【摘要】 【目的】研究中药柴胡及其复方小柴胡汤对慢性乙型肝炎的治疗作用。【方法】将先天感染乙肝病毒的模型鸭48只随机分为6组,每组8只;其中5个治疗组分别给予柴胡、小柴胡汤、拉米呋啶、拉米呋啶合柴胡、拉米呋啶合小柴胡汤治疗而分别命名为柴胡组、小柴胡汤组、拉米呋啶组、拉米呋啶合柴胡组、拉米呋啶合小柴胡汤组,模型对照组给予生理盐水;疗程10d;分别于治疗前、治疗5d、治疗10d和停药3d取血,以检测血清中鸭乙型肝炎病毒脱氧核糖核酸(DHBV-DNA)含量;同时,于治疗前、治疗后8d进行肝组织活检,停药8d进行尸体解剖,取肝、心、肾、胰、生殖器、脑等脏器,用于观察肝组织病理改变和检测脏器组织中DHBV-DNA的含量。【结果】治疗5d和治疗10d时检测,除柴胡组外,各治疗组血清DHBV-DNA含量均比模型对照组降低(P<0.01或P<0.05);但停药3d测定该项指标各组均反跳到与模型对照组相仿水平(均P>0.05),其中含有柴胡的各治疗组的水平略比不含柴胡的各治疗组低,但未显示显著性差别;肝组织病理显示:柴胡及拉米呋啶组的肝脏炎症反应与对照组无显著性差异,但小柴胡汤组的肝细胞损伤程度加重,损伤范围亦较大(与对照组相比,P<0.01或P<0.05),而柴胡或小柴胡汤与拉米呋啶合用后,肝组织的炎性反应有明显改善,网状纤维较对照组少,尤其是更多还原

【Abstract】 【Objective】To study the therapeutic effect of Radix Bupleuri and Xiaochaihu Tang on chronic hepatitis B inducks.【Methods】Forty-eight model ducks with congenital infection of duck hepatitis B virus (DHBV) were allocated tosix groups: A (model control), B (lamivudine), C (Radix Bupleuri), D (Xiaochaihu Tang), E (Radix Bupleuri and lamivudine) and F (Xiaochaihu Tang and lamivudine). Ten days constituted a course of treatment. DNA of duckhepatitis virus (DHBV-DNA) was determined separately before treatment, 10 d after treatment and 3d after suspension oftreatment. Liver biopsy was done before or 8d after treatment and autopsy was done 8d after suspension of treatment.Liver, heart, kidney, pancreas, genital organs and brain were examined and their contents of DHBV-DNA weredetermined.【Results】Serum DHBV-DNA contents in group B, D, E and F were decreased 5d or 10d after treatment( P<0.01 or P<0.05 as compared with group A) and bounced to the level in group A 3d after suspension of treatment( P> 0.05) ; serum DHBV-DNA contents in group D, E and F 3d after suspension of treatment were a little higher thanthat in group B but the differences were insignificant. Results of liver biopsy showed that inflammatory reaction of liver ingroup B and C was as severe as that in group A, the severity and area of hepatocellular damage in group D were increasedas compared with group A (P<0.01 or P<0.05) . After treatment, inflammatory reaction of liver in group E and fiberproliferation in group F were much reduced. DHBV-DNA was detectable in the examined organs except in the heart 8dafter suspension of treatment.【Conclusion】Radix Bupleuri has no effect in clearing serum DHBV while lamivudine andXiaochaihu Tang can clear serum DHBV to some extent. The therapeutic mechanisms of lamivudine and Xiaochaihu Tangare different: lamivudine can clear serum DHBV directly and less immune hepatic damage was induced; Xiaochaihu Tangclears serum DHBV by immunological regulation and can lead to inflammatory reaction of liver. The combination ofChinese and western medicine has a synergistic action in decreasing serum DHBV content, reducing inflammatory reactionof liver and counteracting the hepatic fiber proliferation. Neither Lamivudine or Xiaochaihu Tang can clear DHBV in theorgans and this may cause the bounce of serum DHBV-DNA after suspension of treatment. Xiaochaihu Tang can postponethe bouncing of serum DHBV-DNA, indicating that the clearance of DHBV in the body can be achieved by activating theimmune function. But this needs further research for verification.更多还原