| ObjectiveObserving the effect oftraditional Chinese medicine (TCM)curing chronic hepatitis B (CHB)with liver depression and spleen deficiency and spleen-stomach dampness-heat, to providethe clinical basis ofprevention and treatment of chronic hepatitis B.Test the expression of microRNAs related to the syndromes after the intervention of TCM,preliminarilyinvestigate the mechanism of the effects of TCM, and provide the biological foundationof curative effect of TCM.MethodsRandomlydivided the patients with different symdromes into two group:treatment group (treated by lamivudine) and control group (treated by lamivudine and Chinese medicine). Tested the ALT, TBIL and HBV-DNA after the treatment of 0,3,6,9,12,15,18 months.A total of 12 cases(treatment group and the control group takes 3 patients each,6 patients from the included two symdrome cases with non drug resistance)were included in our study.Before and after the treatment for the sixth months, test the expression of plasma miR-23a-3pin liver stagnation and spleen deficiency syndrome cases byqRT-PCR (probe), and the expression of plasma miR-1280 in spleen-stomach damp-heat syndrome cases.Results1.The level of HBV-DNA was negatively related to age of CHB. (r=-0.197,P=0.000)2.Before treatment, the ALT of the patients with spleen-stomach damp-heat syndrome is higher than the liver stagnation and spleen deficiency syndrome. ALT≥3×ULN in spleen-stomach damp-heat and liver stagnation and spleen deficiency respectively are 38% and 30%.3.For the liver stagnation and spleen cases,after the treatment, each time observations ofALT, TBIL, HBV-DNA were significantly lower than those before treatment(P<0.05). There is no significant difference between the control groupand treatment group(P>0.05). But after treatment, the HBV-DNA, ALT, TBIL of the treatment group are lower than the control group.As time goes on, the treatment group are more stable than the control group.4.For the spleen-stomach damp-heat cases,after the treatment, each time observations of ALT, TBIL, HBV-DNA were significantly lower than those before treatment (P<0.05). There is no significant difference between the control groupand treatment group(P>0.05). But after treatment, the HBV-DNA, ALT, TBIL of the treatment group are lower than the control group.As time goes on, the treatment group are more stable than the control group.5.The rate of lamivudine resistant mutation of treatment group was significantly lower than the control group (P<0.05).For the liver stagnation and spleen deficiency cases, the rate of lamivudine resistant mutation in treatment groupand control group are 18.6% and 32.3%,and for the spleen-stomach damp-heat cases, the rate are 4.1% and 13.8%.6.Compared with the normal group, miR-23a-3p in liver stagnation and spleen deficiency cases is lower. After the treatment,miR-23a-3pof the treatment groupis significantly higher than it was before (P<0.05), while the control group is not (P>0.05).7.Compared with the normal group, miR-1280 in liver stagnation and spleen deficiency cases is lower.After the treatment, miR-23a-3pof the treatment groupis significantly higher than it was before (P<0.05), while the control group is not(P>0.05).Conclusionsl.The level of HBV-DNA was declining with age.2.For the CHB with lamivudine,tested by traditional Chinese medicine combined with lamivudine is more effective in improving hepatic function, inhibit virus replication, reduce HBV resistant mutation, and make the condition more stable.3.MiR-23a-3p, miR-1280 are respectively related to the evolution of CHB with liver stagnation and spleen deficiency syndrome and spleen-stomach damp-heat syndrome.4.According to correlation between miRNA and the effect of TCM, miR-23a-3p,miR-1280 can be further proved to be used as the potential biomarkers of CHB with liver stagnation and spleen deficiency syndrome and spleen-stomach damp-heat syndrome.And it lays a foundation for the research on the mechanism of the treatment of CHB with TCM. |
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