清热祛湿健脾方抗乙型肝炎肝纤维化的研究

Qingrequshijianpi Decoction in Liver Fibrosis of Chronic Hepatitis B

目的:观察清热祛湿健脾方对慢性乙型肝炎肝纤维化的临床疗效及其对TGF-β1和PDGF的影响。方法:将本院100例慢性乙型肝炎早期肝硬化患者纳入研究,随机分为对照组及观察组,各50例。2组患者均接受多烯磷脂酰胆碱胶囊改善肝功能、恩替卡韦抗病毒治疗,观察组在对照组治疗方案基础上加用清热祛湿健脾方,2组均接受为期24周的治疗疗程,治疗结束后比较2组患者肝功能、肝纤维化指标、肝脏彩超结果以及外周血清TGF-β1和PDGF浓度变化。结果:1)治疗后2组患者肝功能、肝纤维化指标、肝脏彩超结果均较治疗前有所改善,其中观察组改善幅度较对照组明显,差异均有统计学意义(P<0.05);2)治疗后2组患者外周血清TGF-β1和PDGF水平均较治疗前下降,其中观察组下降趋势较对照组明显,差异均有统计学意义(P<0.05)。结论:清热祛湿健脾方可明显改善慢性乙型肝炎肝纤维化的病情,其作用机制可能与下调外周血清TGF-β1和PDGF水平有关。

Objective ： To observe the clinical efficacy of Qingrequshijianpi decoction in hepatic fibrosis of chronic hepatitis B and its influence on the expression of TGF-β1 and PDGF. Methods： One hundred cases of chronic hepatitis B patients with early cirrho- sis in our hospital were randomly divided into a control group and an observation group, 50 cases of each. They all received Poly- erie Phosphatidyleholine Capsules to improve liver function and entecavir for antiviral, but the observation group had extra Qin- grequshijianpi decoction. The two groups were treated for 24 weeks and their liver function, liver fibrosis, liver ultrasound results and serum TGF-beta 1 and PDGF concentration changes were compared after treatment. Results ： 1 ） The liver function, liver fi- brosis, liver ultrasound results were all better than those before treatment in the 2 groups, while the observation group improved more significantly and the differences were statistically significant （P 〈 0. 05 ）. 2） After the treatment, all patient＇ serum levels of TGF-beta land PDGF decreased than those before treatment, while the observation group decreased more significantly and the differences were statistically significant （P 〈 0. 05 ）. Conclusion： Qingrequshijianpi decoction can improve hepatic fibrosis in chronic hepatitis B patients, and the mechanism may be related to down-regulation of peripheral serum levels of TGF-beta 1 and PDGF.