到维生素D水平下降70,71。在慢性HCV感染患者中，低水平血清维生素D与慢性HCV感染患者的严重纤维化以及PEG-IFN/RBV治疗的低SVR相关71。已发现补充维生素D可增强HCV对PEG-IFN/RBV治疗的反应72。在最近一项涉及接受PEG-IFN/RBV治疗的HCV基因型2-3患者的研究中，口服补充维生素D可显著改善病毒反应。治疗24周后，95%的治疗组（维生素D）HCV RNA阴性，而对照组为77%73。
6.锌和肌肽锌：
锌具有抑制HCV的能力74。据报道，在接受干扰素治疗的患者中，锌的补充提高了HCV根除率75，减少了胃肠道紊乱和脱发，并改善了慢性HCV患者的指甲健康。它还可以提高患者对IFN-α-2a和利巴韦林的耐受性76。
由锌和L-肌肽组成的螯合化合物（肌肽锌）可以诱导肝脏的抗氧化功能，从而减少肝细胞损伤77。已经发现，补充螯合肌肽锌可以减轻慢性HCV感染或肝硬化患者的肝损伤程度，并改善其长期预后78。在HCV相关的慢性肝病患者中，它似乎通过减少铁过载对肝脏具有抗炎作用79。此外，在PEG-IFN/RBV联合治疗中加入肌肽锌时，观察到的胃肠道副作用较少80。
7.咖啡与绿原酸：
最近的一项研究表明，患有晚期HCV相关慢性肝病的患者，每天喝3杯或更多咖啡对PEG-IFN/RBV治疗的反应是不喝咖啡的患者的3倍；这些患者先前对干扰素治疗无反应81。已发表的研究报告表明，饮用咖啡与肝硬化82,83、肝细胞癌84,85、HCV感染的肝病进展86以及血清ALT活性降低之间存在关联87。
人口研究表明，饮用咖啡可以降低患临床意义重大的慢性肝病的风险88。这些影响可能部分归因于绿原酸的抗病毒活性，绿原酸是一种咖啡多酚，在高温烘焙加工的咖啡中损失多，在绿咖啡提取物中含量特别高89。
8.姜黄素：
姜黄素具有抗氧化、抗炎、抗真菌、抗菌和抗增殖能力90-92。此外，研究发现姜黄素对多种病毒具有抗病毒活性，包括HIV93、流感病毒94和柯萨奇病毒95。姜黄素与IFN-α联合治疗对HCV复制具有“深远的抑制作用”。作者得出结论，姜黄素可能是一种有价值的新型抗HCV药物96。姜黄素也被证明可以预防肝癌97。
9.槲皮素：
槲皮素是一种存在于水果、蔬菜、葡萄酒和茶中的类黄酮，具有抗氧化和抗炎特性。研究表明，槲皮素还具有抗高血压、抗菌、抗纤维化、抗动脉粥样硬化和抗增殖的特性98。槲皮素还被发现可以减少HCV的产生99,100。
10.L-肉碱：
慢性HCV患者接受PEG-IFN/RBV加上氨基酸L-肉碱或PEG-IFM/RBV单独治疗12个月。与非L肉碱组的25%相比，50%的L肉碱组观察到持续病毒学反应显著改善101。补充L肉碱的PEG-IFN/RBV治疗也与慢性丙型肝炎患者的精神和身体疲劳减轻以及健康相关的生活质量改善有关。后一种结果可能会提高患者对PEG-IFN/RBV治疗的依从性102。
更多可点击其个性化的综合干预方案如下：
- 丙肝防控要略（抗氧化应激）
- 丙肝防控要略（防铁质沉积）
- 丙肝防控要略（保肝护肝）
- 丙肝防控要略（辅助治疗）
- 丙肝防控（25-35岁）
- 丙肝防控（36-45岁）
- 丙肝防控（46-55岁）
- 丙肝防控（56-65岁）
- 丙肝防控（66岁以上）
以及参阅本网如下专文的相关内容：
医疗干预
常规治疗包括如下：
丙肝通常采用综合治疗，包括：
- 抗病毒药物
- 增强免疫系统药物
如果不能控制病情，慢性丙肝可导致肝硬化、肝衰竭等严重并发症。
预防
预防丙型肝炎感染措施包括：- 不要共享某些个人用品，如
- 剃须刀
- 牙刷
- 修指甲工具
- 穿孔耳环
- 注意性行为安全。
- 避免非法药物，尤其是注射毒品。
- 小心！纹身或穿孔的病毒传染。
- 注意对肝损伤药物，尤其是发烧止痛药，如对乙酰氨基酚。
- 避免处理可能有丙肝患者血液污染的物品。
- 根据要求，定期检查和检测丙肝和其它性传播疾病。
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参考来源:
美国梅奥诊所
www.mayoclinic.org
美国肝脏基金会
http://www.liverfoundation.org
美国国际肝炎基金会
http://www.hepfi.org
加拿大肝脏基金会
http://www.liver.ca
加拿大卫生部
http://www.hc-sc.gc.ca
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