| Objective:By observing the "kidney raw pulp method" economic living kidney decoction combined the formulas entecavir treatment of liver cirrhosis after hepatitis b patients with spleen and kidney Yang deficiency type of clinical efficacy,safety,and for patients with liver function,the influence of the bone marrow hematopoietic function,and between economic living kidney decoction combined bone marrow mesenchymal stem cell transplantation for treatment of liver cirrhosis rats and the effect of the molecular mechanism,to explore "kidney raw pulp method",the formulas having kidney soup to improve hemopoietic function,improve liver function of the correlation of western and Chinese medicine theory and modern experimental medicine.Methods :(1)Clinical study: 60 patients with hepatocirrhosis of spleen-kidney Yang deficiency type b were randomly divided into treatment group(30 cases)and control group(30 cases)according to the number random table.The control group was only treated with entecavir dispersible tablets for antiviral therapy,while the treatment group was treated with jishengshenqi decoction combined with entecavir dispersible tablets for 3 months.After the course of treatment,the differences in symptom score,blood routine,liver function and serum erythropoietin between the two groups and their adverse reactions were observed.(2)Animal experiment:63 healthy SPF SD rats were randomly separated 5 rats after being executed only drawn between bone marrow mesenchymal stem cells for cell culture,8 as blank group,the remaining50 rats with carbon tetrachloride in combination with ethanol,olive oil with a high-fat diet composite factors building method,induction of eight w replication liver cirrhosis rats model,were put to death,then randomly select 2 rats hepatic biopsy pathological section to show that liver cirrhosis building success.After successful modeling,48 surviving rats were randomly divided into the model group,the single-use Chinese medicine group,the single-use BMSCs transplantation group,the BMSCs transplantation combined with high dose Chinese medicine group,the BMSCs transplantation combined with medium dose Chinese medicine group,and the BMSCs transplantation combined with low dose Chinese medicine group.In the blank group,only distilled water was given by intragastric administration.No intervention by the model group;BMSCs transplantation group was treated with BMSCs transplantation alone.BMSCs transplantation + high dose Chinese medicine group were given BMSCs transplantation + suspension of "jisheng shenqi decoction" by high dose gavage.BMSCs transplantation + medium dose Chinese medicine group were given BMSCs transplantation + medium dose suspension of "jishengshenqi decoction" by gavage.In the BMSCs transplantation + low-dose Chinese medicine group,BMSCs transplantation + low-dose suspension of "ji sheng shenqi tang" was performed by gavage once a day,and BMSCs transplantation was performed once a week,starting at the end of 8W and lasting for 4W to the end of 12 W.Liver histopathology was observed in 7 groups of rats after intervention.The liver function of rats(ALT,AST,ALB,TBIL)was measured by automatic biochemical analyzer.The levels of EPO,GCSF,il-3,il-6,HGF and SCF in peripheral blood of rats were detected by ELISA.The expression of PI3 K,Akt,Jak1 and STAT proteins in rat liver tissues was detected by Western blot.Results:(1)Clinical study:During the experiment,2 cases were excluded due to the reasons such as not taking drugs regularly and patients' personal factors automatically required to quit,and the final effective cases were 58 cases.After the treatment,the treatment group of symptom scores,blood routine,liver function and serum erythropoietin before treatment were improved(P < 0.01),the symptom scores in the control group,routine blood,liver function before treatment were improved(P <0.01),while the control group before and after treatment serum erythropoietin has no obvious difference(P > 0.05);Compared with the control group,the symptom score,blood routine examination,liver function and serum erythropoietin of cirrhotic patients in the treatment group were significantly improved(P<0.01 or P<0.05).During the experiment,no adverse reactions occurred in the two groups.(2)Animal experiment:Rats general situation: after intervention therapy,BMSCs transplantation group,alone,with Chinese traditional medicine group,BMSCs transplantation medicine high dose group,BMSCs transplantation in combination with Chinese medicine dose group and BMSCs transplantation in combination with traditional Chinese medicine(TCM)low dose group of rats mental status,nutritional status,and activity level,and so on and so forth,than before with different degrees of improvement,including BMSCs transplantation in combination with traditional Chinese medicine(TCM)high dose group and BMSCs transplantation in combination with Chinese medicine dose group of rats significantly improve.Changes of HE staining in the liver tissues of rats in each group: in the model group,the liver tissues showed severe fibrosis,false lobule formation,extensive hepatocyte degeneration and necrosis,indicating that the modeling of cirrhosis was successful.After intervention therapy,the treatment group rats liver pathological conditions there are varying degrees of improvement,with BMSCs transplantation in combination with traditional Chinese medicine(TCM)high dose group and BMSCs transplantation in combination with Chinese medicine dose of liver cirrhosis in rats liver pathological conditions improve,the most obvious BMSCs transplantation in combination with traditional Chinese medicine(TCM)low dose and improve use BMSCs transplantation group,but were superior to use Chinese traditional medicine group.Liver function of rats in each group: compared with the blank group,ALT,AST and TBIL levels were significantly increased and ALB levels were significantly decreased in the model group(P<0.01).Compared with the model group,ALT,AST and TBIL levels in all treatment groups decreased to different degrees,and ALB levels increased to different degrees(P<0.01).There was no statistically significant difference between the treatment groups in the effect of BMSCs transplantation + ALT and AST reduction in the high and medium dose groups(P>,0.05).Changes of EPO,GCSF,il-3,il-6,HGF and SCF in peripheral blood of rats in each group: compared with the blank group,the levels of EPO,g-csf,HGF,SCF and il-3 in the model group were significantly decreased,and the levels of il-6 were significantly increased(P<0.01).Compared with the model group,the levels of EPO,g-csf,HGF,SCF and il-3 in each treatment group increased to different degrees,and the levels of il-6 decreased to different degrees(P<0.01).Compared with the treatment group,EPO,il-3,g-csf and HGF were increased in the BMSCs transplantation + high dose group,and il-6 reduction was the best,followed by BMSCs transplantation +medium dose group(P<0.01 or P<0.05).There was no statistically significant difference in the effect of increased g-csf and HGF between the BMSCs transplantation + TCM low-dose group and the BMSCs transplantation + TCM medium-dose group(P>,0.05).Expressions of PI3 K,Akt,Jak1 and STAT proteins in liver tissues of rats in each group:compared with the blank group,the expressions of PI3 K,Akt,Jak1 and STAT proteins in liver tissues of model group were significantly increased,and the difference was statistically significant(P<0.01).Compared with the model group,the expression levels of PI3 K,Akt,Jak1 and STAT proteins in the liver tissues of the treatment group all decreased to different degrees(P<0.01).There was no significant difference in the expression levels of PI3 K,Akt,Jak1 and STAT proteins between the BMSCs transplantation + high dose group and the BMSCs transplantation+ medium dose group(P>,0.05).There was no significant difference in PI3 K,Akt,Jak1 and STAT protein expression between BMSCs transplantation + low-dose Chinese medicine and BMSCs transplantation alone(P>,0.05).The expression levels of PI3 K,Akt,Jak1 and STAT proteins in BMSCs transplantation + high and medium dose Chinese medicine were all lower than those in other treatment groups,and the differences were statistically significant(P<0.01).The expression levels of PI3 K,Akt,Jak1 and STAT proteins in BMSCs transplantation +low-dose Chinese medicine group and BMSCs transplantation group were lower than those in the single-use Chinese medicine group,and the difference was statistically significant(P<0.01).Conclusion: Clinical trials showed that entekawa combined with zishengqi decoction could improve the clinical symptoms,liver function,blood routine,serum EPO and bone marrow hematopoiesis in the treatment of liver cirrhosis patients with spleen-kidney Yang deficiency syndrome.Animal experiments showed that BMSCs transplantation joint economic living kidney decoction treatment of liver cirrhosis in rats of general situation,the liver function and liver inflammation,fibrosis degree have different degrees of improvement,and can promote the migration of bone marrow hematopoietic and BMSCs,with the improvement of EPO,SCF,g-csf,HGF,IL-3,secretion of IL-6,cut P13 K,Akt,Jak1,STAT protein expression,this experiment also showed that BMSCs transplantation plus Chinese medicine treatment of high dose group works best on liver cirrhosis in rats,BMSCs transplantation plus Chinese medicine middle dose group effect,All of them were better than other treatment groups. |
PDF Full Text Request