世界中医药

目的：观察清热祛湿健脾方对慢性乙型肝炎肝纤维化的临床疗效及其对TGF-β1和PDGF的影响。方法：将本院100例慢性乙型肝炎早期肝硬化患者纳入研究，随机分为对照组及观察组，各50例。2组患者均接受多烯磷脂酰胆碱胶囊改善肝功能、恩替卡韦抗病毒治疗，观察组在对照组治疗方案基础上加用清热祛湿健脾方，2组均接受为期24周的治疗疗程，治疗结束后比较2组患者肝功能、肝纤维化指标、肝脏彩超结果以及外周血清TGF-β1和PDGF浓度变化。结果：1）治疗后2组患者肝功能、肝纤维化指标、肝脏彩超结果均较治疗前有所改善，其中观察组改善幅度较对照组明显，差异均有统计学意义（P<0.05）；2）治疗后2组患者外周血清TGF-β1和PDGF水平均较治疗前下降，其中观察组下降趋势较对照组明显，差异均有统计学意义（P<0.05）。结论：清热祛湿健脾方可明显改善慢性乙型肝炎肝纤维化的病情，其作用机制可能与下调外周血清TGF-β1和PDGF水平有关。

English Summary:

To observe the clinical efficacy of Qingrequshijianpi decoction in hepatic fibrosis of chronic hepatitis B and its influence on the expression of TGF-1 and PDGF. Methods: One hundred cases of chronic hepatitis B patients with early cirrhosis in our hospital were randomly divided into a control group and an observation group, 50 cases of each. They all received Polyene Phosphatidylcholine Capsules to improve liver function and entecavir for antiviral, but the observation group had extra Qingrequshijianpi decoction. The two groups were treated for 24 weeks and their liver function, liver fibrosis, liver ultrasound results and serum TGF-beta 1 and PDGF concentration changes were compared after treatment. Results: 1） The liver function, liver fibrosis, liver ultrasound results were all better than those before treatment in the 2 groups, while the observation group improved more significantly and the differences were statistically significant （P<0.05）. 2） After the treatment, all patient’ serum levels of TGF-beta 1and PDGF decreased than those before treatment, while the observation group decreased more significantly and the differences were statistically significant （P<0.05）. Conclusion: Qingrequshijianpi decoction can improve hepatic fibrosis in chronic hepatitis B patients, and the mechanism may be related to down-regulation of peripheral serum levels of TGF-beta 1 and PDGF.

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