复方丹参片联合维生素E对慢性乙型肝炎肝纤维化的影响研究

Study on the effect of cpd Danshen tablet combined with vitamin E in chronic hepatitis B(CHB)-related liver fibrosis

目的研究复方丹参片联合维生素E对慢性乙型肝炎肝纤维化的影响.方法将焦作市人民医院2000～2003年慢性乙型肝炎患者44例,随机分为对照组22例,仅给予保肝药;治疗组22例,在对照组基础上加用复方丹参片及维生素E,疗程6个月.比较两组治疗前后ALT、AST及血清前胶原Ⅲ(PⅢP)、胶原Ⅳ(Ⅳ-C)、层连蛋白(LN)、透明质酸酶(HA)、基质金属蛋白酶(MMP)、金属蛋白酶抑制因子(TIMP)水平.并比较治疗前后肝脏病理炎症积分,分析疗程结束时两组肝纤维化变化情况.结果两组ALT、AST均较治疗前有明显好转(P<0.05).治疗组PⅢP、Ⅳ-C、HA、TIMP1水平较治疗前显著降低(P<0.05),LN、MMP1、MMP2 、TIMP2无明显的变化.对照组PⅢP、Ⅳ-C、HA、LN、MMP1、MMP2、TIMP1、TIMP2水平与治疗前相比则无显著的统计学意义.治疗组治疗后TIMP1与MMP1比值明显低于对照组(P<0.05).治疗组炎症、纤维化积分较治疗前有明显的下降(P<0.05),而对照组无显著性改变.治疗后治疗组各期病理逆转率及总逆转率均优于对照组(P<0.05).结论复方丹参片联合维生素E对肝纤维化的发展具有一定的阻断作用,此疗法具有价格便宜、较好疗效、无明显副反应的特点.

Objective To probe the effect of Cpd danshen tablet combined with vitamin E in liver fibrosis by chronic hepatitis B. Methods 44 patients with CHB- related live fibrosis were allocated randomly into control group and Cpd danshen tablet combined with vitamin E treatment group for 6 months＇ treatment. Serum ALT, AST level and fibrosis markers including hyaluronic acid （HA）, Ⅳ collagen （Ⅳ -C）, amino terminal propeptide of type Ⅲ procollagen （PⅢP）, and laminin （LN） and scrum MMP1, 2, TIMP1, 2 level were determined before and after 6 months. Liver biopsies before and after 6 months were assessced. Results ALT, AST level in the two groups were decreased after 6 months＇ treatment （ P 〈 0.05）. PⅢP, Ⅳ-C, HA, TIMP1 level in treatment group was decreased （ P 〈 0.05）, LN, MMP1, MMP2, TIMP2 level had no significant change. PⅢP, Ⅳ- C, HA, LN, MMP1, MMP2, TIMP1, TIMP2 level in control group had no statistically significant difference compared with before 6 months. TIMP1/MMP1 level was lower compared with before 6 months （ P 〈 0.05）, but no statistically significant difference in control group. Hepatic inflammatory score, fibrosis score decreased significantly, in contrast, there was no significant change in control group. The inversion rate in each pathogenic stage and total inversion rate in treatment group was higher than that in control group, there was statistically significant difference （ P 〈 0.05）. Conclusion Cpd danshen tablet combined with vitamin E can reverse chronic hepatitis B （CHB） - related fibrosis.