五灵胶囊联合富马酸丙酚替诺福韦治疗CHB患者的效果及对TGF-β/Smad信号通路的调节作用

Efficacy of Wuling Capsule Combined with Tenofovir Alafenamide Fumarate in the Treatment of Chronic Hepatitis B Patients and Regulation of TGF-β/Smad Signalling Pathway

目的 探究五灵胶囊联合富马酸丙酚替诺福韦(TAF)治疗慢性乙型肝炎(CHB)患者的效果及对TGF-β/Smad信号通路的调节作用。方法 选取2021年4月至2022年8月新乡市传染病医院收治的200例CHB患者,按照随机数字表法分为观察组(100例)、对照组(100例)。给予对照组TAF,给予观察组五灵胶囊联合TAF,比较治疗前后肝功能指标[谷丙转氨酶(GPT)、谷草转氨酶(GOT)、总胆红素(TBIL)]、肝纤维化指标[透明质酸(HA)、人类软骨糖蛋白39(YKL-40)]、TGF-β/Smad信号通路相关指标[转化生长因子-β_(1)(TGF-β_(1))、Smad2、Smad7、p38丝裂原活化蛋白激酶(p38 MAPK)],比较两组临床疗效及乙肝病毒e抗原(HBeAg)、HBV-DNA转阴率。结果 观察组总有效率高于对照组(P<0.05)。治疗1、3、6个月后观察组TBIL、GPT、GOT、HA、YKL-40、TGF-β_(1)、Smad2、p38 MAPK均低于对照组,Smad7高于对照组(P<0.05);观察组HBeAg转阴率、HBV-DNA转阴率均高于对照组(P<0.05)。结论 五灵胶囊及TAF联合治疗CHB,可有效提升患者肝功能,改善肝纤维化,促进HBV-DNA转阴,其作用机制与TGF-β/Smad信号通路的调节作用相关。

Objective To explore the efficacy of Wuling capsule combined with tenofovir alafenamide fumarate(TAF)in the treatment of chronic hepatitis B(CHB)patients and the regulation of TGF-β/Smad signaling pathway.Methods A total of 200 CHB patients admitted to Xinxiang Infectious Diseases Hospital from April 2021 to August 2022 were selected and divided into observation group(100 cases)and control group(100 cases)according to the random number table.TAF was given to the control group and Wuling capsule combined with TAF was given to the observation group.Hepatic function indexes[glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT),total bilirubin(TBIL)],hepatic fibrosis indexes[hyaluronic acid(HA),human chondroitin 39(YKL-40)],TGF-β/Smad signalling pathway-related indicators[transforming growth factor-β1(TGF-β1),Smad2,Smad7,p38 mitogen-activated protein kinase(p38 MAPK)]before and after treatment were compared.The clinical efficacy,hepatitis B virus e antigen(HBeAg),HBV-DNA conversion rate and adverse reactions of two groups were compared.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).TBIL,GPT,GOT,HA,YKL-40,TGF-β1,Smad2 and p38 MAPK in the observation group were lower than those in the control group after 1 month,3 months and 6 months of treatment,and Smad7 was higher than that of the control group(P<0.05).The HBeAg conversion rate and the HBV-DNA conversion rate of the observation group were higher than those of the control group(P<0.05).Conclusion The combination of Wuling capsule and TAF can effectively improve the liver function of CHB patients,improve liver fibrosis,and promote the negative transformation of HBV-DNA,the mechanism of which is related to the regulation of TGF-β/Smad signaling pathway.