Effect of Anluohuaxian Tablet Combined with γ-IFN on Schistosomal Liver Fibrosis

The therapeutic effects of anluohuaxian tablet combined with γ-IFN on schistosomal liver fibrosis and its mechanism were studied in a murine model and clinical cases of schistosomal liver fibrosis, Fifty Kunming mice were randomly divided into 5 groups： normal control group, infection control group, anluohuaxian tablet-treated group, γ-IFN-treated group and combined treatment （anluohuaian tablet＋γ-IFN） group. Pathologic changes in liver, including hepatic pigmentation and the size of schistosomal egg granuloma, were observed by HE staining after treatment for 8 weeks. The expression of the type Ⅰ and Ⅲ collagen, and TIMP-1 was detected by immunohistochemistry. TGF-β1 mRNA expression was examined by real-time fluorescent quantitative PCR. Sixty patients with schistosomal liver fibrosis were divided into treatment group and control group. The patients in treatment group were treated with anluohuaxian tablet in combination with γ-IFN for 6 months. Before and after treatment, the changes of symptoms and signs, liver function, serum liver fibrosis indexes and imaging indexes were observed. The results showed that as compared with infection control group, all forms of treatments relieved the hepatic pathological injury with apparently diminished size of schistosomal egg nodules and decreased percentage of pigmentation （P〈0.05）. Furthermore, the expression of collagen Ⅰ and Ⅲ, TIMP-1, and TGF-β1 mRNA in combined treatment group was significantly decreased as compared with anluohuaxian tablet-treated and γ-IFN-treated groups （P〈0.05）. In the clinical observation, the serum liver fibrosis indexes, the portal vein width as well as the spleen thickness was significantly reduced in treatment group as compared with control group （P〈0.05）. It was concluded that the combined use of anluohuaxian tablet with γ-IFN in schistosomal liver fibrosis could protect liver function, alleviate liver fibrosis, and could be used as a choice in treating patients with schiatosomal liver fibrosis.

阿德福韦酯联合复方鳖甲软肝片治疗乙型肝炎肝纤维化临床观察

目的:观察阿德福韦酯联合复方鳖甲软肝片治疗乙型病毒性肝炎肝纤维化的疗效。方法:将82例乙型病毒性肝炎肝纤维化患者随机分为治疗组和对照组。治疗组患者用阿德福韦酯和复方鳖甲软肝片口服,对照组患者采用阿德福韦酯治疗,疗程1年。观察并比较两组患者治疗前后的症状、体征和肝功能、肝纤维化指标、B超指标及HBVDNA定量等变化。结果:治疗后治疗组总有效率为90.4%,对照组总有效率为77.5%,治疗组疗效高于对照组;治疗组患者在治疗后AST、TBil、HA等较治疗前有明显改善,且显著优于对照组;患者治疗后门静脉和脾静脉宽度、脾脏厚度明显变小,与对照组比较差异显著;治疗后HBVDNA定量变化,两组相比较差异无显著性意义。结论:阿德福韦酯联合复方鳖甲软肝片治疗,能够通过抑制病毒和抗纤维化,明显改善乙型病毒性肝炎肝纤维化患者的病情及预后。

慢性乙型肝炎肝纤维化不同时段药物干预疗效观察

目的探讨胸腺α1、复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎肝纤维化的效果。方法选取2013年1月至2016年10月在唐山市传染病医院治疗的慢性乙型肝炎肝纤维化患者100例,根据治疗方案分为观察组(n=53)和对照组(n=47),对照组给予胸腺α1和恩替卡韦治疗,观察组在对照组治疗基础上加用复方鳖甲软肝片治疗,检测患者治疗前后肝纤维化指标、中医证候积分、肝脏弹性值(LSM)、肝功能及HBV-DNA含量。结果观察组治疗3个月和6个月血清透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(C-Ⅳ)、Ⅲ型前胶原(PCⅢ)和LSM分别为(142.20±31.44)ng/m L和(94.40±27.81)ng/m L、(220.42±30.05)ng/m L和(110.09±29.89)ng/m L、(78.88±30.57)ng/m L和(40.06±21.16)ng/m L、(194.42±34.44)ng/m L和(107.43±35.54)ng/m L、(8.96±1.53)k Pa和(6.24±1.41)k Pa,明显低于对照组,差异均有统计学意义(P<0.05);观察组治疗3个月和6个月谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL)分别为(89.24±37.41)U/L和(40.42±10.11)U/L、(91.16±37.26)U/L和(41.81±37.33)U/L、(22.51±6.84)mol/L和(16.51±5.11)mol/L,明显低于对照组,而ALB分别为(43.34±11.63)g/L和(50.11±6.43)g/L,明显高于对照组,差异均有统计学意义(P<0.05);观察组治疗3个月和6个月中医证候积分分别为(12.14±1.51)分和(6.40±0.98)分,明显低于对照组,差异均有统计学意义(P<0.05);观察组治疗3个月和6个月HBV-DNA含量分别为(5.22±1.11)×106copy/m L和(3.10±1.03)×106copy/m L,明显低于对照组,差异均有统计学意义(P<0.05)。结论胸腺α1、复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎肝纤维化,能有效改善肝纤维化和肝功能指标,抑制HBV-DNA病毒复制。

复方鳖甲软肝片合γ-干扰素治疗肝炎后肝纤维化

目的:观察复方鳖甲软肝片联合γ-干扰素治疗肝纤维化的疗效。方法:49例慢性乙型肝炎患者,随机分为两组,治疗组28例,对照组21例。治疗组采用γ-干扰素1天100万u,肌肉注射,1日1次,连用2个月后改隔日1次,疗程6个月。同时加用复方鳖甲软肝片4片,1日3次,口服。对照组单用γ-干扰素,剂量疗程同治疗组。疗程结束时观察两组患者肝组织学、肝功能、血清肝纤维化指标、B超检测等指标改变。结果:两组治疗后与治疗前比较,上述指标均有明显改善,治疗组疗效优于对照组。结论:复方鳖甲软肝片联合γ-干扰素治疗肝纤维化疗效优于单用γ-干扰素治疗。

拉米夫定联合复方鳖甲软肝片对乙肝纤维化的影响

目的观察拉米夫定联合复方鳖甲软肝片治疗乙型肝炎肝纤维化的疗效。方法将80例乙型肝炎肝纤维化患者随机分为治疗组和对照组。治疗组患者用拉米夫定和复方鳖甲软肝片口服，对照组患者采用拉米夫定治疗，疗程1年。观察并比较两组患者治疗前后的肝功能、肝纤维化指标及HBV-DNA定量检测指标等的变化。结果治疗组治疗后AST、TBi1、HA等较治疗前有明显改善，且显著优于对照组（P〈0．05-0．01），差异有显著性；HBV-DNA定量变化治疗前后比有显著的统计学差异（P〈0．05），但两组相比较差异无显著性意义。结论拉米夫定联合复方鳖甲软肝片能够通过抑制病毒和抗肝纤维化，明显改善乙型肝炎肝纤维化患者的病情。