柴胡鳖甲柔肝饮对失代偿期乙肝肝硬化患者肝纤维化、病毒学指标及血清vWF、TSP-1水平的影响  

Effects of Chaihu Beijia Soft Liver Drink on liver fibrosis,virological indexes and serum vWF and TSP-1 levels in patients with cirrhosis of hepatitis B in decompensated stage

作　　者：郝芬丽 范兴刚[1] 连博[1] HAO Fen-li;FAN Xing-gang;LIAN Bo(Department of Traditional Chinese Medicine,Fuyang Fifth People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市第五人民医院中医科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2025年第4期346-350,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生健康科研项目(编号:AHWJ2022b069)。

摘　　要：目的观察柴胡鳖甲柔肝饮对失代偿期乙肝肝硬化患者肝纤维化、病毒学指标及血清血管性血友病因子(vWF)、凝血酶敏感蛋白1(TSP-1)水平的影响。方法选取2020年3月至2024年3月阜阳市第五人民医院收治的64例失代偿期乙肝肝硬化患者,采用抽签法分为常规组(n=32)和观察组(n=32)。常规组进行规范用药,观察组在常规组基础上采用柴胡鳖甲柔肝饮治疗。分别比较两组肝纤维化四项指标[层粘连蛋白(LN)、透明质酸酶(HA)、Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ-C)]、肝功能[丙氨酸转氨酶(ALT)、总胆红素(TBil)]、血清vWF、TSP-1、影像学参数(门/脾静脉内径、脾厚度、肝脏硬度)及中医证候积分差异。统计两组乙型肝炎病毒(HBV)DNA转阴率、乙型肝炎e抗原(HBeAg)转阴率、HBV表面抗原(HBsAg)转阴率。结果治疗12周后,两组的LN、HA、PCⅢ、Ⅳ-C水平均较治疗前降低,且观察组的LN、HA、PCⅢ、Ⅳ-C水平分别为(120.14±29.71)mg/L、(110.14±43.37)mg/L、(89.74±16.43)μg/L、(63.24±16.44)μg/L,均低于常规组[(175.25±35.22)mg/L、(156.65±52.02)mg/L、(115.23±21.07)μg/L、(85.25±18.96)μg/L],差异均有统计学意义(P<0.05)。治疗12周后,两组的ALT、TBil水平均较治疗前降低,且观察组的ALT、TBil水平分别为(42.56±8.14)U/L、(19.74±4.69)μmol/L,均低于常规组[(82.95±12.47)U/L、(30.15±5.44)μmol/L],差异均有统计学意义(P<0.05)。治疗12周后,两组的血清vWF、TSP-1水平均较治疗前降低,且观察组的血清vWF、TSP-1水平分别为(1.13±0.15)、(1.02±0.10)ng/mL,均低于常规组[(1.25±0.18)、(1.13±0.12)ng/mL],差异均有统计学意义(P<0.05)。治疗12周后,两组的影像学参数均较治疗前降低,且观察组的门/脾静脉内径、脾厚度、肝脏硬度分别为(9.77±1.06)mm、(8.23±0.87)mm、(36.44±5.02)mm、(26.45±4.05)kPa,均低于常规组[(11.89±1.21)mm、(9.87±0.94)mm、(41.02±5.97)mm、(31.12±4.88)kPa],差异均有统计学�Objective To observe the effects of Chaihu Beijia Soft Liver Drink on liver fibrosis,virological indexes and serum levels of von Willebrand factor(vWF)and thrombin-sensitive protein 1(TSP-1)in patients with hepatitis B cirrhosis in the decompensated stage.Methods Sixty-four patients with hepatitis B cirrhosis in the decompensated stage admitted to the Fuyang Fifth People's Hospital from March 2020 to March 2024 were selected and divided into the conventional group(n=32)and the observation group(n=32)using the lottery method.The conventional group was treated with standardised medication,and the observation group was treated with Chaihu Bajia Soft Liver Drink on the basis of the conventional group.Four indicators of liver fibrosis[laminin(LN),hyaluronidase(HA),procollagen typeⅢ(PCⅢ),typeⅣcollagen(Ⅳ-C)],liver function[alanine transaminase(ALT),total bilirubin(TBil)],serum vWF,TSP-1,imaging parameters(inner diameter of the portal/splenic vein,splenic thickness,and liver stiffness),and Chinese medicine syndrome scores before treatment and after 12 weeks of treatment were compared in the two groups.The hepatitis B virus(HBV)DNA negative conversion rate,hepatitis B e antigen(HBeAg)negative conversion rate and hepatitis B surface antigen(HBsAg)negative conversion rate of the two groups were counted.Results After 12 weeks of treatment,the levels of LN,HA,PCⅢandⅣ-C in the two groups were lower than those before treatment,and the levels of LN,HA,PCⅢandⅣ-C in the observation group were(120.14±29.71)mg/L,(110.14±43.37)mg/L,(89.74±16.43)μg/L,(63.24±16.44)μg/L,respectively,which were lower than those in the conventional group[(175.25±35.22)mg/L,(156.65±52.02)mg/L,(115.23±21.07)μg/L,(85.25±18.96)μg/L],and the differences were statistically significant(P<0.05).After 12 weeks of treatment,the levels of ALT and TBil in the two groups were lower than those before treatment,and the levels of ALT and TBil in the observation group were(42.56±8.14)U/L and(19.74±4.69)μmol/L,respectively,which were lower th

关 键 词：肝硬化 柴胡鳖甲柔肝饮 失代偿期 肝纤维化 肝脾形态 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]