Experimental Study Of Anti-hepatic Failure Compound The Impact Of Severe Hepatitis In Patients With Hepatic Synthetic Function And Mechanisms

Backgroud: Hepatitis B virus infection is common in china, with a infection rate of 10%-12%, and approximately 1%-2% of patients with hepatitis B developed hepatic failure, which is named as severe hepatitis. The complexity of severe hepatitis clinical presentations makes it difficult to bianzheng lunzi. We presume, the severe hepatitis origin from damp-heat and pestilence, which encroach on body and injure the liver and blood, making the function of liver lose the balance. So we develop KangGanShuaiFuFang which can detoxify and eliminate pathogenic heat and moist.Objective: It aimed at evaluating the effects of KangGanShuaiFuFang about composite fuction on severe hepatitis. The rats were induced the model of acute hepatic failure rat. By observing the change of the indexes of HMGB1 and PCNA, the mechanisms of KangGanShuaiFuFang on rats with laboratory acute hepatic failure from two factors which relieve the damage and promoting regeneration has been explored.Methods: 1. Clinical research: The treatment group included 60 severe hepatitis patients. Based on routine treatments, they were oral taken and treated enema with kanganshuaifufang. The control group included 60 severe hepatitis patients. They were only treated with routine treatments. They were all observed the change of the indexes of PTA,Alb and T-ch.2. Experimental study: 110 Wistar male rats were randomly divided into six groups: normal group, model group, PHGF group, YC group, KGSFF group of small dose, KGSFF group of large dose. All rats were injected with D-GalN 800mg.kg^-1 and LPS0.1mg.kg^-1 except the normal group injected with the 0.09 salt solution intraperitoneally. In 2 hours after model being made, the rats were treated with 0.09 normal saline, KGSFF low and high dosages, YC, PHGF respectively twice every day for 3 days. And 72 hours later, the blood and hepatic tissues were collected.1) Observed the mortality of the rats in 3 days, the blood were collected to measure liver function (serum ALT, AST, TBil).2) Observed the pathological morphologies of hepatic tissues under optics microscopy.3) Observed the expression of HMGB1 protein in hepatic tissues with Western-blot.4) Observed the expression of PCNA protein in hepatic tissues.Results:1 Clinical research: The improvement of PTA, Alb and T-ch in treatment group was greater aider treatment than before treatment. The improvement of PTA in treatment group was greater than those of in control group. The difference was significant (P＜0.05 or P＜0.01).2 Experimental study:2.1 Model group can decrease livability conspicuously than normal group(P＜0.01). KGSFF group of large dose and PHGF group can incease livability than model group (P＜0.05).2.2 In model group, the indexes of ALT, AST, TBil increased very high than normal group (P＜0.01). The indexes of ALT, AST, TBil were significantly lower in the PHGF group, YC group, KGSFF group of small dose and KGSFF group of large dose than model group (P＜0.05 or P＜0.01), YC group, KGSFF group of small dose and KGSFF group of large dose are not different conspicuously(P＞0.05).2.3 The ultrastructures of liver were improveded in the PHGF control group, YC group, KGSFF group of small dose and KGSFF group of large dose and the KGSFF group of large dose is better than other groups.2.4 In the model group, the expression of HMGB1 in hepatic tissue were significantly inceased comparing with the normal control (P＜0.01). While in the KGSFF group of large dose and the PHGF group above-mentioned indexes were decreased comparing with the model group(P＜0.05). Among the descending total, the KGSFF group of large dose was the best. Liner regretssion analysis showed that the expression of HMGB1 in hepatic tissue is in proportion to the indexes of ALT, AST, TBil and the change of the pathological morphologies of hepatic tissues.2.5 In the normal group, the expression of PCNA in hepatic tissue were significantly deceased comparing with other groups, the expression of PCNA in the PHGF group significantly increased comparing with those in the model group (P＜0.01), while in the YC group, KGSFF group of small dose and KGSFF group of large dose, the expression of PCNA were better than the model group(P＜0.01), and that KGSFF group of large dose have the best effect.Conelusions: 1 KGSFF may obviously improve the composite ruction of liver of patients with severe hepatitis.2 Immunoreaction damage induced by HMGB1 play a role in ALF.3 The KGSFF have resistance against the rats with acute hepatic failure. It related to decreasing of HMGB1 which is the important medium of relieving the intestinal endotoxemia which can improving the liver function.4 The KGSFF can develop the regeneration of hepatic cells.