Intervention effect and mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Bionjia on CCl4-induced hepatic fibrosis rat model

Objective:To investigate the intervention effect and specific mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Turmeric on carbon tetrachloride(CCl4)-induced liver fibrosis in rats.Methods:SPF SD rats were randomly divided into control group,model group,and Chinese medicine treatment(low,medium and high dose)groups.The model group and Chinese medicine treatment group were given intraperitoneal injection of 40%CCl4 olive oil solution twice a week.A rat model of liver fibrosis was replicated by the method for 8 weeks.After successful modeling,each drug-administered group was gavaged with corresponding drugs,and the control group and model group were gavaged with equal volume of distilled water,once a day,for 4 weeks.After the last intragastric administration,HE staining and Masson staining were used to observe the pathological morphology of liver tissue,and liver function(ALT,AST)was detected;ELISA method was used to determine transforming growth factorβ(TGF-β),angiotensin II(Ang-Ⅱ),chitinase 3-like protein 1(CHI3L1),interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)content;The expression levels of type I,type III collagen(Col-Ⅰ,Col-Ⅲ)and TGF-βmRNA were determined by RT-PCR.Results:①HE and Masson staining showed that a large number of liver cells in the model group were inflamed and necrotic,the collagen fibers in the liver tissue were extensively proliferated,the fibrous septa were interconnected,and the pseudolobules were formed.Compared with the model group,the levels of ALT,AST,TGF-β,Ang-Ⅱ,CHI3L1,IL-1,IL-6 and TNF-αin the traditional Chinese medicine treatment group were decreased,while the levels of Col-Ⅰ,Col-ⅢThe expressions ofⅢand TGF-βmRNA were decreased,and the effect was most obvious in the middle and high dose groups of traditional Chinese medicine(P<0.01).Conclusion:Jisheng Shenqi Decoction combined with Panax notoginseng and Biejia can significantly improve liver fibrosis induced by CCl4 in rats,and its mechanism may be related to the down-regulation of angiotensin-converting enzyme(ACE)-angiotensin II(Ang-II)-angiotensin II receptor 1(AT1R)signaling pathway related gene expression,reducing the level of related cytokines,promoting the degradation of extracellular matrix and so on.

加味济生肾气汤联合穴位注射丹参注射液治疗慢性乙型肝炎肝纤维化患者的临床观察

目的:观察济生肾气汤加三七、鳖甲联合丹参注射液穴位注射对慢性乙型肝炎肝纤维化患者的临床疗效。方法:根据肝纤维化分期的差异,采取随机区组设计,先将80例慢性乙型肝炎肝纤维化患者分成2个区组,再按1∶1均匀分配至对照组及观察组,每组各40例,对照组患者继续服用恩替卡韦,观察组患者在对照组的基础上,采取济生肾气汤加三七、鳖甲中药口服联合丹参注射液穴位注射(膈俞、肝俞、足三里,每周1次)治疗,两组疗程均为24周,比较两组患者治疗前后的临床疗效及肝功能(转氨酶、总胆红素)、肝纤4项、血清血清壳多糖酶3样蛋白1(CHI3L1)水平、肝脏硬度值(LSM)变化,记录两组不良事件发生情况。结果:观察组患者肝功能、肝纤4项、血清CHI3L1水平、肝脏硬度值均低于对照组,差异具有统计学意义(P<0.05);观察组治疗有效率(90%)明显高于对照组(67.5%)(P<0.05)。结论:济生肾气汤加三七、鳖甲联合丹参注射液穴位注射治疗慢性乙型肝炎肝纤维化患者有良好疗效,可降低肝纤指标、改善肝功能及临床症状,减轻肝纤维化程度,延缓疾病进一步进展,从而提高患者生存率。

济生肾气汤加三七、鳖甲对CCl4诱导肝纤维化大鼠模型的干预作用及机制

目的:探讨济生肾气汤加三七、鳖甲对四氯化碳(CCl;)诱导的肝纤维化大鼠模型的干预作用及具体机制。方法:将SPF级SD大鼠随机分为对照组、模型组、中药治疗(低、中、高剂量)组,模型组与中药治疗组采用腹腔注射40%CCl4橄榄油溶液,每周2次,持续8周的方法复制肝纤维化大鼠模型。造模成功后,各给药组分别灌胃相应药物,对照组及模型组予等体积蒸馏水灌胃,每天1次,治疗4周。末次灌胃结束后,对肝组织切片进行HE染色和Masson染色观察肝组织病理形态学,检测肝功能指标(ALT、AST);ELISA法测定转化生长因子β(TGF-β)、血管紧张素Ⅱ(Ang-Ⅱ)、壳多糖酶3样蛋白1(CHI3L1)、白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量;RT-PCR法测定Ⅰ型、Ⅲ型胶原蛋白(Col-Ⅰ、Col-Ⅲ)及TGF-βmRNA的表达水平。结果:HE和Masson染色显示模型组大鼠大量肝细胞炎症坏死,肝组织胶原纤维广泛增生,纤维间隔相互连接,假小叶形成,而中药各剂量治疗组大鼠的肝脏炎症及肝纤维化程度均较模型组减轻;与模型组比较,中药治疗组ALT、AST、TGF-β、Ang-Ⅱ、CHI3L1、IL-1、IL-6、TNF-α水平均下降,Col-Ⅰ、Col-Ⅲ、TGF-βmRNA表达均减少,其中以中药中、高剂量组效果最为明显(P<0.01)。结论:济生肾气汤加三七、鳖甲对CCL4诱导的大鼠肝纤维化具有明显的改善作用,其作用机制可能与下调血管紧张素转换酶(ACE)-血管紧张素Ⅱ(Ang-Ⅱ)-血管紧张素Ⅱ受体1(AT1R)信号通路相关基因表达,降低相关细胞因子水平、促进细胞外基质降解方面等有关。