复方中药抗纤Ⅰ号抗肝纤维化的实验与临床研究

Effects of traditional Chinese herbs complex compounds--antifibrosis-Ⅰ on hepatic fibrosis:an experimental and clinical study

目的 探讨复方中药“抗纤Ⅰ号”方在慢性肝炎患者中抗肝纤维化的作用。方法 选择 70只Wistar大鼠 ,取10只作为正常对照组 ,余 60只给予 40 %四氯化碳橄榄油混合液建立实验性大鼠肝纤维化模型 ,将大鼠均分为 4组 :(1)肝纤维化模型组仅灌生理盐水 ;(2 )中药组灌服“抗纤Ⅰ号”方药 ;(3 )秋水仙碱组灌服秋水仙碱 ;(4 )干扰素组肌肉注射γ 干扰素。均治疗 8周后取鼠肝右叶作病理检查。 63例慢性肝炎肝纤维化患者分成 3组 :(1)中药组 3 4例接受“抗纤Ⅰ号”方治疗 ;(2 )对照组 14例给予传统护肝治疗 ;(3 )干扰素组 15例给予重组γ 干扰素治疗。结果 从动物实验模型上发现 ,中药组灌胃治疗后肝纤维化评分值与秋水仙碱组相比无显著性差异 (P >0 .0 5 ) ,病理检查示肝组织炎症坏死明显吸收好转。临床观察显示 ,中药组与对照组比较肝纤维化患者丙氨酸氨基转移酶 (ALT)、总胆红素 (TBil)和Ⅳ型胶原 (PⅣ)水平降低更明显 (P <0 .0 5 ) ;与干扰素相比 ,中药同样能改善患者的乏力和腹胀症状 ,并一定程度地缩小门、脾静脉内径和脾脏厚径(P >0 .0 5 ) ,未见明显不良反应。结论 “抗纤Ⅰ号”方在肝纤维化模型上具有与秋水仙碱相当的抗炎和抗纤维化作用 ,临床上具有护肝、降酶、退黄和软肝功效 。

Objective To explore the effects of antifibrosis Ⅰ on hepatic fibrosis in patients with chronic viral hepatitis.Methods 40% CCl 4 mixture was used to establish the fibrostic mouse model in 60 Wistar mice,which were divided into 4 groups in average.(1)Hepatic fibrostic model group was healed 0.9% sodium chloride solution.(2)Chinese herbs group was treated with traditional Chinese herbs complex compounds--antifibrosis Ⅰ.(3)Colchicine group was treated with colchicine.(4)Interferon group was treated with interferon γ.The hepatic tissues were obtained for pathological examination.63 patients with hepatic fibrosis were divided into three groups.Chinese herbs group(34 cases) was given antifibrosis Ⅰ twice a day,control group (14 cases) was given traditional therapy and interferon γ group was given interferon γ(IFN γ) therapy.Results In the mouse experiment,there was no significant difference in fibrostic estimation between Chinese herbs group and colchicine group( P >0.05),and pathological examination showed that hepatic pathological histology in Chinese herbs group had improved.The levels of transaminase (ALT),total bilirubin (TBil) and type Ⅳ collagen in patients treated with antifibrosis Ⅰ were much lower than those of control group( P <0.05);as compared with IFN?γ group,the patients achieved improvment,and the inner diameters of portal and splenic veins also slightly decreased( P >0.05).There were no obvious adverse reactions during treatment in Chinese herbs group.Conclusions Antifibrosis Ⅰ has the same effectiveness as colchicine in antiinflammation and antifibrosis in the fibrostic model and its therapeutic effects is much better than the traditional therapy in patients with chronic viral hepatitis.