加减柴平汤对慢性乙型病毒性肝炎肝纤维化及肝星状细胞凋亡的影响

目的观察加减柴平汤对慢性乙型病毒性肝炎（以下简称乙肝）肝纤维化及肝星状细胞（HSC）凋亡的影响。方法将60例慢性乙肝患者随机分为2组,均予甘草酸二胺注射液、门冬氨酸钾镁注射液治疗,治疗组30例加用柴平汤加减治疗;对照组30例加用复方鳖甲软肝片口服治疗。2组均4周为1个疗程,6个疗程后观察生化指标、血清肝纤维化指标、肝脏病理学改变及肝星状细胞凋亡率的变化。结果治疗组治疗后丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TB iL）、血清透明质酸（HA）、Ⅲ型前胶原（PC-Ⅲ）、Ⅳ型胶原（Ⅳ-C）及层粘连蛋白（LN）均低于本组治疗前（P〈0.05）;对照组治疗后ALT、AST、TB iL均低于本组治疗前（P〈0.05）;治疗组治疗后AST、HA、PC-Ⅲ、Ⅳ-C均低于对照组治疗后（P〈0.05）。2组治疗后肝组织炎症计分、肝组织纤维化计分均较本组治疗前降低（P〈0.05）,治疗组治疗后肝组织炎症计分、肝组织纤维化计分均低于对照组（P〈0.05）。治疗组治疗后HSC凋亡率较本组治疗前、对照组治疗后均升高（P〈0.01）。结论加减柴平汤具有明显的保肝降酶、改善血清肝纤维化及促进肝星状细胞凋亡的作用。

Evaluation of Chaiping decoction on hepatic fibrosis and stellate cell apoptosis in chronic viral hepatitis B patients

Objective To evaluate the effect of Chaiping decoction on hepatic fibrosis and stellate cell apoptosis in chronic viral hepatitis B patients.Methods 60 patients with chronic viral hepatitis B were randomly divided into two groups.On the basis of treatment of diamine glycyrrhizin injection and potassium magnesium aspartate injection in two groups,treatment group received Chaiping decoction,and control group received Biejiaruangan tablets.The course was four weeks in two groups.The changes of biochemical indicator,serum fibrosis index,pathology and stellate cell apoptosis of liver were observed after six courses.Results ALT,TBiL,HA,PC-Ⅲ,Ⅳ-C and LN after treatment were decreased in comparison with those before treatment group in treatment group（P0.05）.ALT,AST and TBiL after treatment were decreased in comparison with those before treatment group in control group（P0.05）.AST,HA,PC-Ⅲ and Ⅳ-C in treatment group was lower than those in control group after treatment（P0.05）.Inflammation and fibrosis score after treatment were decreased compared with those before treatment in two groups（P0.05）.Inflammation and fibrosis score in treatment group were lower than those in control group after treatment（P0.05）.Conclusion Chaiping decoction has obvious effect on protection liver and reducing enzyme,improving hepatic fibrosis and stellate cell apoptosis.