清热疏肝合剂用于肝纤维化的临床观察

【摘要】 目的 评价中药制剂清热疏肝合剂对肝纤维化的疗效。方法 将78例慢性中度乙型肝炎伴肝纤维化者随机分为治疗组和对照组，治疗组用清热疏肝合剂，对照组用氢溴酸山莨菪碱（654-2），比较治疗前后血清透明质酸（Hyaluronic acid，HA）、甘胆酸（Glycocholic acid，GCA）、Ⅳ型前胶原（ProcollagenⅣN-terminal Peptide，PⅣNP，7S胶原）及Ⅲ型前胶原氨基端肽（ProcollagenⅢN=terminal Peptide，PⅢNP或PⅢP）的平均下降指数。结果 治疗后HA、PⅣNP、GCA平均下降指数，治疗组分别为54.8%，39.8%，70.5%;对照组分别为13.53%，19.3%，46.5%。治疗组反映肝纤维化的各项血清学指标下降幅度均大于对照组，具有统计学意义（P<0.05）。结论 清热疏肝合剂有阻止慢性乙型肝炎肝纤维化的作用。

　　Xu Xiaoping，Qu Zhangshu，Ou Qiang，et al．

　　Department of Infectious Disease，The People’s Hospital，Xiangxi Autonomous Prefecture of Miao and Tuchia Nationality，Jishou，Hunan416000．

　　【Abstract】 Objective To evaluate the curative effect of Qingre-Shugen misture on hepatic fibrosis.Methˉods 78patients，suffering from（diagnosed as）chronic moderate hepatitis B with hepatic fibrosis，were randomly studˉied in group1with Qingre-shugan mistura taken，or in group2with anisodamine hydrobromide（654-2）received as contrast.Then compared the average descending exponents of serum hyaluronic acid（HA），glycocholic acid（GCA），procollagenⅣN-terminal peptide（PⅣNP）and procollagenⅢN-terminal peptide（PⅢNP）before and after treatment.Results After treatment，the indexes in group1were as following:HA decreased by54.8%，PⅣNP by39.8%，and GCA by70.5%，while in group2，HA by13.53%，PⅣNP by19.3%and GCA46.5%，statistical analysis suggested that the indexes（exponents）in the former could be ameliorated much more greatly than in the latˉter.There was significant diffrernce between them（P<0.05）.Conclusion Qingre-Shugan mistura can restrain the pathological change of chronic Hepatitis B with hepatic fibrosis（has the function of restraining/inbibiting）.Key words qingre-shugan mistura hepatic fibrosis clinical obsrevation肝纤维化是指肝脏纤维增生（细胞外基质合成增加）和纤维分解（细胞外基质降解）不平衡，纤维组织过度沉积。阻止肝纤维化的形成与发展，对防治肝硬化具有重要意义。虽然秋水仙碱等十几种药物可抑制肝纤维化 ［1］ ，但因毒副作用明显，作用机制不明确，临床应用受到限制。近年，我院试用自行研制的中药制剂“清热疏肝合剂”治疗肝纤维化，具有明显的疗效，现将临床观察结果报道如下。