The Study Of Chinese Herb Soup "San Jin Si Ke" From Taiwan Province On Anti-hepatic Fibrosis Effect

Objective:To study the anti-hepatic fibrosis mechanism of "San Jin Si Ke" Chinese herb soup (SJSK for short) and the clinical curative effect, we observed the anti-hepatic fibrosis effect of SJSK soup through the study in vitro and in clinical.Methods:The evaluation of curative effect on anti-hepatic fibrosis of SJSK soup consisted of two parts:in vitro on basic study and evaluation in clinical.In vitro on basic study, we investigated the anti-hepatic fibrosis mechanism of SJSK soup by the model of HSC-T6cell line, and the anti-virus effect on hepatic B virus by the HepG2.215cell line. The cellular signal pathway of TGF-β/SMAD was a classical pathway in hepatic fibrosis, so we evaluated the anti-hepatic fibrosis effect through three parts:the SJSK soup effect on the TGF-β gene transcription level, the effect on the expression level of TGF-β receptor and the effect on expression of SMAD protein. We detected the mRNA transcription level by Real-time PCR, and detected the expression level of TGF-β receptor by flow cytometry and the expression of SMAD protein by Western blot in the study. On the model of HepG2.215cell line, we detected the secretion level of HBsAg and HBeAg by ELISA, and the hepatic B virus DNA synthesize level by Real-time PCR method.In clinical, we observed the28cases of patients with hepatic fibrosis. Those patients were collected from Linyuanquan clinic, Bao’antang clinic and Jian’antang clinic between2008to2012. We observed the development of the symptoms changed in the treatment with SJSK soup for more than4months, and compared the results between the pre-treatment and after-treatment with SJSK soup by the Nimodipine method. We took the SJSK soup as a basic prescription, adjusted others Chinese herbs according to the symptoms differed from TCM type. On the other hand,we also observed the clinical effect of the hepatic function and the degreed of hepatic fibrosis by testing the patients’serum, including HA,LN,PCⅢ, AST,ALT and so on.Result:According to the primary study of the SJSK soup in the treatment with hepatic fibrosis, we found that the SJSK soup had a good effect on anti-hepatic fibrosis both in vitro basic study and in clinical observation.In the vitro basic study of the SJSK soup on HSC-T6model, we found that the SJSK soup impacted the TGF-β/Smad pathway by decreasing the transcription level of TGF-β and adjustment the SMAD protein level, but not impacted the TGF-β receptor. The TC50of SJSK soup on HSC-T6was114.51mg/ml, at the concentration of100mg/ml and25mg/ml, the SJSK soup would reduce the TGF-β transcription level and the expression level of SMAD7. On the HepG2.215cell line, the TC50of the SJSK soup was210.21mg/ml, the IC50of HBsAg and HBeAg was133.67mg/ml,129.99mg/ml respectively. The treatment index (TI) was1.57and1.62respectively which showed that the SJSK soup had some effect on anti-hepatic virus by decreasing the secretion of HBsAg and HBeAg. But on the study of the synthesis of viral, the result showed that the SJSK had little effect on limitation of viral DNA duplication.On the observation of the curative effect of SJSK soup, we found that the SJSK soup would develop the hepatic function and improved the hepatic fibrosis level. In the improvement of the hepatic symptoms, the sequence from best to worst was as below:rib pain>backache>hepatosplenomegaly>fatigue>cold body>bloating>loose stools> edma>development of complexion>fever>hepatic palms. The total efficiency rate of clinical effect was96.55%. And with the treatment of SJSK soup for more than4months, the patients with ascites mitigated the degree of ascites. Compare with the results of pre-treatment, the ALT, AST, TBil and ALP all decrease to61.16%,48.57%,42.33%and35.14%respectively. The level of HA, LN, and PCIII decrease to52.17%,42.86%and44.51%.Conclusion:The SJSK soup had a good effect on anti-hepatic fibrosis by decrease the HA,LN, PCIII,ALT, AST and so on in the patients’serum, which indicated that the SJSK soup would protect the liver from damage and improve the hepatic function, prolonged the hepatic fibrosis development.