活血化瘀法全程干预对慢性乙肝肝纤维化疗效的影响

Therapeutic Effect of Whole-range Treatment with Blood-activating and Stasis-resolving Therapy for Chronic Hepatic Fibrosis After Hepatitis B

目的:观察活血化瘀法对慢性乙肝肝纤维化的临床疗效。方法:将90例患者随机分为常规组、治疗组和对照组各30例。分别给予相应治疗,观察肝功能指标、肝纤维化指标、药物不良反应及疗效。结果:临床疗效治疗组和对照组的基本治愈率均较常规组高,差异有显著性意义(P<0.05)。治疗后3组肝功能各指标均有明显改善,与治疗前比较,差异均有显著性意义(P<0.05)。治疗组治疗后肝功能各指标均较常规组明显改善,差异有显著性意义(P<0.05)。对照组治疗后ALT、TBil、Alb均较常规组明显改善,差异有显著性意义(P<0.05)。治疗后治疗组与对照组肝纤维化各指标均较治疗前明显下降,差异有显著性意义(P<0.05);治疗组PⅢ较时照组明显下降,差异有显著性意义(P<0.05)。治疗组HA、PⅢ、LN均较常规组治疗后明显下降,差异有显著性意义(P<0.05)。对照组治疗后HA较常规组明显下降,差异有显著性意义(P<0.05)。结论:活血化瘀法能保护肝功能,改善肝脏微循环,抑制胶原合成,促进肝纤维化溶解重吸收。

Objective:To observe the therapeutic effect of whole-range treatment with blood-activating and stasis-resolving therapy(BST) for chronic hepatic fibrosis after hepatitis B.Methods:Ninety patients were equally randomized into 3 groups:routine treatment group,BST group and positive control group.After treatment, the changes of parameters of hepatic function and hepatic fibrosis were observed, and the side effect as well as therapeutic effect was evaluated.Results:The cure rate was higher in BST group and positive control group than that in the routine treatment group(P<0.05).The parameters of hepatic function were much improved in the three groups after treatment(P<0.05 compared with those before treatment). After treatment,all of the observation parameters were decreased in BST group,and alanine transferase(ALT),total bilirubin(TBil) and albumin(Alb) were decreased in the positive control group(P<0.05 compsred with those in the routine treatment group).The parameters of hepatic fibrosis were decreased in the positive control group and BST group(P<0.05 compared with those before treatment).After treatment, procollagenⅢ(PⅢ) in BST group was lower than that in the positive control group (P<0.05),and serum levels of hemagglutinin(HA),pⅢ,and laminin(LN) were lower in BST group than that in the routine treatment group(P<0.05).HA level in the positive control group was lowerthan that in the routine treatment group(P<0.05).Conclusion:BST can protect hepatic function,improve hepatic microcirculation, inhibit the synthesis of collagen,and promote the dissolving and reabsorption of hepatic fibrosis.