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1.
Effects of Fuzheng Huayu 319 recipe on liver fibrosis in chronic hepatitis B   总被引:20,自引:0,他引:20  
EfectsofFuzhengHuayu319recipeonliverfibrosisinchronichepatitisBLIUPing1,LIUCheng1,XULieMing1,HuYiYaang1,XUEHuiMing1,LIUCh...  相似文献   

2.
目的明确益气活血方治疗慢性病毒性肝炎肝纤维化的临床疗效。方法采用开放、阳性药平行对照研究的方法,选取经肝穿活组织学及肝脏瞬时弹性成像技术检查确诊的慢性乙型及丙型肝炎肝纤维化患者207例,根据中医辨证施治的原则,分别采用自拟益气活血方(n=127)和扶正化瘀胶囊(n=80)治疗,疗程均为24~48周。对比分析两组患者中医症候积分、肝脏生化学、肝脏硬度值(LSM)、无创性肝纤维化指数[天冬氨酸转氨酶与血小板比值指数(APRI)、基于4因子的肝纤维化指标(FIB-4)]的变化,评估益气活血方抗肝纤维化疗效。结果益气活血方组和扶正化瘀胶囊组患者基线LSM、APRI、FIB-4比较,P值均>0.05,差异均无统计学意义。应用益气活血方和扶正化瘀胶囊患者症候积分均有一定程度改善,益气活血方在改善肝病面容、肝区不适及腰膝酸软方面优于扶正化瘀胶囊(P<0.05);肝脏生物化学指标(丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、碱性磷酸酶)随疗程延长逐渐复常,治疗24~48周复常率两组分别为100%对比100%、100%对比93.8%、96.8%对比92.3%及87.5%对比81.8%。治疗12周后两组APRI值均显著降低;治疗48周,两组LSM显著改善;而FIB-4显著改善仅见于益气活血方治疗48周,与扶正化瘀治疗组比较差异有统计学意义,P<0.05。两组治疗后LSM、APRI、FIB-4的总有效率分别为80.0%对比63.6%,P=0.046;68.4%对比52.0%,P=0.052;68.4%对比62.0%,P=0.437;益气活血方治疗患者LSM总有效率显著高于扶正化瘀胶囊治疗组。结论中药益气活血方可作为治疗慢性病毒性肝炎肝纤维化的优选方案。  相似文献   

3.
目的:比较扶正化瘀胶囊和安络化纤丸临床抗肝纤维化作用。方法选择99例肝纤维化患者,随机分为两组,分别采用扶正化瘀胶囊治疗51例和安络化纤丸治疗48例,疗程为12个月,观察两组治疗前后 Fibroscan 值、肝纤维化四项、肝脏彩色超声以及肝脏病理学等的变化。结果经治疗后,扶正化瘀胶囊组 Fibroscan 值为8.25 KPa、HA 为143.4 ng/mL、LN 为95.9 ng/mL、PC-III 为109.3 ng/mL、Ⅳ-C 为72.1 ng/mL、门静脉内径为10.13 mm、脾脏厚度为38.40 mm。安络化纤丸组 Fibroscan 值为13.04 kPa、HA 为208.7 ng/mL、LN 为155.5 ng/mL、PC-III 为110.0 ng/mL、Ⅳ-C 为117.5 ng/mL、门静脉内径为12.61 mm、脾脏厚度为45.01 mm。两组相比差异有统计学意义(P <0.05),此外扶正化瘀胶囊改善纤维化分级具有显著的效果(P <0.05)。结论与安络化纤丸相比,扶正化瘀胶囊具有更好的临床疗效。  相似文献   

4.
AIM To investigate the short-term and long-term therapeutic effect of traditional medicine preparation andIFN-α1 b on hepatic fibrosis due to chronic hepatitis B.METHODS Fifty-two patients with hepatic fibrosis of hepatitis B were treated by IFN-alb and traditionalmedicine preparation, then observed the change of serum indexes of hepatic fibrosis, liver biopsy,ultrasonography and fibergastroscopy.RESULTS The serum indexes of hepatic fibrosis decreased significantly after 3-month treatment(P<0.05). The improvement of liver fibrosis was confirmed by liver biopsy, ultrasonography andfibergastroscopy. After 3-year continuous follow-up, the conditions of patients were got better. Symptomsand signs were disappeared. The pathohistologic change of liver, serum index of hepatic fibrosis and liverfunction were continuously improved.CONCLUSION The good short-term and long-term effects were obtained by using IFN-α1b to suppressduplication of hepatitis B virus and traditional medicine preparation to reverse hepatic fibrosis.  相似文献   

5.
疏肝化瘀颗粒治疗慢性乙型肝炎和肝炎肝硬化的临床研究   总被引:1,自引:0,他引:1  
目的:研究疏肝化瘀颗粒对慢性乙型肝炎和肝炎肝硬化的治疗作用。方法:用疏肝化瘀颗粒治疗慢性乙型肝炎和肝炎肝硬化病人76例,疗程为3~6个月。观察肝功能、肝纤维化指标、B超声像图及肝脏储备功能的变化,对各组检测结果进行比较。结果:治疗组在降低丙氨酸转氨酶、门冬氨酸转氨酶,提高血清白蛋白及肝脏的储备功能,降低血清肝纤维他指标等方面均明显优于对照组。结论:疏肝化瘀颗粒具有明显改善肝功能和抗肝纤维化的作用,临床应用未发现毒副作用,是临床治疗慢性乙型肝炎和肝炎肝硬化的有效药物。  相似文献   

6.
阿德福韦酯联合扶正化瘀胶囊治疗活动性肝硬化临床观察   总被引:1,自引:0,他引:1  
目的:观察阿德福韦酯联合扶正化瘀胶囊治疗活动性肝硬化的疗效和安全性。方法:95例活动性乙型肝炎肝硬化患者随机分为治疗组52例和对照组43例,两组均在保肝、对症等常规治疗基础上接受阿德福韦酯胶囊10mg/d治疗,治疗组在对照组基础上联合扶正化瘀胶囊3次/d,3粒/次,疗程24周。结果:两组患者治疗后ChildPugh评分下降,肝功能改善,HBVDNA载量下降,配对比较差异有显著性意义(P〈0.01)。治疗组患者肝纤维化指标及脾门厚度的下降值优于对照组,组间比较差异有显著性意义(P〈0.01或P〈0.05)。结论:阿德福韦酯联合扶正化瘀胶囊治疗活动性乙型肝炎肝硬化能显著提高肝纤维化的治疗效果,改善肝功能,临床应用安全。  相似文献   

7.
目的:探讨扶正化瘀胶囊治疗日本血吸虫病肝纤维化的疗效。方法:临床观察日本血吸虫病肝纤维化患者48例,随机分为试验组(基础护肝治疗联合扶正化瘀胶囊)和对照组(基础护肝治疗),每组24例,患者均在护肝及抗纤维化治疗前1个月给予吡喹酮驱虫治疗,治疗前后观察患者临床症状和体征的改善,肝功能、血清肝纤维化指标的复常以及影像学指标的改变。结果:治疗24周后,两组患者临床症状和体征与治疗前比较均有明显改善,尤其肝区不适症状的缓解,试验组优于对照组(P<0.05);两组患者治疗后血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBil)水平均有显著改善(P<0.05);试验组血清透明质酸(HA)﹑Ⅲ型前胶原(PCⅢ)水平在治疗12周、24周较治疗前均显著下降(P<0.05),下降幅度均显著优于对照组(P<0.05);治疗24周患者血清层粘连蛋白(LN)﹑Ⅳ型胶原(Ⅳ-C)含量与治疗前比较两组均有显著改善(P<0.05),且试验组改善优于对照组(P<0.05);治疗24周患者肝门静脉主干内径、脾脏厚度的改变,试验组明显优于治疗前(P<0.05),且与对照组比较差异具有显著性意义(P<0.05)。结论:扶正化瘀胶囊治疗日本血吸虫病肝纤维化可明显改善患者临床症状和体征,促进肝脏功能恢复,有效地减轻肝脏纤维化。  相似文献   

8.
AIM:To evaluate the clinical efficacy of salvianolic acid B(SA-B)on liver fibrosis in chronic hepatitsB.METHODS:Sixty patients with definite diagnosis of liver fibrosis with hepatits Bwere included in the trial.Interferon-γ(IFN-γ)was used as control drug.The patients took orally SA-Btablets or received muscular injection of INF-γin the double blind randomized test.The complets course lasted 6months.The histological changes of liver biopsy specimen before and after the treatment were the main evidence in evaluation.in combination with the results of contents of serumHA,LN,IV-C,P-Ⅲ-P,liver ultrasound imaping,and symptoms and signs.RESULTS:Reverse rate of fibrotic stage was 36.67%in SA-Bgroup and30.0%in IFN-γgroup.Inflammatory alleviating rate was 40.0%in SA-Bgroup and 36.67%inIFN-γgroup.The average content of HAandIV-C was significantly lower than that before treatment.The abnormal rate also decreased remarkably.Overall analysis of 4serological fibrotic markers showed significant improvement in SA-Bgroup as compared with the IFN-γgroup.Score of liver ultrasound imagin g was lower in SA-Bgroup than in IFN-γgroup(HA36.7%vs80%,IV-C3.3%vs23.2%).Before the treatment,ALTASTactivity and total bilirubin content of patients who had regression of fibrosis after oral administration of SA-B,were significantly lower than those of patients who had aggravation of fibrosis after oral administration of SA-B,IFN-γshowed certain side effects(fever and transient decrease of leukocytes,occurrence rates were 50%and 3.23%),but SA-Bshowed no side effects.CONCLUSION:SA-Bcould effectively reverse liver fibrosis in chronic hepatitisB.SA-Bwas better than IFN-γin reduction of serumHAcontert,overall decrease of 4serum fibrotic markers,and decrease of ultrasound imaging score.Liver fibrosis in chronic hepatitis Bwith slight liver injury was more suitable to SA-Bin anti-fibrotic treatment,SA-Bshowed no ovbious side effects.  相似文献   

9.
目的:观察中药复方肝欣合剂对慢性乙型肝炎及肝纤维化的疗效。方法:选择慢性乙型肝炎肝功能及肝纤维化指标异常的患者80例,随机分成两组,治疗组患者口服中药复方肝欣合剂,对照组患者口服强肝丸,观察治疗后肝功能和肝纤维化指标的变化。结果:两组患者血清ALT、TBil、HA、LM和PCⅢ均有明显降低,Alb亦有明显提高,两者相比较有统计学意义(P<0.05或P<0.01)。结论:中药复方肝欣合剂具有明显的抗肝纤维化作用。  相似文献   

10.
目的观察拉米夫定、阿德福韦酯联合扶正化瘀胶囊对于乙肝后肝硬化失代偿期治疗作用。方法将51例乙肝后肝硬化失代偿期患者随机分为两组。对照组(n=21)用常规西药治疗方法,如维生素类和护肝降酶治疗,必要时用人血白蛋白等;治疗组(n=30)给予拉米夫定、阿德福韦酯联合扶正化瘀胶囊,疗程均为2年。观察治疗前后HBV-DNA载量,Child-Pugh评分,透明质酸(HA)、Ⅲ型前胶原肽(PcⅢ)、Ⅳ型胶原(Ⅳ-C)和层黏蛋白(LN)等血清肝纤维化指标,彩色多普勒检查肝脾形态、门静脉内径(Dpv)、脾静脉内径(Dsv)和脾厚度(st)。结果基线时两组以上观察指标均无统计学差异(P>0.05)。治疗结束时,对照组3例死亡(肝癌1例、上消化道出血2例),自身前后对比疗效改善不明显((P>0.05)。治疗组死亡1例(交通意外),自身前后对比观察指标改善优于对照组(P<0.05)。结论拉米夫定、阿德福韦酯联合扶正化瘀胶囊有明显改善乙肝后肝硬化失代偿期Child-Pugh评分作用和肝脾形态,降低HBV DNA水平。  相似文献   

11.
BackgroundFuzheng Huayu tablet is a traditional Chinese medicine (TCM) used for the treatment of liver fibrosis and cirrhosis. However, whether the combination with Fuzheng Huayu tablet could affect the antiviral efficacy of nucleos(t)ide remains a concern. The objective of this trial was to explore the impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis.MethodsA prospective, randomized control trial was conducted. Patients with compensated hepatitis B cirrhosis were randomly divided into the treatment group (entecavir capsule plus Fuzheng Huayu tablet) and the control group (entecavir capsule plus simulant of Fuzheng Huayu), and followed up for 48 weeks. The dynamic changes of HBV DNA load, the rate of serological conversion of HBeAg, liver function, renal function and liver stiffness measurement (LSM) were monitored. The general clinical data and adverse events were also recorded.ResultsThere was no significant difference in the rate of virological response and cumulative virological response between the treatment group and the control group (P > 0.05). After 48 weeks of treatment, the HBeAg seroconversion rate, biochemical response rate and LSM value were 21.05% and 4.76% (P = 0.164), 86.96% and 65.96% (P = 0.017), 9.5 kpa and 10.6 kpa (P = 0.827) in the treatment group and the control group, respectively. No serious adverse events related to the study therapy occurred during the trial.ConclusionsThe antiviral entecavir combined with Fuzheng Huayu tablet did not affect the antiviral efficacy of entecavir, but could improve the rate of biochemical response, and had a tendency to improve the rate of serological conversion of HBeAg and liver fibrosis in patients with hepatitis B cirrhosis. Fuzheng Huayu tablet is clinically safe for patients with hepatitis B cirrhosis.  相似文献   

12.
目的观察五灵丸治疗乙型病毒性肝炎的临床疗效。方法将108例患者随机分为两组,分别给予五灵丸和甘利欣等保肝药治疗,两组疗程均为2个月,观察治疗后30d及60d患者治疗前后血清谷丙转氨酶(LAT)和谷草转氨酶(AST)的含量变化。结果五灵丸可明显降低ALT、AST,以降低ALT为优,慢性肝炎轻度病例效果最佳。治疗后30dALT、AST的复常率分别为58.1%、44.2%,治疗后60dALT、AST的复常率分别为69.7%、46.5%。结论五灵丸可明显降ALT、AST,且对慢性肝炎轻度效果较好,更适合门诊病人应用。  相似文献   

13.
制备二甲基亚硝胺大鼠肝纤维化模型,体内给予扶正化瘀方治疗后,分离培养纤维肝原代贮脂细胞,通过相差显微镜、[~3H]TdR掺入、[~3H]Proline掺入及胶原酶消化法等观察该方对纤维肝贮脂细胞形态及细胞增殖、活力与胶原生成率等功能的影响。结果表明:该方对纤维肝贮脂细胞形态及活动力无明显影响,而显著抑制其细胞增殖及胶原生成率。提示该方抗肝纤维化的主要作用机理之一在于抑制贮脂细胞的病理学增生及其细胞外基质生成。  相似文献   

14.
目的探讨Jak/Stat信号通路在经典的CCl4大鼠肝纤维化模型中的动态变化及扶正化瘀方对其影响。方法复制经典的CCl4大鼠肝纤维化模型和肝纤维化扶正化瘀方干预模型,收集纤维化形成、逆转和干预过程中不同时间的血液和肝组织,观察血清指标、肝组织病理、α-SMA表达及肝组织Jak1、Stat3蛋白和mRNA表达变化。多组间比较采用单因素方差分析。结果 CCl4应用后模型组大鼠肝组织炎症及纤维化逐渐加重,α-SMA及Jak1、Stat3表达逐渐升高,8周时达高峰。8周后随着CCl4停用,大鼠肝组织炎症和纤维化逐渐好转,上述指标亦较前明显降低;扶正化瘀方干预组第4、6、8周时大鼠血清指标,肝组织炎症和纤维化程度、Jak1、Stat3表达均较模型组相同时间点明显降低。结论 Jak/Stat信号通路在肝纤维化发生和逆转中发挥重要作用,扶正化瘀方可通过阻断Jak/Stat通路及减少肝星状细胞活化发挥抗肝纤维化作用。  相似文献   

15.
b-FGF与慢性乙型肝炎肝纤维化相关性研究   总被引:1,自引:0,他引:1  
目的 观察b-FGF(碱性成纤维细胞生长因子)在慢性乙型肝炎患者不同肝纤维化分期(S)的免疫组化表达和定位情况,及其与肝纤维化的相关性.方法 选取进行肝组织活检的慢性乙型肝炎患者111例,对肝组织进行HE、Masson三色、网状纤维染色,进行病理肝纤维化分期(S0-S4)诊断.免疫组织化学法测定肝组织中b-FGF在不同病理分期的表达及定位特点,各组间进行统计分析.结果 b-FGF在肝纤维化不同发展阶段,其表达逐渐增高,差异有高度显著性(P<0.01),与肝纤维化分期有显著正相关(r=0.953,P<0.01).结论 肝组织中b-FGF的表达在慢性乙肝肝纤维化发生发展过程中发挥重要作用.  相似文献   

16.
目的探讨替比夫定片联合扶正化瘀片治疗慢性乙型肝炎肝纤维化的疗效。方法选择本院2011年7月至2012年11月收治的慢性乙型肝炎(CHB)患者120名,随机分为2组,治疗组与对照组各60例。治疗组和对照组常规应用替比夫定片抗病毒及护肝等治疗;治疗组在上述治疗同时,联合应用扶正化瘀片治疗6个月。观测肝功能、肝纤维化四项指标、患者的症状体征等变化。计数资料采用χ2检验,计量资料采用t检验。结果经过6个月治疗,治疗组AST(33.1±155 vs 39.5±18.4)、白蛋白/球蛋白比例(A/G)(1.78±0.41 vs 1.64±0.32)、TBil(13.8±6.6 vs 17.9±8.3)复常,ALT(55.3±23.4 vs 64.7±27.6)降低,与对照组比较差异皆有统计学意义(t值分别为2.060、2.085、3.172、2.012,P值均<0.05);治疗组血清透明质酸(HA)(107.7±82.3 vs 141.6±91.4)、层黏连蛋白(LN)(125.4±73.2 vs 154.9±76.5)、Ⅲ型前胶原(PⅢP)(0.61±0.56 vs 0.96±044)、Ⅵ型胶原(Ⅳ-C)(90.6±78.3 vs 134.3±67.9)有较大程度改善,与对照组比较差异均有统计学意义(t值分别为2155、2135、3.266、3.807,P值均<0.05);治疗组患者疲乏感减轻(71.7% vs 53.3%)、食欲增加(83.3% vs 65.0%)、腹胀减轻(80.0% vs 58.3%),与对照组比较差异皆有统计学意义(P<0.05)。结论CHB患者存在着不同程度肝纤维化,应用替比夫定片联合扶正化瘀片治疗,患者在症状改善、肝功能恢复及肝纤维化改善方面明显优于单用替比夫定。  相似文献   

17.
目的:观察自制中药软肝健脾丸对慢性乙型肝炎肝纤维化的临床疗效。方法:将87例慢性乙型肝炎肝纤维化患者随机分为两组:治疗组44例,服用软肝健脾丸,对照组43例,服用安络化纤丸;治疗前后检测患者血清透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)的水平,并观察主要症状、肝功能相关指标及肝脏B超声像图情况。结果:两组临床疗效比较,治疗组的显效率和总有效率分别为52.27%和88.63%;对照组分别为25.58%和67.44%,差异均有显著性意义(P〈0.01、P〈0.05)。HA、LN、PCⅢ、Ⅳ-C的水平治疗组患者治疗前后比较,差异有显著性意义(P〈0.01);与对照组治疗后比较,差异均有显著性意义(P〈0.01、P〈0.05)。治疗组患者治疗前后ALT、AST、TBil、Alb比较差异有显著性意义(P〈0.01),但与对照组治疗后比较差异无显著性意义(P〉0.05)。两组间在改善主要症状、脾脏回缩、肝脏声像图改变方面比较,差异有显著性意义(P〈0.05)。结论:软肝健脾丸对慢性乙型肝炎患者有较好的抗肝纤维化作用。  相似文献   

18.
Summary.  Clinical and experimental studies have demonstrated that connective-tissue growth factor (CTGF) expression is increased in fibrotic human liver and experimental animal models of liver fibrogenesis. CTGF has been linked to transforming growth factor-beta (TGF-β) pathways in fibroproliferative diseases and specific polymorphisms within the CTGF gene may predispose for fibrosis in systemic sclerosis. As CTGF is detectable in various human fluids (serum, plasma and urine), it may provide information about fibrotic remodelling processes and reflect hepatic TGF-β bioactivity. We established a novel ELISA for the measurement of serum CTGF and tested its clinical value in patients with chronic hepatitis C virus (HCV) infection and chronic liver disease (CLD). HCV infected patients ( n  =   138) had significantly higher serum CTGF levels than healthy controls. CTGF was linked to the histological degree of liver fibrosis. To expand the results to other aetiologies, a separate cohort of CLD patients ( n  =   129) was evaluated, showing higher serum CTGF than healthy controls and again an association with advanced stages of liver cirrhosis (Child B and C). Although independent of the underlying aetiology, serum CTGF was most powerful in indicating fibrosis/advanced disease states in HCV-related disorders. The genotyping of six polymorphisms (rs6917644, rs9399005, rs6918698, rs9493150, rs2151532 and rs11966728) covering the CTGF locus in 365 patients suffering from chronic hepatitis C revealed that none of these polymorphisms showed a genotypic or allelic association with the severity of hepatic fibrosis. Taken together, serum CTGF is suitable for determination of hepatic fibrosis and most powerful in patients with chronic HCV infection.  相似文献   

19.
BACKGROUND: AND AIM: The serum type IV collagen test is now used as a diagnostic aid for the detection of liver fibrosis and cirrhosis. Recently, a platelet count has been reported to be a useful marker for assessing the fibrotic stage in chronic hepatitis C. The aim of this study was to compare the usefulness of the serum type IV collagen test and platelet count for diagnosing the fibrotic stage in chronic hepatitis C patients. METHODS: The diagnostic values were assessed by the use of receiver operating characteristic (ROC) analysis in 165 patients with chronic hepatitis C, with the exception of those patients with cirrhosis. RESULTS: The serum type IV collagen level increased, and the platelet count decreased significantly with the progression of fibrosis staging. As judged from ROC curves, the serum type IV collagen test was more useful than the platelet count for differentiating moderate or severe fibrosis from no or mild fibrosis. At a cut-off value of 110 ng/mL, the serum type IV collagen test had an overall diagnostic accuracy of 75%, while at a cut-off value of 16 x 10(4)/mm(3), the platelet count had a diagnostic accuracy of 70%. The serum type IV collagen test and platelet count were similar in differentiating severe fibrosis from no, mild or moderate fibrosis. Both serum type IV collagen (at a cut-off value of 130 ng/mL) and platelet count (at a cut-off value of 14 x 10(4)/mm(3)) had a diagnostic accuracy of 73%. CONCLUSION: The serum type IV collagen test was slightly superior to the platelet count for assessing the fibrotic stage in patients with chronic hepatitis C.  相似文献   

20.
目的:研究丹红软肝胶囊对肝纤维化患者血小板生长因子(PDGF)的影响.方法:以108例慢性乙型肝炎肝纤维化患者为观察对象,随机分为两组,治疗组56例采用丹红软肝胶囊治疗,对照组52例服用复方鳖甲软肝片,均治疗6个月,观察治疗前后患者血清肝功能、肝纤维化指标及PDGF含量的变化.结果:治疗6个月时,治疗组患者肝纤维化血清指标透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和Ⅲ型前胶原( PCⅢ)水平较治疗前均显著降低(P<0.05);肝功能丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)与治疗前比较均显著改善(P<0.05);PDGF含量较治疗前明显降低(P<0.05).上述指标与对照组比较差异无显著性意义(P>0.05).结论:丹红软肝胶囊可能通过抑制PDGF的分泌来抑制肝纤维化的发生发展.  相似文献   

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