中医药阻断逆转肝纤维化的现状、希望与挑战

陈艳; 杨永平

doi:10.3969/j.issn.1001-5256.2018.04.002

中医药阻断逆转肝纤维化的现状、希望与挑战

DOI: 10.3969/j.issn.1001-5256.2018.04.002

陈艳,
杨永平

解放军第三○二医院肝脏肿瘤诊疗与研究中心

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2857
- HTML全文浏览量: 53
- PDF下载量: 559
- 被引次数: 0
出版历程
- 出版日期: 2018-04-20

The role of traditional Chinese medicine in blocking and reversing hepatic fibrosis:current status, hope, and challenge

Center of Therapeutic Research for Hepatocellular Carcinoma, 302 Hospital of PLA

摘要

摘要:
中医药辨证论治具有阻断逆转肝纤维化的整体治疗优势,是未来治疗肝纤维化候选药物的源泉。概述了中医药治疗肝纤维化的渊源和现状,重点论述了如何按照循证医学和国际认同的临床试验标准再评价中医药阻断逆转肝纤维化的临床疗效和安全性,介绍了最新临床研究成果。强调了发掘和认同中医药阻断逆转肝纤维化所面临的挑战与重要意义。
- 肝硬化 /
- 中医学 /
- 中草药 /
- 治疗
Abstract:
Traditional Chinese medicine (TCM) syndrome differentiation-based treatment has certain advantages in blocking and reversing hepatic fibrosis and is the source of candidate drugs for hepatic fibrosis in future.This article overviews the origin and current status of TCM treatment of hepatic fibrosis, discusses how to reevaluate the clinical effect and safety of TCM in blocking and reversing hepatic fibrosis in accordance with evidence-based medicine and internationally acknowledged standards for clinical trials, and introduces the latest clinical research findings.It also emphasizes the challenge and significance of the exploration and recognition of TCM in blocking and reversing hepatic fibrosis.
- liver cirrhosis /
- TCM science /
- drugs, Chinese herbal /
- therapy

HTML全文

参考文献(32)

[1]SCHUPPAN D, KIM YO.Evolving therapies for liver fibrosis[J].J Clin Invest, 2013, 123 (5) :1887-1901.

[2]FRIEDMAN SL, SHEPPARD D, DUFFIELD JS, et al.Therapy for fibrotic diseases:nearing the starting line[J].Sci Transl Med, 2013, 5 (167) :167-161.

[3]SCHUPPAN D, JIA JD, BRINKHAUS B, et al.Herbal products for liver diseases:a therapeutic challenge for the new millennium[J].Hepatology, 1999, 30 (4) :1099-1104

[4]XU LM.An exploration of therapeutic evaluation of traditional Chinese medicine treatment of hepatic fibrosis[J].J Clin Hepatol, 2017, 33 (5) :825-828. (in Chinese) 徐列明.中医药抗肝纤维化疗效评价的探索[J].临床肝胆病杂志, 2017, 33 (5) :825-828.

[5]World Health Organization.WHO traditional medicine strategy 2014-2023[EB/OL].http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en.

[6]ZHANG L, SCHUPPAN D.Traditional Chinese medicine (TCM) for fibrotic liver disease:hope and hype[J].J Hepatol, 2014, 61 (1) :166-168.

[7]LIU CH, LIU P, HU YY, et al.Progress of clinical and basic research on liver fibrosis with traditional Chinese medicine[J].World Sci Technol Modern Tradit Chin Med, 2007, 9 (2) :112-119. (in Chinese) 刘成海, 刘平, 胡义扬, 等.中医药抗肝纤维化临床与基础研究进展[J].世界科学技术:中医药现代化, 2007, 9 (2) :112-119.

[8]LUK JM, WANG X, LIU P, et al.Traditional Chinese herbal medicines for treatmentof liver fibrosis and cancer:from laboratory discovery to clinical evaluation[J].Liver Int, 2007, 27 (7) :879-890.

[9]Hepatobiliary Disease Group, Internal Medicine of Traditional Chinese, China Association of Traditional Chinese Medicine;Expert Consensus of Hepatology, World Federation of Chinese Medicine Societies;Hepatology Group, Chinese Association of the Integration of Traditional and Western Medicine.Guideline for traditional Chinese medical diagnosis of chronic heoatitis B[J].J Clin Hepatol, 2012, 28 (3) :164-168. (in Chinese) 中华中医药学会内科肝胆病学组, 世界中医药联合学会肝病专业委员会, 中国中西医结合学会肝病分组.慢性乙型肝炎中医诊疗专家共识 (2012年1月) [J].临床肝胆病杂志, 2012, 28 (3) :164-168.

[10]YIN SS, WANG BE, WANG TL, et al.The effect of Cpd 861 on chronic hepatitis B related fibrosis and early cirrhosis:a randomized, double blind, placebo controlled clinical trial[J].Chin J Hepatol, 2004, 12 (8) :467-470. (in Chinese) 尹珊珊, 王宝恩, 王泰龄, 等.复方861治疗慢性乙型肝炎肝纤维化与早期肝硬化的临床研究[J].中华肝脏病杂志, 2004, 12 (8) :467-470.

[11]GAO GF, YANG X.Effects of Fufang Biejia Ruangan pills on hepatic fibrosis in patients with HBV-relate cirrhosis[J].J Clin Hepatol, 2005, 21 (6) :375-376. (in Chinese) 高广甫, 杨宣.复方鳖甲软肝片临床研究[J].临床肝胆病杂志, 2005, 21 (6) :375-376.

[12]LIU P, LIU C, XU LM, et al.Effects of Fuzheng Huayu 319 recipe on liver fibrosis in chronic hepatitis B[J].World J Gastroenterol, 1998, 4 (4) :348-353.

[13]WANG ZW.Effects of Qianggan Ruanjian Tang for 38 patients with hepatitis cirrhosis[J].J Military Surg Southwest China, 2009, 11 (4) :805. (in Chinese) 王兆伟.强肝软坚汤化裁治疗肝炎肝硬化38例[J].西南军医, 2009, 11 (4) :805.

[14]WANG XS, LI Y.The effects of Qianggan Ruangan Formulas on liver function, portal vein flow and fibrotic markers in patients with cirrhosis[J].Shanghai J Tradit Chin Med, 2003, 37 (4) :26-27. (in Chinese) 王晓素, 李勇.强肝软坚方对肝硬化患者肝功能、门脉血流及纤维化标志物的影响[J].上海中医药杂志, 2003, 37 (4) :26-27.

[15]SHI HL, ZHANG JY, TIAN FL, et al.Clinical observation of 70cases of liver cirrhosis after hepatitis by Qianggan Ruanjian Capsule[J].Jilin J Tradit Chin Med, 2006, 26 (1) :16-17. (in Chinese) 史海立, 张继元, 田锋亮, 等.强肝软坚丸治疗肝炎后肝硬化脾大70例临床观察[J].吉林中医药, 2006, 26 (1) :16-17.

[16]LI L, ZHANG XJ, LAN Y, et al.Treatment of non-alcoholic fatty liver disease by Qianggan Capsule[J].Chin J Integr Med, 2010, 16 (1) :23-27.

[17]WANG H, YANG LM, HUANG L, et al.Clinical effects of qianggan capsule on the liver tissue pathology and PDGF-BB, TGFbeta1, TIMP-1, and MMP-1 factors in patients with chronic hepatitis B[J].Chin J Integr Trad West Med, 2011, 31 (10) :1337-1340. (in Chinese) 王华, 杨柳明, 黄玲, 等.强肝胶囊对慢性乙型肝炎患者肝组织病理及PDGF-BB, TGF-β1, TIMP-1, MMP-1的影响[J].中国中西医结合杂志, 2011, 31 (10) :1337-1340.

[18]ZHANG W, XING LJ, WANG Y, et al.Clinical obsevation of“Qianggan Capsule”in treating 60 cases of non-alcohol-fatty liver disese of damp-heat retention[J].Shanghai J Tradit Chin Med, 2007, 41 (4) :26-27. (in Chinese) 张玮, 邢练军, 王奕, 等.强肝胶囊治疗非酒精性脂肪肝湿热蕴结证的临床观察[J].上海中医药杂志, 2007, 41 (4) :26-27.

[19]XUE GQ, JI FF.Treantment of 80 patients with chronic hepatitis B-related hepatic fibrosis by Qianggan capsule[J].Shandong J Tradit Chin Med, 2004, 23 (7) :404-405. (in Chinese) 薛桂芹, 季风帆.强肝胶囊治疗慢性乙型肝炎肝纤维化80例[J].山东中医杂志, 2004, 23 (7) :404-405.

[20]YAO HS, YAO XX, YAO DM, et al.Treantment of 365 patients with chronic hepatitis B-related hepatic fibrosis by Yigan Kang[J].Clin Focus, 2009, 24 (8) :690-693. (in Chinese) 姚洪森, 姚希贤, 姚冬梅, 等.益肝康治疗慢性乙型肝炎肝纤维化365例疗效观察[J].临床荟萃, 2009, 24 (8) :690-693.

[21]CUI SY, JIA M.Preparation and clinical observation of yihekang oral liquid[J].Chin Remed Clin, 2007, 7 (10) :802-803. (in Chinese) 崔淑云, 贾曼.益肝康口服液的制备及临床疗效观察[J].中国药物与临床, 2007, 7 (10) :802-803.

[22]HUANG QW.Effects of anluohuaxian capsule on hepatic fibrosis indexes in patients of chronic hepatitis[J].Chin J Integr Tradit West Med Liver Dis, 2004, 14 (4) :206-208. (in Chinese) 黄其文.安络化纤丸对慢性肝炎患者肝纤维化指标的影响[J].中西医结合肝病杂志, 2004, 14 (4) :206-208.

[23]ZHANG YH, GUO WQ, GUO PJ.The effect of adefovir dioxin combined with Anluo Huaqian pills on hepatic fibrosis indexes in patients with chronic hepatitis B[J].Chin Hepatol, 2013, 18 (9) :620. (in Chinese) 张义红, 郭伟琪, 郭平静.阿德福韦酯联合安络化纤丸对慢性乙型肝炎患者肝纤维化指标的影响[J].肝脏, 2013, 18 (9) :620.

[24]HE J, DU L, LIU G, et al.Quality assessment of reporting of randomization, allocation concealment, and blinding in traditional Chinese medicine RCTs:a review of 3159 RCTs identified from 260 systematic reviews[J].Trials, 2011, 12:122-131.

[25]CHENG CW, WU TX, SHANG HC, et al.CONSORT Extension for Chinese herbal medicine formulas 2017:recommendations, explanation, and elaboration[J].Ann Intern Med, 2017, 167 (2) :112-121.

[26]CHEN JM, YANG YP, CHEN DY, et al.Efficacy and safety of Fufang Biejia Ruangan tablet in patients with chronic hepatitis B complicated with hepatic fibrosis[J].Chin J Exp Clin Virol, 2007, 21 (4) :358-360. (in Chinese) 陈菊梅, 杨永平, 陈德永, 等.复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床研究[J].中华实验和临床病毒学杂志, 2007, 21 (4) :358-360.

[27]DONG Q, QIU LL, ZHANG CE, et al.Identification of compounds in an anti-fibrosis Chinese medicine (Fufang Biejia Ruangan Pill) and its absorbed components in rat biofluids and liver by UPLCMS[J].J Chromatogr B Analyt Technol Biomed Life Sci, 2016, 1026:145-151.

[28]ZHOU J, CHEN XM, LIU SW, et al.Effects of Biejia Ruangan Tablet-containing serum on matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 expression in cultured renal interstitial fibroblasts[J].Chin J Integr Med, 2015, 21 (2) :152-156.

[29]YANG FR, FANG BW, LOU JS.Effects of Fufang Biejia Ruangan pills on hepatic fibrosis in vivo and in vitro[J].World J Gastroenterol, 2013, 19 (32) :5326-5333.

[30]GUO SG, ZHANG W, JIANG T, et al.Influence of serum collected from rat perfused with compound Biejiaruangan drug on hepatic stellate cells[J].World J Gastroenterol, 2004, 10 (10) :1487-1494.

[31]QU J, YU Z, LI Q, et al.Blocking and reversing hepatic fibrosis in patients with chronic hepatitis B treated by traditional Chinese medicine (tablets of biejia ruangan or RGT) :study protocol for a randomized controlled trial[J].Trials, 2014, 15 (1) :438.

[32]CHANG TT, LIAW YF, WU SS, et al.Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B[J].Hepatology, 2010, 52 (3) :886-893.

施引文献

资源附件(0)

访问统计