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  本文關(guān)鍵詞：康氏抗纖方治療慢性乙型肝炎肝纖維化的臨床研究　出處：《中國中西醫(yī)結(jié)合雜志》2017年10期 　論文類型：期刊論文

  更多相關(guān)文章： 康氏抗纖方 慢性乙型肝炎肝纖維化 內(nèi)源性大麻素系統(tǒng)

【摘要】：目的觀察康氏抗纖方治療慢性乙型肝炎肝纖維化的臨床療效,探討其對肝組織N-花生四烯酸氨基乙醇(arachidonoylethanolamine,AEA)、2-花生四烯酸甘油(2-arachidonoylglycerol,2-AG)、大麻素受體1(cannabinoid receptor 1,CBR1)mRNA、大麻素受體2(cannabinoid receptor 1,CBR2)mRNA含量變化的影響。方法將110例慢性乙型肝炎肝纖維化患者按隨機數(shù)字表法分為治療組和對照組,每組55例。治療組予中藥康氏抗纖方聯(lián)合恩替卡韋分散片治療,對照組用恩替卡韋分散片單藥治療,兩組均治療48周。判定兩組臨床療效,檢測血清ALT水平,HBV DNA、HBsAg、HBs Ab定量,肝組織病理、肝硬度變化,肝組織AEA、2-AG含量和CBR1、CBR2 mRNA表達水平。結(jié)果與對照組比較,治療組的臨床總有效率、HBsAg陰轉(zhuǎn)率、肝組織纖維化分期療效有效率均高于對照組(χ2=4.453,4.152,6.364,均P0.05)。與本組治療前比較,治療后兩組患者肝纖維化瞬時彈性測定值、AEA、2-AG含量及CBR1、CBR2 mRNA表達均降低(均P0.05),且治療組降低更明顯(均P0.05)。肝組織病理顯示:治療后治療組肝小葉結(jié)構(gòu)基本完整,肝細胞輕度水樣變性,匯管區(qū)纖維組織無增生,局部少量淋巴細胞浸潤,炎癥及纖維化較對照組明顯改善。結(jié)論康氏抗纖方具有提高慢性乙型肝炎肝纖維化患者的臨床總有效率、HBsAg陰轉(zhuǎn)率、肝組織纖維化分期療效有效率,其作用機制可能與調(diào)節(jié)內(nèi)源性大麻素系統(tǒng)有關(guān)。
[Abstract]:Objective to observe the clinical effect of Kangxianfang on chronic hepatitis B liver fibrosis. Objective: to study the effect of arachidonoylethanolamine (AEAA) on N-arachidonic acid aminoethanol (AEAA) in liver tissue. 2-arachidonoylglycerol (2-AGN), cannabinoid receptor 1 (cannabinoid 1). CBR1 mRNAs, cannabinoid receptor 1 receptor 2 cannabinoid. Methods 110 patients with chronic hepatitis B liver fibrosis were randomly divided into treatment group and control group. 55 cases in each group. The treatment group was treated with Kangshinxianfang combined with entecavir dispersible tablets, while the control group was treated with entecavir dispersible tablets for 48 weeks. The levels of serum ALT were measured in order to determine the quantity of HBsAb, the pathological changes of liver tissue, the changes of liver hardness, the content of AEA2-AG and CBR1 in liver tissue. Results compared with the control group, the total effective rate of the treatment group was higher than that of the control group. The effective rate of hepatic fibrosis staging was higher than that of the control group (蠂 2 / 4.453 / 4.152 / 6.364, P < 0.05). After treatment, the instantaneous elastic value of hepatic fibrosis and the expression of CBR1 and CBR2 mRNA were decreased in both groups (all P 0.05). The liver histopathology of the treatment group showed that the hepatic lobule structure was basically intact, the liver cells were slightly watery degeneration, and the fibrous tissue in the catchment area was not proliferated. Local small amount of lymphocytes infiltration inflammation and fibrosis were significantly improved compared with the control group. Conclusion Kangxianfang can improve the total effective rate of chronic hepatitis B patients with liver fibrosis and HBsAg negative rate. The effective rate of hepatic fibrosis staging may be related to the regulation of endogenous cannabinoid system.
【作者單位】： 廈門大學醫(yī)學院;廈門市中醫(yī)院肝病中心;甘肅中醫(yī)院臨床教學部;廈門市第一醫(yī)院中醫(yī)科;福建中醫(yī)藥大學中醫(yī)系;
【基金】：國家自然科學基金資助項目(No.81503529,No.81673660) 福建省科技計劃引導性項目(No.2015D007,No.2016D012) 廈門市科技惠民項目(No.3502Z20174028) 福建中醫(yī)藥大學臨床專項校管課題基金(No.XB2016080)
【分類號】：R259
【正文快照】： 慢性乙型肝炎肝纖維化是指由于各同原因引起的肝臟慢性、進行性、彌漫性病變,其特點是在肝細胞壞死的基礎(chǔ)上發(fā)生纖維化,并代之以纖維包繞的異常肝細胞結(jié)節(jié)(假小葉)。我國慢性乙型肝炎肝纖維化以乙型肝炎病毒(hepatitis B virus,HBV)的長期感染為主[1],同時慢性乙型肝炎肝纖維

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