当归补血汤治疗家兔血吸虫病肝纤维化的组织病理学分析

目的 探讨当归补血汤对家兔血吸虫病肝纤维化的治疗作用.方法 家兔34只,体质量2.0～2.5kg.取感染日本血吸虫的钉螺,置于150 ml三角烧瓶内逸蚴,每只家兔经腹部皮肤感染血吸虫尾蚴100条.感染血吸虫后第13周开始,每周B超检查家兔肝脏.在感染18周后,当B超确定家兔肝发生了纤维化,将家兔按体质量随机分为治疗组和对照组,对照组12只,治疗组按口服当归补血汤剂量分为高剂量组(50g/kg)和低剂量组(5 g/kg),每组11只.治疗组每天给药1次,连续给药10周,对照组不予治疗.在治疗开始时,3组家兔同时给吡喹酮进行杀虫治疗,吡喹酮剂量按300mg/kg,1次灌服.10周后解剖家兔,取出肝脏,HE染色,光镜下进行病理学观察,肝纤维化病理学分级采用Scheuer法.结果 家兔感染18周后,B超检查显示,肝实质粗网络状,高回声光带光斑,"地图样"改变,肝脏形态异常,门、脾静脉内径增宽,表明肝硬化动物模型复制成功.光镜下,高剂量组家兔肝脏有纤维化表现或轻度纤维化,肝脏汇管区扩大,周围少量纤维组织增生;低剂量组家兔肝脏轻微或中度纤维化,肝脏汇管区周围纤维组织增生明显,小叶结构保留;对照组家兔肝脏出现严重纤维化,肝脏汇管区周围大量的纤维组织增生,可见虫卵结节的分布.肝纤维化病理学分级组间比较差异有统计学意义(χ2=13.585,P<0.01);高剂量和低剂量组与对照组比较,差异有统计学意义(P均<0.01).结论 高剂量与低剂量当归补血汤对血吸虫病肝纤维化均有很好的治疗效果,对终止和逆转肝纤维化有一定的作用.

Analysis of Dangguibuxue decoction on rabbit schistosomiasis hepatic fibrosis through histopathological evaluation

Objective To evaluate the treatment effects on schistosomiasis hepatic fibrosis with Dangguibuxue decoction.Methods Thirty-four rabbits weighing 2.0-2.5 kg were selected.The procedure for the model of schistosomiasis liver fibrosis was as follow.Thirty-four snails infected by schistosoma japonicum were placed in triangle flask to escape cercariain.Abdominal skin of each rabbit wag infected by 100 schistosoma japonicum cercariaes.All rabbits were housed in conventional cages at room temperature.After 13 weeks schistosoma japonicum infected,the rabbits'livers were examined by B-ultrasound examination every week.After 18 weeks of infection,B-ultrasound showed images of schistosomiasis liver fibrosis,the rabbits were thus identified as schistosomiasis liver fibrosis.Praziquantel Was as insecticide to treat rabbits.All rabbits were divided into treatment and control groups according to body weigh.The high and low dosage group were treated with Dangguibuxue decoction at 50 g/kg and 5 g/kg(n=11),respectively,and the control group with no treatment(n=12).Two groups were treated with Dangguibuxue decoction every day for 10 weeks.After 10 weeks of treatment,the rabbits were killed and the livers were obtained to go HE staining and histopathological examination under microscope.Results After 18 weeks of infection,B-ultrasound showed that the liver parenchyma Was coarse and net-shaped.having hyperechoie spots with lightbrand and facula.The liver's shape Was abnormal,portal and splenic vein diameter was widened.Histopathological examination showed that the high dosage group presented fibrosis,which was formed by collagen fiber extending to peripherM regions,low dosage group showed mild fibrosis,mild collagen fiber present with extension without compartment formation, while the control group presented severe fibrosis and severe collagen fiber present with a thickening of the partial compartments and the distribution of eggs nodules. The liver histopathological ranking results from different groups showed that the difference was significant (χ2= 13.585,P < 0.01), the difference between the treatment groups of high and low dosage and control group was significant,respectively(all P < 0.01 ). Conclusions The histopathology results showed that both high and low dosage Dangguibuxue decoction can reverse or eliminate schistosomiasis liver fibrosis in rabbits.