| Background:Chronic hepatitis B is systemic disease by hepatitis B virus (HBV) infection and damage caused by immune dysfunction, it is a serious infectious disease against humanity, life and health. Chronic hepatitis B distribute almost worldwidely, the chronic hepatitis B infects more than 350 million people. China's chronic asymptomatic hepatitis B virus (HBV) carriers may be more than 120 million, the annual infection rate is about 2770/100,000, the annual incidence rate of 230/100,000. The scope of this epidemic, the complexity of transmission, morbidity, has become urgent difficult to overcome.OBJECTIVE:According to the TCM Master Professor Zhou Zhongying Medical treatment of chronic hepatitis B clinical experience, established drug by the principle of clearing stasis and dispersing toxic. Treating chronic hepatitis B patients by using the liver detoxification decoction, to evaluate the clinical efficacy and safety, in animal experimental study, the mechanism of the liver Decoction on chronic hepatitis B intervention was explored.Methods:Clinical study of adopt the randomized controlled parallel design, included the number of cases 83 cases. collected 42 cases for the treatment group and control group 41 cases. Based therapy:lamivudine, oral, Test group (treatment group):on the basis of basic treatment, taking Chinese herbal medicine decoction of liver detoxification daily, concentrated fried for 200ml. Control group:in the basic treatment, the same time taking hepatitis B Qingrejiedu tablets,0.3g/piece,. Both groups received treatment for 6 months. The end of treatment were followed up for 6 months. Primary efficacy observed indicators include indicators, such as the use of points to record the clinical symptoms and signs (Xie Tong, loss of appetite, fatigue, abdominal distension, jaundice, hepatosplenomegaly, tongue, pulse, etc.), liver function, etiology of indicators, hepatic fibrosis, immune function examination, pathological histological observation.animal experiement's methods is as following, the SD rats were randomly divided into five groups, In accordance with 3ml/kg weight, subcutaneous injection of 40%of carbon tetrachloride (CC14) olive oil solution, the control group in the same way 3ml/kg subcutaneous injection of pure olive oil solution,2 times per week for the first time double dose, continuous injection for 10 weeks; carotid artery taking blood. For rheology and coagulation 3 (PT, TT, APTT) testing; second time, carotid artery blood for alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP) activity, albumin (ALB content, total protein (TP) concentration, NO, iNOS levels, the liver tissue visual inspection, respectively. Results:Clinical studies showed that the effective rate of treatment group, markedly basic cure rate were 38%,35.7%, total effective rate was 92.9%; control group,24.4%,22%, and the total efficiency of 73.2%. the difference was statistically significant, P<0.05. In comparing the symptom score, the results show that the test group of each group have different degree of improvement in symptoms, compared with those before treatment, the difference was statistically significant (P<0.01); control group, fatigue, jaundice, there is a certain improvement, but no significant difference in (P> 0.05). ALT, AST of the two groups after treatment, the difference was statistically significant (p<0.05). Treatment group was even more pronounced decline in liver function. Observation of two pairs e antigen seroconversion and virological indicators found that the treatment group compared with the control group, HBeAg and HBV-DNA negative conversion overcast was no significant difference. Two groups of patients with elevated serum HA, LN, IV collagen to varying degrees lower than before treatmen (P <0.05). Liver fibrosis can be seen in the two groups have similar effect.Experimental results show that the control group, high dose group of liver detoxification, hepatitis B Qingrejiedu film growth of normal body weight, compared with the model group were significantly different (P<0.05, P<0.01). the model rats ALT, AST, AKP activity significantly increased, compared with the normal group, while treatment of the above indicators decreased significantly, indicating improvement of liver detoxification soup with liver function, reducing chronic liver injury. In the evaluation of protein synthesis in the liver in rat model, the experimental results suggest that model group, total protein, albumin levels significantly lower than the control group (P<0.05), Blood coagulation model group and four of the indicators were higher than the normal group, indicating the existence of chronic hepatitis B patients with abnormal clotting mechanisms and the microcirculation, coagulation four in each group after treatment, hemorheology indices were all improved. The TXB2 content in model group,6-Keto-PGF1αcontent, TXB2/6-Keto-PGF1αratio compared with the control group, differences are significant (** P<0.01), shows modeling success; Compared with model group, of liver Detoxification of high-dose group of TXB2 content,6-Keto-PGFla content, TXB2/6-Keto-PGF1αthere are significant differences in the ratio of (## P<0.01); low-dose group, positive medicine group, TXB2 content,6-Keto-PGF1αcontent, TXB2/6-Keto-PGF1αratio compared with the model group differences (# P<0.05); Model group compared with control group, NO levels, iNOS activity were increased in two significantly different (P<0.01), description of chronic hepatitis B in rat liver inflammation occurs, NOS was induced by generating increased inflammation and cytokine macrophages can also stimulate the production of NO, a large number of NO on the liver to produce toxic effects and damage to liver cells. Medication in each group after treatment, compared with model group, the treatment group NO levels, iNOS decreased the vitality, the difference was significant (P<0.05 or P<0.01), This study showed that rats of model group compared with control group IL-2, IFN-y were significantly decreased, while IL-4, IL-13 significantly increased, indicating the existence of chronic hepatitis B in rat cytokine imbalance Thl/Th2.Conclusion:The decoction of liver detoxification can improve chronic hepatitis B patients with heat and damp symptoms, signs, improve the patient's liver function, reduce inflammation of liver cells, protecting liver cells. By animal experimental study that the decoction of liver detoxification mechanism maybe lie in①reducing liver inflammation, protecting the liver cells;②promoting liver regeneration, so that repairing damaged liver tissue;③improving the liver microcirculation, liver cells to restore normal metabolism and blood supply;④regulating immune function, reducing immune injury;⑤improving the morphological changes of liver injury. |
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