CAJ | 학술논문

目的：观察扶正化瘀胶囊对慢性丙型肝炎患者血清细胞因子和纤维化指标的影响。方法选择慢性丙型肝炎既往使用干扰素失败治疗目前已停药的肝纤维化患者60例，随机分为两组，每组各30例，分别给予扶正化瘀胶囊（实验组）和复方鳖甲软肝片（对照组），疗程24周，停药后随访12周。从不同时段分析肝纤维化指标、血清血清肿瘤坏死因子α（TNF-α）、转化生长因子-β1（TGF-β1）、透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原（PC-Ⅲ）、Ⅳ型胶原（Ⅳ-C）及肝功能变化，并对治疗前后各项指标进行比较。结果两组患者治疗前、治疗后12周、治疗后24周、停药6周血清TNF-α、TGF-β1、PDGF、HA、LN、PC-Ⅲ、Ⅳ-C、ALT、ALT、AST和TBil较治疗前均明显改善，差异具有统计学意义（P均＜0.05）。实验组患者TNF-α和PDGF水平在治疗后12周、24周和停药6周较对照组显著下降，差异具有统计学意义（P均＜0.05）；实验组患者治疗12周后TGF-β1、HA、LN、PC-Ⅲ和Ⅳ-C水平显著下降，差异具有统计学意义（P均＜0.05）。两组患者治疗24周和停药6周后以上指标差异无统计学意义。而两组患者ALT、AST和TBil在治疗的各时段相比差异均无统计学意义。入组病例易出现恶心、胃胀、乏力等不良反应。结论两组患者用药后均可显著改善血清TNF-α、TGF-β1、PDGF、HA、LN、PC-Ⅲ、Ⅳ-C及肝功能等其他指标的水平，扶正化瘀胶囊在降低肝纤维化血清细胞因子，改善肝纤维化指标疗效较好。
목적：관찰부정화어효낭대만성병형간염환자혈청세포인자화섬유화지표적영향。방법선택만성병형간염기왕사용간우소실패치료목전이정약적간섬유화환자60례，수궤분위량조，매조각30례，분별급여부정화어효낭（실험조）화복방별갑연간편（대조조），료정24주，정약후수방12주。종불동시단분석간섬유화지표、혈청혈청종류배사인자α（TNF-α）、전화생장인자-β1（TGF-β1）、투명질산（HA）、층점련단백（LN）、Ⅲ형전효원（PC-Ⅲ）、Ⅳ형효원（Ⅳ-C）급간공능변화，병대치료전후각항지표진행비교。결과량조환자치료전、치료후12주、치료후24주、정약6주혈청TNF-α、TGF-β1、PDGF、HA、LN、PC-Ⅲ、Ⅳ-C、ALT、ALT、AST화TBil교치료전균명현개선，차이구유통계학의의（P균＜0.05）。실험조환자TNF-α화PDGF수평재치료후12주、24주화정약6주교대조조현저하강，차이구유통계학의의（P균＜0.05）；실험조환자치료12주후TGF-β1、HA、LN、PC-Ⅲ화Ⅳ-C수평현저하강，차이구유통계학의의（P균＜0.05）。량조환자치료24주화정약6주후이상지표차이무통계학의의。이량조환자ALT、AST화TBil재치료적각시단상비차이균무통계학의의。입조병례역출현악심、위창、핍력등불량반응。결론량조환자용약후균가현저개선혈청TNF-α、TGF-β1、PDGF、HA、LN、PC-Ⅲ、Ⅳ-C급간공능등기타지표적수평，부정화어효낭재강저간섬유화혈청세포인자，개선간섬유화지표료효교호。
Objective To observe the effects of Fuzhenghuayu capsule on inflammation-fibrosis indexes in serum of patients with chronic hepatitis C (CHC). Methods Total of 60 CHC cases with failure treatment of interferon were divided into the two groups randomly, there were 30 cases of liver ifbrosis due to chronic hepatitis C treaded by Fuzhenghuayu cppusle as treatment group while 30 cases of the diseased treaded by cytokines as control. All patients were treated for 24 weeks, then the serum levels of liver function indicators such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and the serum level of fribrosis indicators, such as hyaluronic acid (HA), laminin (LN), procollagen type (PC-Ⅲ), collagen typeⅣ(Ⅳ-C) and tumor necrasis factor (TNF-α), transforming growth factor (TGF-β1), platelet-derived growth factor (PDGF) in 12 weeks, 24 weeks and 24 weeks after treatment were compared, respectively. Reasults After trenment, the levels of TNF-α, TGF-β1, PDGF, HA, LN, PC-Ⅲ,Ⅳ-C, ALT, AST and TBil were singinifcantly improved comparing with the control group (P<0.05). The levels of TNF-αand PDGF were lower in treatment group than that in the control group at the same point, which at 6 weeks, 12 weeks, 24 weeks and after treatment for 6 weeks. The levels of TGF-β1, HA, LN, PC-ⅢandⅣ-C were signiifcantly decreased than control group after 12 weeks for treatment, but with no siniifcant difference at 24 weeks and after treatment for 6 weeks. The levels of ALT, AST and TBil were with no sinificant difference between the two groups (P > 0.05). Conclusions The two groups could improve the levels of TNF-α, TGF-β1, PDGF, HA, LN, PC-Ⅲ, Ⅳ-C, ALT, AST and TBil. Fuzhenghuayu capsule obtained a higher curative effect in treating liver fibrosis due to chronic hepatitis C, but adverse reaction of nause abdominal distension, weekness in a particular patient.