中药鳖甲煎丸抗肝纤维化作用的临床研究

Cnilical Study on Chinese Herb Biejiajian Pill for Treating Hepatic Fibrosis

目的:研究中药鳖甲煎丸对慢性肝炎肝纤维化的治疗作用。方法:用肝穿或RIA法测定血清肝纤维化指标如透明质酸(HA)、Ⅲ型前胶原(PCⅢ)及层粘蛋白(LN)等,筛选出肝纤维化指标明显异常的慢性肝炎患者80例,随机分为鳖甲煎丸组及对照组各40例,对照组用普通保肝药治疗,疗程均为3个月,观察治疗前后的血清肝纤维化指标及肝脏组织病理学变化。结果:血清HA、PCⅢ及LN水平:治疗前,鳖甲煎丸组为465.3±121.5(ng/ml)、190.5±77.1(μg/L)及164.7±41.9(ng/ml),对照组为479.9±198.3(ng/ml)、206.4±87.2(μg/L)及175.2±67.5(ng/ml),两组之间无显著性差异(P>0.05);治疗后,鳖甲煎丸组为87.2±41.7(ng/ml)、126.7±53.6(μg/L)及43.4±20.7(ng/ml),对照组为261.7±105.3(ng/ml)、191.2±61.3(μg/L)及89.4±45.3(ng/ml),两组差异显著(P<0.05)。鳖甲煎丸组患者血清肝纤维化指标治疗后与治疗前相比有非常显著性差异(P<0.01),且治疗后其肝纤维化指柝接近正常组(P>0.05),其组织病理学显示肝纤维化组织增生程度显著减轻。结论:中药鳖甲煎丸具抗纤维化作用,可用于临床。

Objective: To study the treating effect of Chinese herbs Biejiajian pill on hepatic fibrosis in chronic hepatitis patients. Methods: Serum hepatic fibrosis marks such as hyaluronic acid (HA)、 procollagen 333333 type (PC Ⅲ) and laminin (LN) were measured with radioimmunoassay (RIA), 80 chronic hepatitis patients with abnomal hepatic fibrosis marks were chosen. These patients were randomly divided into two groups: Biejiajian pill group (n = 40) and control group (n = 40). The control group was given common liver protective drugs. The serum hepatic fibrosis marks and liver histopathological change under microscope were observed after 3 months. Result: The level of serum HA、 PC Ⅲ and LN were significantly lower after treating (87. 2±41. 7ng/ml、126. 7?3. 6μg/L and 43. 4±20. 7ng/ml) than those before treating (465. 3±121. 5ng/ml、 190. 5±77. lμg/L and 164. 7±41. 7ng/ml) in Biejiajian pill group (P<0. 01) and closed to healthy people (57. l ±27ng/ml、 83. 5± 17. 8μg/L and 38.2±11.85ng/ml) (P>0. 05). There was significant change in serum hepatic fibrosis marks between in Biejiajian pill group(87. 2±41. 7ng/ml, 126. 7 ±53. 7μg/L and 43. 4 ± 20. 7ng/ ml) and in control group(261. 7±105. 3ng/ml, 191. 2±61.3μg/L and 89. 4± 45. 3ng/ml)(P<0. 05). Liver histopathological result under microscope showed that the degree of hepatocyte degeneration and hepatic fibrosis were obviously reduced after treating than those before treating in Biejiajian pill group. Conclusion: Chinese herbs Biejiajian pill can effectively treat hepatic fibrosis in chronic hepatitis patients.