基于TGF-β_(1)/Smad信号通路探讨健脾化瘀汤抗肝硬化的疗效和作用机制  

Effect and Mechanism of Jianpi Huayu Decoction on Liver Cirrhosis Based on TGF-β_1/Smad Signaling Pathway

作　　者：张杭洲 朱岩洁 王菲[1] 娄静[1] 徐娇娇 侯留法[1] 赵雷[1] ZHANG Hangzhou;ZHU Yanjie;WANG Fei;LOU Jing;XU Jiaojiao;HOU Liufa;ZHAO Lei(Hepatobiliary Spleen and Stomach Department,Henan Integrated Traditional Chinese and Western Medicine Hospital(Affiliated Hospital of Traditional Chinese Medicine of Henan),Zhengzhou 450004,China)

机构地区：[1]河南省中西医结合医院(河南省中医药研究院附属医院)肝胆脾胃科,河南郑州450004

出　　处：《河南医学研究》2023年第18期3383-3387,共5页Henan Medical Research

基　　金：河南省中医药青苗人才培养项目[豫中医函[2021]16号];河南省中医药传承与创新人才工程(仲景工程)中医药学科领军人才项目[豫中医函[2021]8号];河南省中医药传承与创新人才工程(仲景工程)中医药学科拔尖人才项目[豫中医函[2021]15号]。

摘　　要：目的探究健脾化瘀汤治疗肝硬化的临床效果,并分析其对转化生长因子-β_(1)(TGF-β_(1))/Smad信号通路的影响。方法选取2021年12月至2022年10月在河南省中西医结合医院诊治80例的乙肝肝硬化患者作为研究对象,随机分为对照组和治疗组,各40例。对照组接受富马酸替诺福韦二吡呋酯胶囊治疗,治疗组接受富马酸替诺福韦二吡呋酯胶囊联合健脾化瘀汤治疗。比较两组临床疗效、中医证候积分、肝功能指标[白蛋白(ALB)、γ-谷氨酰基转移酶(GGT)、总胆红素(TBIL)、谷丙转氨酶(GPT)]、肝纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ胶原蛋白(Ⅳ-C)、透明质酸(HA)]、肝硬度值、TGF-β_(1)/Smad信号通路相关mRNA。结果治疗组临床总有效率高于对照组(P<0.05)。治疗后,治疗组胃脘胀满、食欲不振、倦怠乏力、胁肋疼痛证候积分低于对照组(P<0.05);TBIL、GGT、GPT、PCⅢ、Ⅳ-C、HA低于对照组,ALB高于对照组(P<0.05);肝硬度值低于对照组(P<0.05);TGF-β_(1)、Smad3、Smad5 mRNA低于对照组(P<0.05)。结论健脾化瘀汤可改善肝功能、肝硬度,其作用机制可能与抑制TGF-β_(1)/Smad信号通路有关。Objective To investigate the clinical efficacy of Jianpi Huayu decoction in the treatment of liver cirrhosis,and to analyze its effect on transforming growth factor-β1(TGF-β1)/Smad signaling pathway.Methods A total of 80 patients with hepatitis B cirrhosis diagnosed and treated in Affiliated Hospital of Traditional Chinese Medicine of Henan from December 2021 to October 2022 were selected as the research objects and randomly divided into control group and treatment group,40 cases in each group.The control group received tenofovir dipivoxil fumarate capsules,and the treatment group received tenofovir dipivoxil fumarate capsules combined with Jianpi Huayu decoction.The clinical efficacy,traditional chinese medicine syndrome score,liver function index[albumin(ALB),total bilirubin(TBIL),γ-glutamyltransferase(GGT),glutamic-pyruvic transaminase(GPT)],liver fibrosis index[typeⅢprecollagen(PCⅢ),Ⅳcollagen(Ⅳ-C),hyaluronic acid(HA)],liver hardness value,TGF-β1/Smad signaling pathway related mRNA were compared between the two groups.Results The total effective rate of the treatment group was higher than that of the control group(P<0.05).After treatment,the syndrome scores of epigastric fullness,loss of appetite,fatigue and hypochondriac pain in the treatment group were lower than those in the control group(P<0.05).TBIL,GGT,GPT,PCⅢ,Ⅳ-C and HA were lower than those in the control group,while ALB was higher than that in the control group(P<0.05).The liver hardness was lower than that of the control group(P<0.05).TGF-β1,Smad3 and Smad5 mRNA were lower than those in the control group(P<0.05).Conclusion Jianpi Huayu decoction can improve liver function,liver fibrosis and liver hardness in patients with hepatitis B cirrhosis,and its mechanism may be related to the inhibition of TGF-β1/Smad signaling pathway.

关 键 词：TGF-β_(1)/Smad信号通路 健脾化瘀汤 乙肝肝硬化 疗效 

分 类 号：R657.3[医药卫生—外科学]