强肝胶囊对慢性乙型肝炎患者肝组织病理及PDGF-BB、TGF-β<sub>1</sub>、TIMP-1、MMP-1的影响

Clinical Effects of Qianggan Capsule on the Liver Tissue Pathology and PDGF-BB, TGF-β₁, TIMP-1, and MMP-1 Factors in Patients with Chronic Hepatitis B

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DOI：

中文关键词: 强肝胶囊慢性乙型肝炎肝纤维化病理

英文关键词:Qianggan Capsule chronic hepatitis B hepatic fibrosis pathology

基金项目:广东省湛江市科技攻关项目[No.湛科(2007)83号]

作者	单位
赵延龙	广东省廉江市人民医院
杨柳明	广东省廉江市人民医院
王华	广东省廉江市人民医院
黄玲	广东省廉江市人民医院
陈杜芳	广东省廉江市人民医院

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中文摘要:

目的从病理学及肝纤维化血清标志物角度,探讨中药强肝胶囊对慢性乙型肝炎肝纤维化的临床疗效。方法将70例慢性乙型肝炎患者随机分为治疗组(45例)和对照组(25例),治疗组给予强肝胶囊,对照组给予肝泰乐、复合维生素B溶液治疗,疗程均为6个月。治疗前1个月内和治疗结束后,分别检查丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、白蛋白(ALB)、凝血酶原时间(PT)、肝组织病理学和肝纤维化血清学指标以评价疗效。结果 (1)ALT、TBIL、ALB、PT:两组ALT、TBIL、PT水平均较治疗前明显下降(P<0.05),ALB水平均较治疗前明显升高(P<0.05),两组间比较差异无统计学意义(P>0.05)。(2)肝纤维化指标:治疗组血小板生长因子-BB(PDGF-BB)、转化生长因子-β1(TGF-β1)、金属蛋白酶组织抑制物-1(TIMP-1)水平均较治疗前显著下降(P<0.05),且低于对照组治疗后水平(P<0.05);而基质金属蛋白酶-1(MMP-1)水平较治疗前显著升高(P<0.05),也较对照组治疗后为高(P<0.05)。对照组治疗前后各项指标比较差异无统计学意义(P>0.05)。(3)肝组织病理学:治疗组炎症坏死活动度、肝纤维化程度改变明显(P<0.05),炎症坏死活动度改善的总有效率为40.00%,肝纤维化程度改善的总有效率为57.78%;对照组炎症坏死活动度、肝纤维化程度均无明显改善(P>0.05)。结论强肝胶囊能有效地改善慢性乙型肝炎患者肝纤维化血清学指标及病理指标,在逆转慢性乙型肝炎肝纤维化和减轻肝内炎症坏死方面有较好的疗效。

英文摘要:

Objective To study the therapeutic efficacy of Qianggan Capsule (QC) in treating patients with chronic hepatitis B fibrosis from the pathological aspect and serum fibrosis markers. Methods Seventy patients with chronic hepatitis B were randomly assigned to two groups, the treated group (45 cases) and the control group (25 cases). QC was given to patients in the treated group, while glucurone and compound vitamin B were given to those in the control group. The therapeutic course for both groups was 6 months. The therapeutic effect was assessed by determination of fibrosis markers including serum levels of platelet-derived growth factor-BB(PDGF-BB), transforming growth factor beta 1 (TGF-β1), matrix metalloproteinases-1 (MMP-1), tissue inhibitors of metalloproteinases-1 (TIMP-1) and serum levels of alanine transaminase (ALT), total bilirubin (TBIL), albumin (ALB), and prothrombin time (PT) were completed 1 month before treatment and at the end of the trial respectively. Results (1) Serum levels of ALT, TBIL, PT decreased obviously and the serum ALB level obviously increased in both groups (all P<0.05), showing no significant difference between the two groups (P>0.05). (2) Hepatic fibrosis markers: Serum levels of PDGF-BB, TGF-β1, and TIMP-1 significantly decreased, and serum MMP-1 level markedly increased in the treated group more than before treatment (all P<0.05). No significant difference was shown between before and after treatment in each index of the control group (P>0.05). Serum levels of PDGF-BB, TGF-β1, and TIMP-1 were obviously lower and the serum MMP-1 level was obviously higher in the treated group than in the control group after treatment (all P<0.05). (3) Hepatic histopathological results: The hepatic inflammatory necrosis activity and the hepatic fibrosis degree in the treated group were significantly improved (P<0.05), with the total effective rate of the hepatic necrosis activity improvement being 40.00% and that of the hepatic fibrosis degree being 57.78%. But there was no obvious improvement in the hepatic inflammatory necrosis activity or the hepatic fibrosis degree in the control group (P>0.05). Conclusion QC could effectively improve serological indices and pathological indices of chronic hepatitis B fibrosis patients, showing better therapeutic effect in reversing hepatic fibrosis and alleviating hepatic inflammatory necrosis.

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