以肝脏大体形态学联合组织学变化探讨中西医治疗乙肝肝硬化的效果  

A study on the therapeutic effect of hepatitis B-related liver cirrhosis treated with different treatments of Chinese and western medicine by researching the general morphological changes and histological changes of liver

作　　者：李野平[1] 王岭[1] 张均倡[1] 王新华[2] 谭志健[3] 何军明[3] 凌云彪[4] 李国焕[1] 李金菊[1] 熊倩[1] 俞家福[1] 张志魁[5] 付新录[5] 秦传英[6] 刘勇[6] 王超[6] 

机构地区：[1]广东省中医院珠海医院,广东珠海519015 [2]广州医学院,广东广州510000 [3]广东省中医院,广东广州510000 [4]中山大学附属第三医院,广东广州510000 [5]广州金域医学检验中心,广东广州510000 [6]广州中医药大学,广东广州510000

出　　处：《时珍国医国药》2013年第7期1738-1741,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金课题(No.30672575;No.81072950);广东省自然科学基金课题(No.8151902501000004);广东省科技厅科技计划项目(No.2008B030301292)

摘　　要：目的从肝脏大体形态学及组织学变化探讨中西医治疗乙肝肝硬化的效果,为分析疗效提供循证医学依据。方法对7例中西医治疗前后行二次肝脏大体形态学和组织学检查的乙肝肝硬化患者,采用描述性方法分析中药(4例)、西药(1例)及中西药结合(2例)治疗对肝脏大体形态学及组织学的变化的影响。结果与治疗前相比,①肝脏大体形态学改变方面:1例小结节肝脏表面结节基本消失,6例结节形态未见明显变化;②在组织学改变方面:肝脏纤维化程度改变方面,中西药结合治疗后纤维化程度减轻最明显,其次为中药,西药治疗无变化;在反映肝脏受损的炎症程度及范围方面,中西药结合治疗可见减轻,中药、西药治疗未见明显变化;在肝脏受损的坏死程度方面,西药治疗后坏死程度减轻最明显,其次为中药、中西药结合治疗。结论①经过积极适当的治疗,肝硬化患者的肝脏大体结节形态可争取不变化或延缓进展,甚至部分可以有逆转;②三种治疗方法对乙肝肝硬化的治疗均具有一定的疗效,各有所长:中西药结合治疗在抗纤维化和抗炎方面效果较单用中药或西药治疗为优,西药治疗在抗炎方面可能较中药治疗效果为好,而中药治疗的抗肝纤维化效果较明显。Objective Using liver morphological and histological changes to analyz therapeutic effect of hepatitis B-related liver cirrhosis treated with different models of Chinese and western medicine to provide evidence of EBM.Methods We surveyed 7 case of hepatitis B-related liver cirrhosis who suffered liver morphological and histological examination before and after treatment.In these 7 cases,4 cases were treated with Chinese medicine,1 case with western medicine and 2 cases with combination of Chinese and western medicine.We utilized descriptives to analyze the morphological and histological changes.Results Compared with the situation before treatment,1 case had nodules disappeared in the morphological changes while 6 cases had no obvious change.In the fibrosis extent of the histological changes,it relieved more in cases treated with combination of Chinese and western medicine,followed by cases treated with Chinese medicine,while there was no obvious change in the cases treated with western medicine.In the inflammatory extent of the histological changes,it relieved more in cases treated with combination of Chinese and western medicine while there was no obvious change in cases treated with Chinese medicine or western medicine.In the necrosis extent of the histological changes,it relieved more in the case treated with western medicine,followed by cases treated with Chinese medicine and combination of Chinese and western medicine.Conclusion After proper treatment,the liver nodules in patients with liver cirrhosis stop progression,some even may be reversed.Three kinds of treatment have certain effect,and each has its own advantage.It works better in cases treated with combination of Chinese and western medicine with regards to anti-fibrosis and anti-inflammatory effect.Western medicine works better in anti-inflammatory effect,and Chinese medicine works better in anti-fibrosis effect.

关 键 词：大体形态学 组织学 肝硬化 疗效 中药 

分 类 号：R256.4[医药卫生—中医内科学]