抗癌方阻止大鼠肝癌前病灶生长及肝癌形成的研究

目的：观察抗癌方阻止肝癌前细胞增殖和发展的情况，并阐明抗癌方防治肝癌变的作用及机制。方法：观察实验第4周和第40周抗癌方对DEN＋2-AAF＋PH化学诱导SD大鼠肝癌变模型的影响。结果：抗癌方，①能明显减少癌前病灶数量、缩小癌前病灶平均体积；②能明显减少癌前病灶中增殖细胞核抗原指数；③用药40周后能明显抑制肿瘤的形成和发展；对于肿瘤的数量和平均体积，长期用药较短期用药明显减少。结论：抗癌方通过抑制癌前细胞增殖和可能部分依赖p53独立途径诱导p21表达，直接阻止和延缓肝癌前病变的形成和发展，具有阻止肝癌变和肝癌形成的作用。     

温补培元方对脾肾阳虚型小鼠红细胞免疫功能的影响

１ 材料动物：实验动物用近交系Ｃ５７ＢＬ 小鼠，６～８ｗ龄体重２２± ４ｇ左右，雌雄兼用，由中国科学院上海实验动物中心提供。实验前在本校实验中心饲养１ｗ，全部实验期间，加喂生葵花子和鸡蛋黄。药物：人参（红参）、黄芪、附子、山萸肉、黄柏等由安徽中医学院附院中医房提供。试剂：补体致敏酵母菌和非致敏酵母菌，由上海长海医院免疫室提供。２方法２．１ 动物分组与造模方法 将４０只小鼠随机分为４组．每组１０只，空白对照组：每天喂正常饲料，每次３ｇ，每ｄ２次，同时给生理盐水胃饲０．３ｍｌ／次／ｄ，连续１４ｄ；病理模…     

祛脂复肝汤治疗脂肪性肝炎大鼠的实验研究

目的探讨祛脂复肝汤治疗脂肪性肝炎的疗效及作用机制。方法采用高脂饮食复制脂肪性肝炎大鼠模型,用祛脂复肝汤治疗,以东宝肝泰为对照组,观察其对模型大鼠血清肝功能、血脂、FFA、肝脂及血清和肝组织中MDA含量的影响。结果祛脂复肝汤能明显降低血脂、FFA及肝脂,改善肝功能,降低血清及组织中MDA含量,均明显优干东宝肝泰组（P〈0．05或P〈0．01）;结论祛脂复肝汤可通过调节体内脂质代谢,减轻MDA等脂质过氧化物损伤肝细胞,改善肝功能,对脂肪性肝炎疗效显著。     

熊去氧胆酸联合通胆汤对原发性胆汁性肝硬化的治疗作用

目的:观察熊去氧胆酸(ursodeoxycholic acid,UDCA)联合通胆汤治疗Ⅱ、Ⅲ期原发性胆汁性肝硬化患者30例的临床疗效.方法:60例入组的患者被随机分配到对照组(n=30)和治疗组(n=30),分别给UDCA和UDCA联合中药通胆汤治疗.在治疗4-24 wk分别记录患者的临床症状、肝功能、免疫指标及不良反应,并随访1-3年.结果:24 wk后,治疗组25例(83.3%)完全反应,对照组17例(56.7%)(P<0.05);治疗组第4周临床症状阳性率低于对照组(P<0.05),12wk后90%的患者症状基本消失;在降低胆汁淤积及转氨酶上治疗组均明显优于单用UDCA(P<0.05);治疗组IgM、IgG及IgA在治疗96 wk后较治疗前明显降低,与对照组比较有明显差异(1.93±1.71 g/L vs 2.16±1.81 g/L,10.25±6.23 g/L vs 12.45±5.98 g/L,1.86±1.72g/L vs 2.78±2.12 g/L,P<0.05).不良反应主要是腹泻与总胆汁酸升高所导致偶发皮肤瘙瘁,减量后很快缓解.结论:UDCA联合通胆汤治疗原发性胆汁性肝硬化,较单用UDCA能更有效改善临床症状与生化指标.     

乙型肝炎相关肝癌的癌前病变早期干预的临床研究

肝癌前变是指一种很易发生癌变的组织病理学异常[1].近5年来,我们对影像学诊断为再生或不良结节的乙型肝炎肝硬化患者进行复方叶下珠干预和临床观察,试图为肝癌前病变提供一种简易的诊断方法与疗效判断指标.     

左旋叶下珠复合物治疗52例早期乙型肝炎病毒相关肿瘤的临床疗效

Objective:To observe the change in the number of antibodies of preneoplastic hepatocellular carcinoma(HCC) using early treatment by Compound Phyllanthus Urinaria L.(CPUL) on patients with preneoplastic hepatitis B virus(HBV)-associated HCC.Methods:A total of 102 cirrhosis patients with regenerative or dysplastic nodules whose sera were tested positive for at least one of these six proteins(five up-regulated genes URG4,URG7,URG11,URG12 and URG19,and one down-regulated gene DRG2) were assigned randomly to two groups using continual random codes by SPSS software.Fifty-two patients were in the treatment group and 50 patients were in the control group.CPUL was used in the treatment group for 3 years,while the control group did not receive any treatment.The changes in HBV-DNA level,number of antibodies,and hepatocarcinogenesis occurred were observed.Patients who did not develop HCC were followed up for another 2 years.Results:HBV-DNA levels decreased 2log in 22.2%(10/45) of patients in the treatment group in contrast to only 5.0%(2/40) of patients in the control group(P=0.0228).The number of antibodies that were tested positive in the treatment group(1.08± 1.01)was significantly lower compared with the control group(2.11 ±1.12) after 24 months of drug treatment(P0.01).Both the positive rates of anti-URG11(33/52) and anti-URG19(31/52) were over 60%at baseline in the two groups,and were decreased to 48.1%(25/52) and 46.2%(24/52) respectively at 36 months of drug treatment,while the rates increased to 68.0%(34/50) and 66.0%(33/50) respectively(P=0.0417,P=0.0436) in the control group.The positive rate of anti-DRG2 was increased to 55.8%(29/52) at 36 months of drug treatment,while in the control group was decreased to 36.0%(18/50,P=0.0452).Among the 102 patients who developed HCC,2 were in the treatment group and 9 were in the control group,meaning that a significant difference between the two groups(P=0.0212).In11 patients who developed HCC,anti-URG11 and anti-URG19 were always positive,while anti-DRG2 was negative.Patients newly developing HCC were 6(20.0%) in the control group,and only one(2.5%) in the treatment group(P=0.0441) during 2-year follow-up after the end of the treatment.Conclusions:Anti-URG11,anti-URG19 and antiDRG2 could be used as early markers in the prediction of the therapeutic efficacy of CPUL in treating preneoplastic HCC.CPUL is useful in preventing or delaying the development of HBV-associated cirrhosis to HCC.     

补肾清透方对慢性乙肝HBeAg阳性患者血清IL-2、IL-4、IL-10、TNF-α及IFN-γ的影响

目的：观察补肾清透方治疗慢性乙型肝炎（CHB）乙型肝炎e抗原（HBeAg）阳性患者外周血中白细胞介素-2（IL-2）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、肿瘤坏死因子α（TNF-α）和干扰素-γ（IFN-γ）的变化。方法60例CHB HBeAg阳性患者被随机分成治疗组和对照组,每组30例,C HB治疗组接受补肾清透方治疗,疗程48周,C HB对照组不接受药物治疗。分别在开始和第48周时两组患者抽血检测 HBV DNA、IL-2、IL-4、IL-10、TNF-α和IFN-γ。结果 CHB治疗组治疗后与治疗前比较,IL-2、TNF-α、IFN-γ明显升高,HBV DNA、IL-4、IL-10明显下降（P＜0．01）;CHB对照组治疗前、后各项指标比较,差异无统计学意义（P＞0．05）。结论补肾清透方能抑制CHB HBeAg阳性患者HBV DNA复制,可提高机体的细胞免疫功能。     

慢性乙型肝炎患者单用抗炎保肝药物治疗的长期随访结果

2010年版慢性乙型肝炎(CHB)防治指南中指出：“慢性乙型肝炎治疗主要包括抗病毒、免疫调节、抗炎和抗氧化、抗纤维化和对症治疗,其中抗病毒治疗是关键,只要有适应证,且条件允许,就应进行规范的抗病毒治疗”[91]。但由于各种原因,有些CHB患者没有进行抗病毒治疗。我们对ALT升高的单用“抗炎保肝”治疗CHB患者252例,进行长期临床随访,评估其预后,现报道如下。     

补肾健脾方对HBeAg阳性乙肝病毒携带者的免疫调节作用

目的：评价补肾健脾方对HBeAg阳性乙肝病毒携带者血清细胞因子的调节作用。方法：采用多中心、随机、双盲、对照的研究方法。400例HBeAg阳性乙肝病毒携带者随机分为治疗组和对照组,分别给予补肾健脾方、安慰剂治疗52周。观察治疗前后血清细胞因子IL-2、IL-4、IL-10、IFN-γ、TNF-α水平及HBV DNA载量的变化。结果：治疗52周后,补肾健脾方组患者的血清细胞因子IL-2和IFN-γ显著上升,TNF-α、IL-4和IL-10则明显下降（P<0.01）;治疗前后的各细胞因子差值比较,均优于安慰剂对照组（P<0.01）;而血清HBV DNA载量较基线下降>1 log10,>2 log10,>3 log10比例均显著高于安慰剂对照组（P<0.01）。结论：补肾健脾方通过调节Th1/Th2型细胞因子水平,打破HBV感染的免疫耐受状态,实现对HBV复制的抑制作用。