强肝胶囊治疗非酒精性脂肪性肝纤维化的疗效及机制研究

目的:研究强肝胶囊治疗非酒精性脂肪性肝纤维化的疗效及机制。方法:将104例非酒精性脂肪性肝纤维化患者随机分为2组,对照组40例进行基础护肝治疗,治疗组64例在对照组基础上加用强肝胶囊(1.2g,tid)治疗。2组疗程均为6个月。观察治疗前后2组患者的肝纤维化谱(HA、PcⅢ、CⅣ、LN)、基质金属蛋白酶组织抑制因子-1(TIMP-1)及肝脏病理变化。采用逆转录多聚酶链反应(RT-PCR)检测结缔组织生长因子(CTGF)及细胞外基质前胶原α2(collα2)mRNA水平。免疫组化法检测CTGF的蛋白表达。结果:治疗组治疗后,其肝纤维化谱及肝脏病理均明显减轻,与治疗前比较差异有统计学意义(P<0.05),2组治疗后肝纤维化程度均明显改善,治疗组优于对照组,差异有统计学意义(P<0.05)。TIMP-1水平及CTGF、collα2mRNA水平以及CTGF蛋白表达水平,治疗组治疗后较治疗前显著下降,与对照组治疗后比较差异也有统计学意义(均P<0.05),而上述指标对照组治疗前后差异无统计学意义(P>0.05)。结论:强肝胶囊通过下调肝脏组织中CTGF的基因和蛋白水平,降低TIMP-1水平,下调collα2mRNA的表达等多条途径而实现抗肝纤维化的功能,显示其为治疗非酒精性脂肪性肝纤维化的有效药物之一。

Clinical Observation and Mechanism of Qianggan Capsule in the Treatment of Nonalcoholic of Nonalcoholic Fatty Liver Fibrosis

OBJECTIVE：To study the efficacy and the mechanism of Qianggan capsule in the treatment of nonalcoholic fatty liver fibrosis.METHODS：104 patients with nonalcoholic fatty live fibrosis were randomly divided into treatment group（n=64） and control group（n=40）.Both groups were given basic treatment of hepatoprotective drug for 6 months.Treatment group were treated with Qianggan capsule additionally.Hepatic fibrosis（HA、PcⅢ、CⅣ、LN）,TIMP-1,the hepatocyte CTGF、collα2 mRNA and CTGF protein expression indicators of 2 groups before and after treatment were observed as well as liver biopsy.RESULTS：Hepatic fibrosis indicators and histopathology score were significant improved after experiment in Qianggan capsule group,and statistical results indicated significant difference between 2 groups（P0.05）.The expressions of CTGF、collα2 mRNA gene were inhibited and the expressions of CTGF protein were reduced after experiment in Qianggan capsule group,and statistical results indicated significant difference between 2 groups（P0.05）.CONCLUSION：Qianggan capsule can protecting hepatocyte,anti-fibrosis through cut down TIMP-1 level,and reduced CTGF、collα2 mRNA and the expressions of CTGF protein.It is a suitable drug in the treatment of nonalcoholic fatty liver fibrosis.