The Clinical Research Of "Noudshing Kidney To Produce Marrow And Form Liver" In Treatment For Chronic Hepatitis B Liver Failure

To observe the clinical effect of "nourishing kidney to produce marrow and form liver" in treatment for chronic hepatitis B liver failure and the mechanism.By adopting randomized controlled clinical trial (RCT) method, collect hospitalized patients of Hubei Province Chinese Medicine Hospital, Wuhan medical treatment center, Wuhan no.1hospital, Wuhan hospital of traditional chinese medicine, Wuhan no.7hospital, Zhongnan hospital of wuhan university from January2007to June2011, dividing into three groups according to the1:2:1western control group, Integrative Medicine group1, Integrative Medicine group2(treatment group of nourishing kidney to produce marrow and form liver). A total of144cases of selected cases, due to a variety of reasons the selected12cases off,132cases were included in the statistical analysis,110cases male and22females. Western medicine treatment group were treated with basic therapy+symptomatic and supportive treatment program; Integrative Medicine group1was treated with basic therapy+symptomatic and supportive treatment+cooling blood and promoting blood circulation to subsided jaundice, Qingrejiedu and dampness, the Onyang and strong spleen to subsided jaundice, YiQi Jieduhuayu law treatment programs; Integrative Medicine2group based therapy+symptomatic and supportive therapy plus nourishing kidney to produce marrow and form liver treatment rule. Treatment observation period lasted for8weeks. Observation time points:0weeks,1week,2weeks,3weeks,4weeks,5weeks,6weeks,7weeks,8weeks; follow-up period for24to48weeks. Observation time:12weeks,24weeks,48weeks. The main outcome measures were the mortality, complication rate, virological indicators, biochemical indicators, including mortality for the primary efficacy evaluation. Combined with pre-clinical application and basic research to explore the possible action mechanism of "nourishing kidney to produce marrow and form liver" on the treatment of chronic hepatitis B liver failure.Result:Integrative Medicine Group (1+2) mortality rate (28.71%) compaired with Western medicine treatment group mortality (51.61%), statistically significant difference (P<0.05), where mortality of treatment group of nourishing kidney to produce marrow and form liver (Integrative Medicine group2)(16.67%) below mortality of Integrative Medicine Integrative Medicine group1(35.38%),there were the statistically significant difference (P<0.05). ALB average level of Western medicine group after treatment, does not rise, but slightly decreased; Integrative Medicine (group1, group2) were both increased, the statistical difference was significant (P<0.05), which combined treated group2increased significantly, compaired with the difference before and after treatment with Western medicine, the difference before and after integrative medicine group2(nourishing kidney to produce marrow and form liver) exits statistically significant difference P<0.05 Conclusion:"Nourishing kidney to produce marrow and form liver" could improve clinical effect in treatment for chronic hepatitis B liver failure and reduce the death rate. The potential mechanism was that "nourishing kidney to produce marrow and form liver" regulates liver regeneration. Integrative Medicine treatment of chronic hepatitis B liver failure has significantly reduced mortality in the guidance of "nourishing kidney to produce marrow and form liver", to a certain extent improve liver tissue reconstruction, and promote the function of compensatory or restore."Nourishing kidney to produce marrow and form liver" regulating disorders of the liver regeneration process of patients with chronic hepatitis B liver failure may be its mechanism of action. Clinical application and basic research results suggest that "nourishing kidney to produce marrow and form liver" can promote bone marrow stem cells into hepatocytes, regulate liver regeneration-related gene expression and signal pathway, that may be the molecular mechanism.