“补肾生髓成肝”对乙型肝炎病毒前C区基因突变的影响  

Effect of tonifying kidney to regulate stem cells for transforming liver on HBV Pre-C gene mutation

作　　者：肖琳[1] 李瀚旻[1] 叶之华[2] 高翔[1] 晏雪生[1] 

机构地区：[1]湖北省中医院脏象肝病研究所,湖北武汉430061 [2]湖北中医药大学

出　　处：《中西医结合肝病杂志》2013年第4期217-218,233,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家中医(肝病)临床研究基地(湖北)重点病种研究项目(No.JDZX2012054);国家自然科学基金(No.90709041;30672590;30271562;30371787;81102531;81274147);国家科技部重大基础研究项目"973"项目(No.2002CCC00300);湖北省自然科学基金重点项目(No.2011CDB463);国家"十二五"重大专项(No.2012ZX10005005-001-015)

摘　　要：目的:研究"补肾生髓成肝"治疗法则指导治疗慢性乙型肝炎(CHB)对乙型肝炎病毒(HBV)前C区基因突变的影响。方法:采用基因芯片技术定量检测经体现"补肾生髓成肝"指导治疗法则的"地五养肝方"、"抗毒软坚方"序贯或合方辨证加减及拉米夫定(LAM)治疗后HBV前C区基因变异。结果:治疗组的HBV前C区1762、1764、1896、1899位点变异率(2.56%、3.85%、5.13%、6.41%)明显低于LAM对照组(6.06%,9.09%,12.12%、13.64%),差异有显著性意义(P<0.05)。治疗组HBV前C区1762、1764、1896、1899位点变异株信号强度(893.54±332.79、821.34±662.32、1134.67±919.98、643.43±234.99)显著低于LAM对照组(1671.13±321.89、1267.45±451.53、2869.55±461.16、1211.12±138.67),差异有显著性意义(P<0.05)。结论:采用体现"补肾生髓成肝"法则的"地五养肝方"、"抗毒软坚方"辨证加减治疗CHB相对于采用LAM治疗CHB对HBV前C区基因突变影响较小,可在一定程度上降低因HBV基因突变导致的临床风险。Objective： To research the effect of TCM therapeutic principle of ＂tonifying the kidney to regulate stem cells for transforming the liver＂ on chronic hepatitis B with Pre-C gene mutation. Methods： Using gene chip technology to make a quantitative detection of HBV Pre-C gene mutation after seguential or differentiation modified treatment by two TCM formulas ＂Diwuyangganfang＂ and ＂Kangduruanjianfang＂ based on the TCM therapeutic principle of ＂tonifying the kidney to regulate stem ceils for transforming the liver＂ （the treatment group）, or by lamivudine tablets （the control group） Results： In the treatment group, the mutation rates of HBV Pre-C in locus of 1762, 1764, 1896 and 1899 （2. 56%, 3. 85%, 5. 13% and 6. 41% ） were significantly lower than the control group （6. 06%, 9. 09%, 12. 12% and 13. 64% ）, what showed a significant difference in statistics （P 〈0. 05） . The signal intensity of variant strains in locus of 1762, 1764, 1896, 1899 of HBV Pre-C in the treatment group （893.54 ＋332.79, 821.34 ＋662.32, 1134. 67 ＋ 919. 98 and 643. 43 ~ 234. 99） was significantly lower than the control group （ 1671.13 ＋ 321.89, 1267. 45 ＋ 451.53, 2869. 55 ~461.16 and 1211.12 ~ 138. 67 ）, and the difference between the two groups was significant （P 〈0. 05） . Conclusion： Compared with the control group treating by lamivudine tablets, HBV Pre-C gene mutation was less affected in the treatment group which is trea- ting by differentiation modified TCM formulas ＂Diwuyangganfang＂ and ＂Kangduruanjianfang＂ based on the TCM therapeutic principle of ＂tonifying the kidney to regulate stem cells for transforming the liver＂ What＇s more, the using the TCM therapeutic principle ＂toni- fying the kidney to regulate stem cells for transforming the liver＂ to treat chronic hepatitis B can reduce the clinical risk which is caused by gene mutation of I-IBV in some extent.

关 键 词：肝炎 乙型 慢性 补肾生髓成肝 乙肝病毒 基因变异 基因芯片 

分 类 号：R259[医药卫生—中西医结合]