The Clinical Studies Of BuyiKangxian Recipe’s Anti-hepatic Fibrosis

ObjectiveHBV infection is a worldwide epidemic.It’s also a global public health problem. chronic infection often and gradually progress by hepatitis, fibrosis, cirrhosis, and eventually lead to liver failure and liver cancer, etc. In ourcountry,chronic HBV infection is the most important cause of liver fibrosis.liver fibrosis formation is an important stage in the disease development. Therefore, controling the development of liver fibrosis is important for the further development of the prevention and treatment of viral hepatitis.This study is to observe the clinical effect of the BuyiKangxian recipe combined with entecavir in patients with chronic hepatitis B.These index include liver function (ALT, AST, GGT, TBIL), serum liver fibrosis makers (HA, LN, C-Ⅳ, PⅢP), serum TGF-β1, IFN-γ, IL-33 index, Color Doppler imaging examination,and the value of liver stiffness measure (LSM). We Evaluate the clinical effect of the BuyiKangxian recipe in CHB, and try to explore the possible mechanism of action. Providing a new method and theoretical basis for traditional Chinese medicine treatment in liver fibrosis.MethodsThis study adopts randomized test methods.60 patients of chronic hepatitis B were randomly divided into the treatment group and the control group, the control group was treated with entecavir tablets 0.5mg, oral,1 times/d; the trial group were treated with entecavir tablets on the basis, and to take the Buyi Kangxian recipe (The Buyi Kangxian recipe consists of Astragalus root, Codonopsis, Radix rehmanniae, Pearl grass, Fructus aurantii.White atractylodes rhizome, Salvia miltiorrhiza.Chicken’s gizzard skin,Vinegar turtle shell,Pinellia tuber, Radix bupleuri).The course of treatment were observed for 48 weeks.Respectively detecting related index in the 0 and 48 weeks.Observed and compared the liver function(ALT, AST, GGT, TBIL), serum liver fibrosis makers (HA, LN,C-Ⅳ, PⅢP), serum TGF-β1, IFN-γ, IL-33 index.Color Doppler imaging examination, and the value of liver stiffness measure (LSM)between the two groups after the treatment.SPSS 19.0 software was applied for statistical treatment of the obtained data. Results① Both of the groups can effectively improve the patients’ ALT, AST, GGT index compared with the data before treatment (P<0.05). The two groups have no significant difference between each other (P>0.05). ②HA, LN, PⅢP, C-IV of the two groups were significantly lower than those before treatment.And the improvement of HA and LN compared with the control group have significant difference(P<0.05).③The two groups before and after treatment of spleen’s thickness were significantly improved (P<0.05), there was significant difference between the treatment group and the control group (P<0.05); the diameter of portal vein in treatment group than before treatment improved, but compared with the control group had no significant difference (P>0.05). ④After the treatment, LSMs of two groups were obviously decreased, and the two groups had significant difference with each other(P<0.05).⑤After the treatment, serum TGF-β1 index of two groups were both obviously decreased, and there is significant difference between two groups(P<0.05). ⑥Two groups can improve the levels of Th1 cytokines IFN-γ, and decrease the level of Th2 cytokines IL-33(P<0.01), the treatment group effect was better than the control group (P<0.05); and the changes of IFN-γ, IL-33 were associated with TGF-β1.ConclusionThe BuyiKangxian recipe can significantly improve some indices of liver fibrosis in chronic hepatitis B patients, can plays a certain part in reversing hepatic fibrosis. The mechanisms of its action may be affected TGF-β1 and other cytokines closely related to hepatic fibrosis.And it may play a role in the moderation of HSC.