The Role And Mechanism Of Yiganjiayin San In The Treatment Of Hepatitis B Cirrhosis With Entecavir Dispersible Tablets

Objective:Observe the clinical effect of Yiganzhuanyin powders combined with Entecavir on patients with compensated cirrhosis of hepatitis B.Detecting the change of the PI3K/Akt signal pathway in liver tissue of rats with liver fibrosis and to observe the effect of Yiganzhuanyin powders on this signal pathway,in order to explore the mechanism of Yiganzhuanyin powders against liver fibrosis.Method:1?Clinical research Patients with compensated cirrhosis of hepatitis B were randomly divided into control group and treatment group.The control group was treated by Entecavir only,treatment group was treated by Yiganzhuanyin powders combined with Entecavir,both of them were treated for six months.liver function,liver fibrosis markers,abdominal ultrasound,HBe Ag seroconversion and safety indicators of all patients in two groups were observed before and after treatment.2?Experiment research Intraperitoneal injection of CCl4 in SD female rats to prepare the rat model of liver fibrosis.Rats were randomly divided into blank group/model group/low dose group of Yiganzhuanyin powders/high dose group of Yiganzhuanyin powders.Blank control group and model control group were given with purified water;low dose group were given with Yiganzhuanyin powders 0.12 g /100g;high dose group were given with Yiganzhuanyin powders 0.508g/100 g once a day.At the end of the experiment,Liver function and liver fibrosis markers were detected,HE staining was used to observe the pathological changes of liver tissue and the expression of Akt1 and phospho-Akt1 was detected by immunohistochemistry and Westernblot.The apoptosis of HSCs was determined by TUNEL assay.Result:1?Clinical research After treatment,liver function,liver fibrosis markers,abdominal ultrasound of the control group and treatment group were better than before treatmen(P<0.05).The total effective rate and HBe Ag seroconversion of treatment group is higher than the control group.Liver function,liver fibrosis markers,abdominal ultrasound of the treatment group compared with the control group showed significant difference(P<0.05).There had no adverse reactions been found in the two groups during treatment.2?Experimental research1).Compared with the blank group,the AST,ALT,TBIL,HA,PC-III,IV-C,LN in model group were increased,while ALB was decreased(P<0.05).Compared with the model group,the levels of AST,ALT,TBIL,HA,PC-III,LN in high dose group and low dose group of Yiganzhuanyin powders were decreased,while ALB was increased(P<0.05).Compared with the low dose group of Yiganzhuanyin powders,the AST,ALT,TBIL,HA,LN in high dose group of Yiganzhuanyin powders were decreased,while ALB was increased(P<0.05).2).HE staining results showed that liver fibrosis of model group is most worst,as the dose increased in low dose group and high dose group of Yiganzhuanyin powders,the degree of liver fibrosis was gradually reduced.3).Compared with the blank group,the expression of Akt1 and phospho-Akt1 in the model group were increased(P<0.05).After the intragastric administration of Yiganzhuanyin powders,the expression of Akt1 and phospho-Akt1 in high dose group of Yiganzhuanyin powders were decreased more significantly than the model group and the low dose group(P<0.05).4).At the same time,TUNEL method to detect apoptosis of HSCs.The results showed that apoptosis of HSCs in the low dose group and high dose group of Yiganzhuanyin powders were higher than that in the model group(P<0.05).And the apoptosis of HSCs of high dose group of Yiganzhuanyin powders were higher than the low dose group of Yiganzhuanyin powders(P<0.05).Conclusion:Yigan Zhuanyin powders combined with entecavir in the treatment on patients with compensated cirrhosis of hepatitis B can effectively improve the patient's clinical curative effect and the response rate of entecavir anti hepatitis B virus,thus delay the progression of hepatitis B cirrhosis patients in compensatory stage to decompensation stage.At the same time,the treatment group compared with the control group in the recovery liver function,decrease the liver fibrosis index and narrow the main diameter of the portal vein,spleen thickness et al showed more effective,also safety.The PI3K/Akt signal pathway may play an important role in CCl4 induced liver fibrosis,and Yiganzhuanyin powders can improve liver function and indexes of liver fibrosis in hepatic fibrosis rats.Additionally,Yiganzhuanyin powders can inhibit the activation of the PI3 K / Akt signal pathway and promote the apoptosis of HSC to play the role of anti liver fibrosis.