The Clinic And Experimental Study On Eight-Ingredient Decoction Of Anti-Fibrosis Treat Liver Fibrosis

Objective:To observe therapeutic effect of Eight-Ingredient Decoction of Anti-Fibrosis against experimental liver fibrosis induced by carbon tetrachloride(CCl₄),and to discuss its therapeutic mechanism initially.To observe the clinical effect of the Eight-Ingredient Decoction of Anti-Fibrosis treated liver fibrosis in chronic hepatitis B.Method:1.The carbon tetrachloride mixed with olive oil was injected intraperitoneal for 16 times to establish the model of the rat with liver fibrosis.Since the beginning of the model establishment,the rats were administrated with high dose of TCM.and low dose of TCM separately.Observe the influence of ALT and AST of the rats with 'hepatic injuries. Referring to of Ishak liver disease pathological changes correction scoring scheme,make use of HE stain,Masson stain and immunohistochemistry stain to study the influence of the Eight-Ingredient Decoction of Anti-Fibrosis against rats' liver fibrosis.Make use of a-SMA immunohistochemistry stain marked the activating HSC to discuss the probably mechanism of Eight-Ingredient Decoction of Anti-Fibrosis against liver fibrosis.2.Sixty-six patients with chronic hepatitis B who are differentiated with Qi deficiency and blood stasis along with Dampness and Heat are randomly separated into TCM group and control group by ratio of 2:1,with 44 patients in TCM group and 22 patients in control group.The patients in both group were treated with basic liver protection treatment which is made of 2 vitamin C pills t.i.d and vitamin B complex pills t.i.d.The TCM group was also treated with Eight-Ingredient Decoction of Anti-Fibrosis which consists of huangqi, danshen,dangshen,baizhu,yujin,huangqin,chenpi,shichangpu,300ml a day,patients drink the liquor in the morning and at night for six months.To observe the TCM symptoms, liver function,mark of liver fibrosis which is made up with hyaluronic acid,precollagenâ…¢,â…£type collagen,laminin.Compared to the liver issue biopsy of some cases before the treatment,we observe the therapeutic action of Eight-Ingredient Decoction of Anti-Fibrosis against liver fibrosis of chronic hepatitis B.Results:1.The level of ALT,AST,TBIL of model of the rats with liver fibrosis are significantly higher than the normal group.The AST level of both group with high TCM dose and low TCM dose are all significant lower than the model control group.Ballooning degeneration and fatty degeneration of liver cells can be seen very clear in the model group, which has more acidophilic degeneration and apoptotic body.Masson stain shows loss of normal structure of hepatic lobules,portal areas is enlarged,collagen deposition is increased,the fibrous septa is broadened,collagen is compact and even pseudolobule proliferation in the model group.Theα-SMA positive stain region of liver issue is broad and significantly stained along with portal areas,the fibrous septa and hepatic sinusoid,the positive stain of the portal areas shows zonal distribution and the width odds,and increased by the level of liver fibrosis.While in the TCM group,Ballooning degeneration and fatty degeneration of liver cells,acidophilic degeneration and apoptotic body are all fewer than the model group.There are few fibrous tissue and hyperplasia with lower degrees,the fibrous septa are fewer and finer.The number ofα-SMA positive cells is smaller,which shows fine bundles distribution.According to pathological changes of liver disease correction scoring scheme,both level of inflammation and fibrosis of the group with high TCM dose and low TCM dose are significantly lower than that of the model control group. The score of level of inflammation and fibrosis is significantly different.2.The two group patients of chronic hepatitis B is comparable in age,liver function, multiply serum marks and fibrosis lever of liver biopsy.The patients' symptom of hypodynamia is remarkable improved in TCM treatment group.The TCM treatment group shows marked effect on the basis of multiply serum marks of fibrosis compared to the control group(P=0.020).TCM can improve the abnormally increased of HA.Eighteen patients completed both the liver biopsy before and after the treatment.Two of the patients' lever of fibrosis in the treatment group declined,seven cases remained the same,while only one case ascends.At the same time,five patients' lever of fibrosis in the control group remained the same,and three cases ascend.Conclusion:Eight-Ingredient Decoction of Anti-Fibrosis can inhibit rat liver fibrosis induced by CCl₄,fiber connective tissue hyperplasia and formation of pseudo-lobe.The mechanism of it is likely to be inhibition of hepatic stellate cell activation and collagen synthesis to protect hepatic cells.The basic pathogenesis of chronic hepatitis with liver fibrosis is qi deficiency and blood stasis,and phlegm-damp obstruction in collaterals.This decoction has the function of replenishing qi and activating blood,clearing heat and resolving dampness,resolving phlegm and dissipating mass,which can make vital qi sufficient,circulation of qi and blood fluent,treat both root and manifestation and interrupt live fibrosis.