补肾法对慢性乙型肝炎病毒携带者肝组织病理的影响  

Effect of Tonifying Kidney Therapy on Pathology of Chronic Hepatitis B Virus Carriers

作　　者：邢宇锋[1] 童光东[1] 周大桥[1] 贺劲松[1] 魏春山[1] 陈英杰[1] 

机构地区：[1]深圳市中医院肝病科,广东深圳518033

出　　处：《中国中医药信息杂志》2016年第5期24-27,共4页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家科技重大专项(2008ZX10005-008)

摘　　要：目的观察补肾法干预对慢性乙型肝炎病毒(HBV)携带者肝组织病理的影响。方法采用多中心、随机、双盲、安慰剂对照研究方法,将600例患者随机分为补肾清透组、补肾健脾组和对照组各200例,分别使用补肾清透方、补肾健脾方和安慰剂治疗,疗程52周,治疗前后进行肝穿检查,观察肝脏病理学改变,分别采用Knodell组织学活动指数(HAI)和Ishak纤维化评分评价肝组织炎症活动度和纤维化程度。结果共得到106例病理样本。补肾清透组、补肾健脾组和对照组治疗后Knodell HAI评分下降≥2分者分别为21、18、6例(P<0.05),Knodell HAI评分上升≥2分者分别为3、2、8例(P<0.05),补肾清透组和补肾健脾组炎症活动度明显低于对照组,两治疗组间作用相似(P>0.05)。补肾清透组、补肾健脾组和对照组治疗后Ishak纤维化评分下降≥1分者分别为13、12、9例(P>0.05),Ishak纤维化评分上升≥1分者分别为8、3、11例,补肾健脾组与对照组比较差异有统计学意义(P<0.01),补肾清透组与对照组比较差异无统计学意义(P>0.05),补肾健脾组患者肝组织纤维化恶化比例明显低于对照组。结论补肾法(补肾清透方和补肾健脾方)有改善慢性HBV携带者炎症活动和延缓纤维化进展的作用。Objective To study the effects of tonifying kidney therapy on pathology in chronic hepatitis B virus carriers.MethodsWith the multi-center, randomized, double-blinded and placebo-controlled methods, 600 cases of chronic hepatitis B virus carriers were divided intoBushen Qingtou group,Bushen Jianpi group and control group, 200 cases in each group, and were treated withBushen Qingtou prescription,Bushen Jianpi prescription and placebo prescription respectively for 52 weeks. The pathological changes of the liver biopsy were observed by liver biopsy examination before and after treatment. Inflammatory active degree and fibrosis were scored with Knodell HAI and Ishak.Results The number of decreasing more than 2 points on Knodell HAI inBushen Qingtou group,Bushen Jianpi group and control group was 21, 18, and 6 respectively (P<0.05); the number of increasing more than 2 points on Knodell HAI in three groups was 3, 2, and 8 respectively (P<0.05). The curative effect ofBushen Qingtou prescription,Bushen Jianpi prescription were significantly obviously better than control group, without statistical significnce between the two treatment groups (P>0.05). The number of decreasing more than 1 points on Ishak in Bushen Qingtou group,Bushen Jianpi group, and control group was 13, 12, and 9 respectively (P>0.05); the number of increasing more than 1 points on Ishak inBushen Qingtou group,Bushen Jianpi group and control group was 8, 3, and 11 respectively, with statistical significance betweenBushen Jianpi group and controlled group (P<0.01), without statistical significance betweenBushen Qingtou group and control group (P>0.05), which meantBushenJianpi prescription could prevent the deterioration of liver tissue fibrosis more significantly than placebo prescription did. ConclusionTonifying kidney therapy, includingBushen Qingtou prescription andBushen Jianpi prescription, can inhibit the inflammatory activity and slow down the fibrosis progression of the chronic HBV carriers.

关 键 词：慢性乙型肝炎 病毒携带者 肝组织病理 补肾法 临床随机对照试验 

分 类 号：R259.126.2[医药卫生—中西医结合]