芪冬复肝合剂抗肝纤维化的临床探究.pdf

提 要 目的：观察并评价益气养阴、祛瘀清热方芪冬复肝合剂抗肝纤维化的临床作用， 并探讨其相关作用机理。方法：将 80 例慢乙肝轻度、中度患者及早期肝硬化患者随 机分为试验组和对照组，分别服用芪冬复肝合剂和大黄蛰虫丸治疗180天，观察并比 较治疗前后两组患者症状、血清生化学、影像学及肝组织病理学变化，通过相关统计 学分析，讨论芪冬复肝合剂防治肝纤维化的临床疗效及相关作用机理。结果：芪冬复 肝合剂抗肝纤维化中医症状总疗效显效率为 65.85％，总有效率 90.24％；并能有效 改善血清生化学、影像学及肝组织病理学相关纤维化指标，与对照组大黄蛰虫丸相比 有显著性差异（P0.01）。结论：气阴两虚，瘀热内结是肝纤维化的重要病机；益气 养阴、祛瘀清热是肝纤维化的有效治法；芪冬复肝合剂能有效防治肝纤维化，临床疗 效明确；其作用机制可能是减轻肝脏炎症，减少肝脏细胞外基质（ECM）的合成，增 加其ECM降解和抑制肝星形细胞的活化与增殖。 关键词 气阴两虚，瘀热内结； 芪冬复肝合剂； 肝纤维化。 3 The clinical studies of QiDongFuGan mixture’s anti-hepatic fibrosis Abstract Speciality: Clinical Discip line of Chinese and Western Integrative Medicine Author : Sun qing-yong Tutor : Yuan cheng-min Objectiive :To observve and evaluation the clinical effect of QiDongFuGan mixture in treating hepatic fibrosis, and to search for the possible mechanism. Method:80 patients with chronic hepatitis b patients with mild, moderate and early cirrhosis randomly divided into trial group and control group, take QiDOngFuGan mixture and DaHuangZheChong pill respectively for 180 days , observe and compare the changes of liver tissue pathology, serology and imaging of the two groups pre-and post-treatment,through the relevant statistics analysis,discuss the clinical curative effect of anti-hepatic fibrosis and the possible mechanism. Result: The TCM symptoms significant efficiency of QiDOngFuGan mixture is 65.85％, the total effective rate is 90.24％;and it can effectively improve the related indexof liver fibrosis,there was significant difference between trial group and control group（P0.05）. Conclusion:Qiyinliangxu and Yureneijie is important pathogenesis of hepatic fibrosis;Yiqiyangyin and Quyuqingre is the effective treatment of hepatic fi