世界中医药

目的：探讨扶正化瘀胶囊对乙型肝炎肝硬化患者肝功能及丙二醛（MDA）、基质金属蛋白酶-1（MMP-1）表达的影响。方法：选取2014年6月至2016年2月成都市公共卫生临床医疗中心收治的乙型肝炎肝硬化患者148例作为研究对象,按照随机数字表法分为观察组与对照组，每组74例，对照组给予阿德福韦酯片治疗，观察组在对照组的基础上加用扶正化瘀胶囊治疗，2组均持续治疗12个月。治疗前后检测并比较2组肝功能、肝纤维化指标以及MDA、MMP-1水平，记录2组临床疗效和HBV DNA阴转率。结果：治疗后观察组和对照组的治疗有效率分别为86.96%、68.57%，差异有统计学意义（P<0.05）。治疗后2组患者血清肝功能指标谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）和肝纤维化指标透明质酸（HA）、Ⅲ型前胶原肽（PⅢNC）、Ⅳ型胶原（ColⅣ）及层粘连蛋白（LN）水平较治疗前显著降低，且观察组低于对照组，差异有统计学意义（P<0.05）。与治疗前比较，治疗后2组患者血清MDA降低、MMP-1升高，且差异有统计学意义（P<0.05）。治疗后，观察组和对照组血清HBV DNA阴转率分别为94.20%和90.00%，2组间差异无统计学意义（P>0.05）。结论：扶正化瘀胶囊联合西药可显著改善乙型肝炎肝硬化患者肝功能，在降低其血清MDA表达的同时促进MMP-1的表达，进而减轻肝纤维化程度。

English Summary:

To discuss the effects of Fuzheng Huayu Capsule on liver function and malonaldehyde(MDA)and matrix metalloproteinase-1(MMP-1)expression in patients with hepatitis B cirrhosis.Methods:From June 2014 to February 2016,148 patients with hepatitis B cirrhosis admitted in Chengdu Public Health Clinical Medical Center were divided into an observation group and a control group according to random number table,with 74 cases in each group.The control group was given adefovir dipivoxil tablet treatment,and the observation group was added Fuzheng Huayu capsule on the basis of the control group.And 2 groups were treated for 12 months continuously.The levels of liver function,liver fibrosis and MDA and MMP-1 were detected and compared before and after treatment,the clinical efficacy and HBV DNA negative conversion rate were recorded.Results:After treatment,the total effective rate of the observation group and the control group were 86.96%,68.57%,and the observation group was higher than the control group(P<0.05).The serum liver function indexes-levels of ALT,AST,TBIL and hepatitis fibrosis indexes-HA,PⅢNC,Col Ⅳ,LN in the 2 groups patients after treatment were significantly lower than before treatment and the observation group were lower than the control group(P<0.05 or P<0.01).Compared with before treatment,the serum MDA decreased and MMP-1 increased in the 2 groups patients(P<0.01),and there was apparent difference between the 2 groups(P<0.05 or P<0.01).After treatment,the serum HBV DNA negative conversion rate of the observation group and the control group were 94.20% and 90.00%,there was no significant difference between the 2 groups(P>0.05).Conclusion:Fuzheng Huayu Capsule combined with western medicine can significantly improve the liver function of patients with hepatitis B cirrhosis,reduce the expression of serum MDA,promote the expression of MMP-1,and reduce the degree of hepatic fibrosis.

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