自擬抗纖方對肝硬化纖維化的影響
張小兆1,喬漢臣2(1.河南省駐馬店市婦幼保健院,河南 駐馬店 463000; 2.新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院傳染科,河南 衛(wèi)輝 453100)
【摘要】 目的:探討中藥抗纖方對肝硬化患者肝纖維化的治療作用及其機(jī)制。方法:將86例乙型肝炎(乙肝)后肝硬化患者隨機(jī)分為兩組觀察。對照組用常規(guī)西藥治療方法,如維生素類和保肝類藥物,必要時用人血白蛋白等;觀察組在對照組用藥基礎(chǔ)上服用中藥抗纖方(主要成分:丹參、川芎、赤芍、柴胡、黃芪、黨參、當(dāng)歸、鱉甲、莪術(shù)、茯苓、白術(shù)、虎杖、白花蛇舌草、砂仁、炙甘草等);療程均為1年。觀察患者治療前后肝纖維化指標(biāo)透明質(zhì)酸酶(HA)、層粘連蛋白(LM)、Ⅲ型前膠原(PCⅢ)、Ⅵ型膠原(Ⅵ-C)、肝功能、乙肝病毒(HBV)標(biāo)志物的變化;部分患者進(jìn)行肝活檢病理檢查。結(jié)果:隨著治療時間的延長,兩組肝纖維化指標(biāo)水平均明顯下降,除Ⅵ-C外,觀察組各指標(biāo)下降更顯著(P均<0.05)。停藥4個月后肝纖維化指標(biāo)均有所回升,但仍低于治療前,且兩組間差異存在顯著性(P均<0.05);治療后觀察組丙氨酸轉(zhuǎn)氨酶(ALT)和總膽紅素(TBil)復(fù)常率(75.4%和49.6%)均明顯高于對照組(40.7%和17.5%,P均<0.05);停藥4個月后ALT和TBil復(fù)常率兩組比較差異無顯著性(P均>0.05)。HBsAg、HBeAg、HBV-DNA陰轉(zhuǎn)率及臨床癥狀改善率優(yōu)于對照組(P均<0.05)。觀察組組織病理學(xué)改變稍優(yōu)于對照組,但差異不明顯。兩組均未出現(xiàn)藥物不良反應(yīng)。結(jié)論:抗纖方有較明顯的抗肝硬化纖維化、改善肝功能、抑制HBV及其復(fù)制等作用。
【關(guān)鍵詞】 肝硬化;肝纖維化;中藥抗纖方劑
Influence of anti-fibrosis prescription (抗纖方) on hepatic fibrosis in patients with cirrhosis
ZHANG Xiao-zhao1, QIAO Han-chen2.
1. The Health Center for Women and Children, Zhumadian 463000, Henan, China; 2. Department of Infections Disease, First Affiliated Hospital of Xinxiang Medical College, Weihui453100, Henan, China
【Abstract】 Objective: To study the curative effects and mechanism of anti-fibrosis prescription in treatment for hepatic fibrosis in patients with cirrhosis. Methods: Eighty-six patients with cirrhosis induced viral hepatitis B were randomly divided into two groups: the control group (42 cases) was treated with western medicine, including vitamins, hepatoprotective medicine, and albumin was administered if necessary; the treatment group (44 cases) was treated with anti-fibrosis prescription(main ingredients: salvia miltiorrhiza(丹參), ligusticum (川芎), radix paeoniae rubra (赤芍), bupleurum chinense (柴胡) ......
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