【作者】 王伟芹；

【导师】 尹常健；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2004， 硕士

【摘要】 目的 观察柔肝抑纤饮抗肝纤维化的临床疗效及优势，并揭示其抗肝纤维化作用机制。方法 临床观察：以60例早期肝硬化患者为研究对象，治疗时限为6个月。检测其治疗前后血清的肝功能指标、纤维化指标(HA、LN、PCⅢ、Ⅵ-C)等，并观察肝脾的多普勒影像学改变。实验研究：用CCI4复制大鼠肝纤维化模型，分为四组，除模型组及空白对照组外，预防组及治疗组各给药8周。治疗结束后各组检测血清肝功能指标、纤维化指标(HA、LN、PCⅢ)及过氧化反应指标(SOD、MDA)，肝组织采用HE染色、Masson染色及Desmin免疫组化技术，半定量观察各组肝细胞变性、胶原增生及HSC的活化情况。结果 经统计学处理，早期肝硬化患者症状体征、肝功能、纤维化指标及肝脾多普勒影像学表现均有不同程度的改善，治疗前后比较差异具有显著性(P<0． 05，P<0． 01) ；用药实验大鼠的血清学指标有不同程度的改善，肝组织细胞变性、胶原增生及HSC活化半定量亦较模型组有统计学意义，且治疗组好于预防组。结论 柔肝抑纤饮通过保护肝细胞、抑制胶原增生及拮抗HSC活化而有确切的抗肝纤维化作用，能明显改善早期肝硬化患者的临床表现及实验室指标。更多还原

【Abstract】 Object Observe the curative effect and the advantage caused by Rougany ixianYin in terms of anti-hepatic fibrosis, and reveal the mechanism of it.Methods Clinic study: 60 patients with early hepatocirrhosis are treated with RouganyixianYin for 6 months. Before and after treatment, test the indexes of hepatic function and the contents of fibrosis including HA, LN, PC III and VI-C in serum, and observe the show of liver and spleen in Doppler. Experimental research: The rats in which hepatic fibrosis model was induced by carbon tetrachloride (CCL4) were divided into three groups. Except the model and control groups, the prevention and therapy groups all received RouganyixianYin in different period for 8 weeks by poured in. After all rats were put into death, tested the indexes of hepatic function and the contents of HA, LN, PC III in fibrosis and SOD, MDA in peroxidation in serum. The histopathology of hepatic tissue was observed by histological examination and Masson’ s dye which were performed in hepatic tissue, and immunohistochemical assay which the expression of Desmin was measured by, so we can comprehend the changes of denaturation of hepatic cells, hyperplasia of collagen and the activation of hepatic stellate cells in terms of semi-quantity in all groups.Results After counted with statistics, there were vary amendments in clinic symptoms, hepatic function, the indexes of fibrosis and the show ofliver and spleen in Doppler of 60 patients, and the discrepancies compared between before and after treatment were obvious (p<0.05 or P<0.01). The indexes in serum and the semi-quantities of denaturation of hepatic cell, hyperplasia of collagen and the activation of HSC in hepatic tissue of treatment groups had better amendments than those in model group, and the discrepancies compared among them are significant. The effect in therapy group was better than that in prevention group.Conclusion RouganyixianYin has accurate curative effects, including the protection of hepatic cells, the depression of collagen’ s hyperplasia and the antagonism of hepatic stellate cell’ s activation. So it can ameliorate the symptoms and the indexes tested in lab of patients.更多还原