抗纤肝汤治疗慢性乙型肝炎肝纤维化54例  

Effect of Kangxian'gan Decoction in Treating 54 Cases with Liver Fibrosis Caused by Chronic Hepatitis B

作　　者：韩曼珠 王芬[1] 李丽[1] 卢碧雪 罗凌介[1] 

机构地区：[1]海南省中医院,海口570203

出　　处：《中国实验方剂学杂志》2015年第16期183-187,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局"全国名老中医药专家传承工作室"资助项目(国中医药规财发[2010]35号)

摘　　要：目的:观察抗纤肝汤治疗慢性乙型肝炎肝纤维化的疗效及对血清瘦素和转化生长因子-β1(TGF-β1)的影响。方法:将106例患者随机按数字表法分为观察组54例和对照组52例。两组均采用阿德福韦酯片10 mg/次,1次/d。对照组加服扶正化瘀胶囊,1.5 g/次,3次/d。观察组加服抗纤肝汤,1剂/d。两组疗程均为48周。检测治疗前后透明质酸(HA),层粘连蛋白(LN),血清III型前胶原(PCIII),血清IV型胶原(IV-C),天门冬氨酸氨基转移酶(AST),丙氨酸氨基转移酶(ALT),总胆红素(TBIL),白蛋白(ALB),乙肝病毒脱氧核糖核酸(HBV-DNA)水平;检测转化生长因子-β1(TGF-β1)和瘦素(Leptin,LP)水平;采用酶联免疫法检测治疗前后乙肝病毒血清学标志物(HBV-M);采用彩色多普勒超声仪检测门静脉内径、脾静脉内径、脾脏厚度和血流速度。结果:经Ridit分析,观察组临床疗效优于对照组(P<0.05);治疗后观察组血清HA,PCⅢ,LN及IV-C水平低于对照组(P<0.01);治疗后观察组ALT,AST及TBIL水平低于对照组(P<0.01),ALB水平高于对照组(P<0.01);治疗后观察组和对照组HBe Ag阴转率分别为29.6%和25%,两组比较差异无统计学意义;治疗后观察组HBV-DNA,LP和TGF-β1水平低于对照组(P<0.01);治疗后观察组门静脉内径、脾静脉内径、脾脏厚度低于对照组,血流速度快于对照组(P<0.01)。结论:在抗病毒治疗的基础上,采用抗纤肝汤能抗病毒、有保护肝功能、改善肝脾彩色多普勒超声,降低血清LP和TGF-β1水平,对乙型肝炎肝纤维化的发展有抑制作用,其临床疗效优于扶正化瘀胶囊。Objective： To observe the efficacy of Kangxian＇gan decoction in treating liver fibrosis caused by chronic hepatitis B and its effect on serum leptin and transforming growth factor-β1（ TGF-β1）. Method：Totally 106 patients were divided into the control group（ 54 cases） and the observation group（ 52 cases） by the random number table. Both groups received Adefovir Dipivoxil tablets,10 mg / time,1 time / day. Patients in the control group took Fuzheng Huayu capsules,1. 5 g / time,3 times / day. Patients in the observation group took Kangxiangan decoction,1 dose / day. The treatment courses of both groups lasted for 48 weeks. The hyaluronic acid（ HA）,laminin（ LN）,serum levels of procollagen type III（ PCIII）,serum level of collagen type IV（ IV-C）,aspartate aminotransferase（ AST）,alanine aminotransferase（ ALT）,total bilirubin（ TBIL）,albumin（ ALB）,HBV-DNA,TGF-β1and leptin levels were detected. The HBV serological markers（ HBV-M） were detected by the euzymelinked immunosorbent assay before and after the treatment. The portal vein diameter,splenic vein diameter,thickness of spleen and blood flow velocity were detected by the color Doppler ultrasound. Result： According to the Ridit analysis,the clinical efficacy in the observation group was higher than that in the control group（ P〈0. 05）. After the treatment,the serum HA,PCⅢ,LN and IV-C levels in the observation group were less than that in the control group（ P〈0. 01）. After the treatment,ALT,AST and TBIL levels in the observation group were lower than that in the control group（ P〈0. 01）,but with higher ALB level than the control group（ P〈0. 01）.The HBe Ag negative conversion rate in the observation group was 29. 6%,while that in the control group was25%,with no statistical significance in their difference. The HBV-DNA, leptin and TGF-β1levels in the observation group were lower than that in the control group after the treatment（ P〈0. 01）. The portal vein diameter,spleen vein diameter

关 键 词：慢性乙型肝炎 肝纤维化 抗纤肝汤 瘦素 转化生长因子-Β1 

分 类 号：R287[医药卫生—中药学]