肝豆汤Ⅳ号联合短期驱铜治疗对肝豆状核变性患者肝纤维化血清学指标的影响

Effect of Gandou Decoction Ⅳ Combined with Short-term Decoppering Therapy with Sodium Dimercapto sulphonate on Serum Indexes of Hepatic Fibrosis in Patients with Wilson’s Disease

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中文关键词: Wilson病肝纤维化指标基质金属蛋白酶-1 组织抑制因子-1 肝豆汤Ⅳ号

英文关键词:Wilson’s disease serum indexes of hepatic fibrosis matrix metalloproteinase-1 tissue inhibitor of metalloproteinase-1 Gandou Decoction Ⅳ

基金项目:

作者	单位
薛本春	安徽中医学院神经病学研究所附属医院
杨任民	安徽中医学院神经病学研究所附属医院
胡纪源	安徽中医学院神经病学研究所附属医院
韩咏竹	安徽中医学院神经病学研究所附属医院
王居华	安徽中医学院

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中文摘要:

目的观察肝豆汤Ⅳ号治疗对肝豆状核变性(WD)患者肝纤维化血清学指标的影响以及对肝功能的作用。方法61例WD患者分为二巯基丙磺酸钠(DMPS)组(30例)和肝豆汤Ⅳ号组(31例)。DMPS组单纯予DMPS驱铜,肝豆汤Ⅳ号组予DMPS驱铜同时,口服中药复方肝豆汤Ⅳ号,均治疗8个疗程(6天1个疗程)。两组治疗前后测定肝功能,采用双抗体夹心ABC-EIASA法检测血清基质金属蛋白酶-1(MMP-1)及其组织抑制因子(TIMP-1);放射免疫法(RIA)检测血清透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)。结果治疗后DMPS组肝纤维化血清学指标及肝功能指标变化不明显(P>0.05);而肝豆汤Ⅳ号组治疗后血清TIMP-1明显下降(P<0.05),MMP-1/TIMP-1的比值明显升高(P<0.01),血清HA、LN、PCⅢ仅略有下降(P>0.05),血清C-Ⅳ、MMP-1略有升高(P>0.05),肝功能指标明显下降(P<0.05)。结论WD患者短期内单纯驱铜治疗并不能改变血清肝纤维化指标水平及肝功能,而联合应用中药肝豆汤Ⅳ号治疗可以明显改善肝功能,并且可能通过抑制TIMP-1水平,提高MMP-1/TIMP-1的比值,而发挥抗肝纤维化作用。

英文摘要:

Objective To observe the effect of Gandou Decoction Ⅳ (GDⅣ) on serum indexes of hepatic fibrosis and liver function in patients with Wilson’s disease (WD). Methods Sixty-one WD patients were assigned to two groups, 30 patients in the sodium dimercaptosulphonate (DMPS) group and 31 patients in the GDⅣ group. Both groups received 8 courses of DMPS treatment with 6 days as one course, and the GD Ⅳgroup was given GD Ⅳ additionally. Serum indexes of liver function were examined, serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were detected by double antibody sandwish ABC enzyme-linked immunosorbent assay (ELISA), and serum hyaluronic (HA), laminin (LN), procollagen Ⅲ (PCⅢ) and collagen type Ⅳ (C-Ⅳ) were determined by radioimmunoassay (RIA). Results After treatment, all indexes of hepatic fibrosis and liver function had no significant change in the DMPS group, while in the GD Ⅳ group, the serum TIMP-1 level markedly decreased (P<0.05), the ratio of MMP-1/TIMP-1 significantly increased (P<0.01), and serum indexes of liver function markedly decreased (P<0.05), but the changes in serum levels of HA, LN and PCⅢ, as well as in serum MMP-1 and C-Ⅳ were insignificant (P>0.05), though they showed a trend of decreasing or increasing, respectively. Conclusion Short-term decoppering treatment with DMPS alone has no significant effect on hepatic function and serum fibrosis indexes in WD patients, while combined with GD Ⅳ, it can improve liver function and display an anti-fibrosis effect through inhibiting the serum TIMP-1 level and increasing the ratio of MMP-1/TIMP-1.

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