The Clinical And Experimental Research Of Chi Yin Mixture On Treatment Of Intrahepatic Cholestatic Jaundice

Part1The clinical researchObjective: To evaluate the clinical efficacy of Chi Yin Mixture on treatment ofintrahepatic cholestatic jaundice.Methods:60patients with intrahepatic cholestatic jaundice were randomly assigned,treatment group30cases and control group30cases.The treatment group: Inconventional protect liver, fall enzymes such as symptomatic treatment, on the basis ofcombined with red mixture40ml each time, three times a day, oral, the course is4weeks. Original antiviral therapy of patients continue to treatment. The control group: Inconventional protect liver, fall enzymes such as symptomatic treatment, on the basis ofcombined with UDCA250mg each time,2times a day, oral, course of4weeks.Observed two groups of patients before and after treatment of TCM syndrome and thechange of liver function and liver fibrosis indexes.Results:①In curative effect evaluation of clinical disease, treatment group totaleffectiveness is92.86%, control group total effective rate is89.66%,(P>0.05), so youcan think, in improving clinical disease curative effect the two groups have the similareffect.②In the aspect of TCM symptoms curative effect evaluation, the total effectiverate of treatment group is96.43%, control group total effective rate was82.76%(P<0.05), so you can believe that the treatment group was better than that of control groupin improving symptoms of traditional Chinese medicine.③In the aspect of TCMsymptom integral, the treatment group in the before and after treatment，the symptomsintegral comparison (P<0.01);Control group in the before and after treatment, thesymptom integral comparison (P<0.05);Compares the integral of the two groups aftertreatment (P<0.05), so can support that the treatment group is better than that of controlgroup in improving TCM symptoms integral.④In terms of improvement of serumbilirubin, TBiL and DBiL levels in treatment group after treatment were decreased, there was a significant difference compared with before treatment (P<0.01); TBiL andDBiL of the control group have significant differences before and after therapy (P<0.01); Comparing the two groups’ TBiL and DBiL results after treatment had nodifference (P>0.05), treatment and control group have similar efficacy in improvingserum bilirubin.⑤In improving the biochemical indicators, the serum ALT, GGT andALP level of the treatment group had significant difference before and after therapy (P<0.01);The control group’s also had significant difference before and after therapy (P<0.01); the ALT, GGT and ALP results of Two groups after treatment compare nodifference (P>0.05), shows that the two groups in improving the biochemical indicatorsis similar.⑥In improving the indicators of liver fibrosis, the levels of HA and PⅢP ofthe treatment and control groups compared with before treatment were decreased (P <0.01), while the treatment group compared with control group can significantly reducethe intrahepatic cholestasis jaundice patients’serum LN and C-IV level, shows Chi Yinmixture in improving liver tissue fibrosis, also have very good effect.Conclusion: Treatment group and control group in improving clinical curative effect issimilar， and in improving the patients’ serum and biochemical indicators havesignificantly effect, and no obvious side effects occurred. And Chi Yin mixture caneffectively improve the intrahepatic cholestasis jaundice patients with clinicalsymptoms of TCM, and it can reduce the degree of liver fibrosis, and the price is low, inthese areas were superior to the control group. Part2The experimental researchObjective: To evaluate the therapeutic effect of Chi Yin Mixture on SD rat model ofcholestasis jaundice which induced by ANIT,investigate the molecular mechanism ofChi Yin mixture treatment of jaundice.Methods:40SD rats were randomly divided into normal group, model group, treatmentgroup and control group, each group of10. All the rats adaptive breeding in7days,model group, treatment group and control group of rats disposable lavage with2%ANIT salad oil solution of5ml/kg, then to strengthen the preparation of intrahepaticcholestasis icteric model in the same way per48h again, normal group rats given thesame dose of salad oil to fill the stomach.48h after the first molding, the normal groupand model group rats were given normal salad oil, treatment group and control groupwere given Chi Yin mixture, UDCA lavage treatment7days, observe the generalsituation of the rats. After the experiment, put to death all the rats, to detect serumbilirubin and biochemical indicators, to observe the liver tissue pathological changes,and to detect NTCP expression in rat liver by immunohistochemical and RT-PCR.Results:①In terms of improvement of serum bilirubin, compared with model group,treatment group rats’ TBiL and DBiL levels were significantly lower (P <0.01); TBiL,DBiL levels of control group rats also significantly reduced (P<0.01), twogroups’TBiLand DBiL results comparison (P>0.05), respectively, showed that UDCAand Chi Yin mixture in reducing intrahepatic cholestasis jaundice rats bilirubin levelhave no obvious difference.②In terms of improving the serum biochemical indicators,compared with model group, treatment group rats’ ALT, AST, ALP levels weresignificantly lower (P <0.05or P <0.01);And the control group rats’ decreased notobviously (P>0.05), two groups’results compared differently (P<0.05or P<0.01),showed that in the improvement of biochemical indicators UDCA slightly less than ChiYin mixture.③In the expression regulation of NTCP, by immunohistochemistry andRT-PCR test，as you can see, compared with normal group，respectively, there are differences in the expression of model group, treatment group and controlgroup(P<0.01)，account for that NTCP expression of intrahepatic cholestasis jaundicerat model were depressed; compared with model group,respectively,,there aredifferences in the expression of treatment group and control group(P<0.01or P<0.05)，illustrate that Chi Yin mixture and UDCA improve the NTCP expression of intrahepaticcholestasis jaundice rat model; compared between treatment group and control group(P>0.05), the two have no obvious differences in regulate the expression of NTCP.Conclusion: Chi Yin mixture can effectively improve the serum bilirubin, biochemicalindicators and pathological histology of intrahepatic cholestasis jaundice model rats,improve NTCP expression, contribute to the recovery of rat liver bile salt transportsystem, so as to promote the metabolism of bilirubin, reduce the damage caused by bilesalts to the liver,and have effective treatment effect.