鳖甲煎丸联合恩替卡韦对慢性乙型肝炎肝纤维化患者肝功能、肝纤维化指标和外周血TGF-β1/smad信号通路的影响  

Effects of Biejiajian Pill Combined with Entecavir on Liver Function,Liver Fibrosis Indexes and Peripheral Blood TGF-β1/smad Signaling Pathway of Patients with Chronic Hepatitis B Liver Fibrosis

作　　者：康海燕 叶协琼 唐静 彭平[1] 孙静[1] 丁蕊 KANG Hai-yan;YE Xie-qiong;TANG Jing;PENG Ping;SUN Jing;DING Rui(Department of Infectious Diseases,Wangjing Hospital of the Chinese Academy of Traditional Chinese Medicine,Beijing,100102,China;Department of Hepatic,Beijing Ditan Hospital affiliated to Capital Medical University,Beijing,100015,China)

机构地区：[1]中国中医科学院望京医院感染科,北京100102 [2]首都医科大学附属北京地坛医院肝病一科,北京100015

出　　处：《现代生物医学进展》2023年第23期4441-4445,共5页Progress in Modern Biomedicine

基　　金：北京市科委科技计划重大项目(D171100003117005)。

摘　　要：目的:探讨鳖甲煎丸辅助恩替卡韦治疗慢性乙型肝炎肝纤维化患者肝功能、肝纤维化指标和外周血转化生长因子β1(TGF-β1)/smad信号通路的影响。方法:选取2021年01月~2022年01月中国中医科学院望京医院收治的132例慢性乙型肝炎肝纤维化患者分为对照组和观察组,各66例。对照组以恩替卡韦治疗,观察组增加鳖甲煎丸治疗。比较两组临床疗效、肝功能指标、肝脾B超指标、中医证候积分、肝纤维化指标、外周血TGF-β1/smad信号通路、不良反应发生率。结果:观察组总有效率为90.91%高于对照组74.24%(P<0.05)。治疗后,观察组肝门静脉主干内径、脾门厚度均小于对照组,中医证候积分低于对照组(P<0.05)。治疗后,观察组直接胆红素(DBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)水平均低于对照组(P<0.05)。治疗后,观察组的Ⅲ型前胶原(PC Ⅲ)、Ⅳ型胶原(Ⅳ-C)、透明质酸酶(HAase)、层粘连蛋白(LN)水平均低于对照组(P<0.05)。治疗后,观察组外周血Smad同源物7(Smad7)水平高于对照组,TGF-β1、Smad同源物3(Smad3)水平低于对照组(P<0.05)。两组患者不良反应发生率组间对比无统计学意义(P>0.05)。结论:鳖甲煎丸结合恩替卡韦对慢性乙型肝炎肝纤维化患者可提升治疗效果,降低中医证候积分,改善肝功能和肝纤维化损伤状态,其疗效机制可能与调控TGF-β1/smad信号通路有关。Objective:To investigate the effects of Biejiajian pill combined with entecavir on liver function,liver fibrosis indexes and peripheral blood transforming growth factor-β1(TGF-β1)/smad signaling pathway of patients with chronic hepatitis B liver fibrosis.Methods:132 patients with chronic hepatitis B liver fibrosis who were treated to Wangjing Hospital of the Chinese Academy of Traditional Chinese Medicine from January 2021~January 2022 were selected,and they were divided into control group and observation group,with 66 cases in each group.The control group was treated with entecavir dispersed-tablet,and the observation group was treated with Biejiajian pill on the basis of the control group.Compared the clinical efficacy,liver function indexes,liver and spleen B-ultrasound indexes,traditional Chinese medicine syndrome score,liver fibrosis indexes,peripheral blood TGF-β1/smad signaling pathway,adverse reaction rate between two groups.Results:The total effective rate of observation group was 90.91%higher than 74.24%in the control group(P<0.05).After treatment,in the observation group,the inner diameter of the main hepatic portal vein and the thickness of splenic hilum were lower than those in the control group,and the scores of the traditional Chinese medicine syndrome score was lower than that in the control group(P<0.05).After treatment,the levels of direct bilirubin(DBIL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)in the observation group were lower than those in the control group(P<0.05).After treatment,in the observation group,the levels of procollagen typeⅢ(PC Ⅲ),collagen type Ⅳ(Ⅳ-C),hyaluronidase(HAase),and laminin(LN)were lower than the control group(P<0.05).After treatment,in the observation group,the levels of peripheral blood Smad homolog 7(Smad7)were higher than the control group,and the levels of TGF-β1,and Smad homolog 3(Smad3)in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse rea

关 键 词：慢性乙型肝炎 肝纤维化 肝功能 鳖甲煎丸 恩替卡韦 TGF-Β1/SMAD信号通路 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]