[Bushen Rougan Recipe in prevention of hepatic fibrosis in rats induced by dimethylnitrosamine: a study on its preliminary mechanism].

OBJECTIVE: To study the effects of Bushen Rougan Recipe (BSRGR), a compound traditional Chinese herbal medicine, on hepatic fibrosis in rats induced by dimethylnitrosamine (DMN), and to explore its preliminary mechanism. METHODS: A total of 40 male Wistar rats were randomly divided into normal control group (n=10), untreated group (n=15), and BSRGR group (n=15). Except for the rats in normal control group, hepatic fibrosis in rats was induced by peritoneal injection of DMN for 4 weeks. And the rats in the BSRGR group were also intragastrically administered BSRGR within the 4-week course. At the end of the 4-week course, rats were all sacrificed. The liver functions were determined by automatic biochemistry analyzer, including serum total bilirubin (Tbil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin. Expressions of connective tissue growth factor (CTGF) and collagen type I mRNA in liver tissue were detected by reverse transcription polymerase chain reaction. RESULTS: It was found that the serum Tbil level and the activities of AST, ALT were declined in the BSRGR group as compared with those in the untreated group (P<0.01). The serum albumin content in the BSRGR group was increased as compared with that in the untreated group (P<0.01). The expressions of collagen type I and CTGF mRNAs in the untreated group were higher than those in the BSRGR group (P<0.01). CONCLUSION: BSRGR can decrease the expressions of collagen type I and CTGF mRNAs in the rats with hepatic fibrosis, which may be one of possible mechanisms in treating hepatic fibrosis.

[Effect of spleen-invigorating prescription on dendritic cell function in patients with chronic hepatitis B of TCM Pi-deficiency syndrome type].

OBJECTIVE: To observe the effect of Spleen-invigorating Prescription (SIP) on dendritic cell function in patients with chronic hepatitis B. METHODS: A total of 60 patients with chronic HBV of Pi-deficiency syndrome type were enrolled and randomized to 2 groups, 30 in each group. Patients in the control group were given intramuscular injection with human interferon alpha 1b, 3 times a week, while those in the treated group were given orally with SIP twice a day, the therapy lasted for 6 months. Dendritic cells (DCs) were isolated from peripheral blood and cultured, then the expression of surface markers, HLA-DR, CD86, CD80, CD40, CD14 and CD11c were detected before and after treatment by flow cytometry, and the function of DCs was also evaluated by mixed lymphocyte reaction (MLR) determination once before treatment and once after treatment. RESULTS: The expressions of DCs' surface CD86, CD80, CD40 and CD11c in the treated group were higher (P < 0.05, P < 0.01) and the changes of stimulating index, IFN-gamma and IL-12 were superior in the treated group to those in the control group (P < 0.05). CONCLUSIONS: SIP can significantly improve DC's function, so, one of mechanisms of SIP in improving clinical efficacy may be the regulation of immune function.

Prospects of a comprehensive evaluation system for traditional Chinese medicine services.

Traditional Chinese medicine (TCM) is a unique health resource in China and one of the main representative traditional medicines globally. TCM has formed a new way of looking at medical practices, health care, scientific research, education, industry and culture. It focuses on promoting and safeguarding the health of people, with an increasing contribution to economic and social development. Establishing a comprehensive evaluation system in accordance with the characteristics of TCM services could promote the scientific merit and the standardization of services management. This would improve health service quality and the social and economic benefits of TCM. It would broaden the field of TCM services research. It would also provide the basis for the formulation of relevant government policies. This study estimates the prospect of establishing a comprehensive evaluation system of TCM services.

[Clinical study on effect of bushen granule combined with marine injection in treating chronic hepatitis B of Gan-shen deficiency with damp-heat syndrome type].

OBJECTIVE: To evaluate the antiviral efficacy of Bushen Granule (BSG) combined with Marine Injection (MI) in treating patients with chronic hepatitis B of Gan-shen deficiency with Damp-Heat (GSD) syndrome type. METHODS: A total of 90 patients, who were HBV DNA, HBsAg, and HBeAg positive and of GS-DD type, were enrolled, and they were randomly assigned into 2 groups. The 49 patients in the treated group were treated with the combined therapy of BSG and MI and the 41 were administered with lamivudine, the therapeutic course for both groups was 1 year. The negative conversion rate of HBeAg and HBV DNA and the changes in HBV DNA titre, liver function, symptoms and physical signs were observed in the two groups before and after treatment. RESULTS: In the treated group, the negative conversion rate of HBV DNA was 42.6% (20/ 47), insignificantly different to that in the control group (61.0%, 25/41, P > 0.05); the negative conversion rate of HBeAg and HBeAg/anti-HBe sero-conversion rate was 42.6% and 36.2%, respectively, significantly higher than those in the control group (22.0% and 17.0%, P < 0.05); the ALT normalizing rate was 74.4%, higher than that in the control group (51.4%, P < 0.05); the improvement of liver function (ALB and GLB) and clinical symptoms, especially the dizziness, soreness of waist, hypochondrial distending pain, and yellowish urine, were significantly superior to those in the control group(P < 0.01 or P < 0.05); and the partial response rate was 29.8%, insignificant different to that in the control group (14.6%, P > 0.05). CONCLUSIONS: Combined treatment of BSG and MI has an ideal short-term effect in treating patients with chronic hepatitis B of Gan-shen deficiency with Damp-Heat syndrome type, it can inhibit HBV replication and improve patients' liver function and physical signs.

[Relationship between basal core promoter combined point mutation of hepatitis B virus and TCM syndrome type].

OBJECTIVE: To investigate the relationship between basal core promoter (BCP) combined point mutation of hepatitis B virus (HBV) and TCM syndrome type. METHODS: One hundred and two patients with chronic hepatitis with positive HBV DNA and hadn't ever been treated by Lamivudine and interferon were differentiated according TCM syndrome differentiation into 5 types, two excess types (damp-heat blocking zhong-jiao type and blood stasis blocking collaterals type) and three deficiency types, gan-stagnation with pi-dificiency type, gan-shen yin-deficiency type and pi-shen yang-deficiency type. The serum HBV DNA, hepatic biochemical indexes, and the mutation of BCPnt 1762A-T and nt1764G-A combined point were determined, respectively. RESULTS: The variant strain positive rate detected in the excess type was significantly higher than that in the deficiency type, the highest rate appeared in patients of damp-heat blocking zhong-jiao type. CONCLUSION: BCP combined point mutation may be liable to happen in patients of TCM excess type, especially in patients of damp-heat blocking zhong-jiao type.

[Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver].

OBJECTIVE: To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes. METHODS: A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded. RESULTS: In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%. CONCLUSION: The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.

[Therapeutic effect of Bushen Rougan Recipe on hepatic fibrosis in rats].

OBJECTIVE: To study the therapeutic effect of Bushen Rougan Recipe (BSRGR) on hepatic fibrosis in rats. METHODS: Forty male Wistar rats were randomly divided into normal control group (n=10), model group (n=15), and BSRGR-treated group (n=15). Rats in the model and BSRGR-treated groups were administered intraperitoneally with 0.5% dimethylnitrosamine (DMN), 10 mg.kg(-1).d(-1), successive 3 days per week for 4 weeks to induce hepatic fibrosis. Then rats in the above 2 groups were given normal saline and BSRGR (10 ml.kg(-1).d(-1), ig) for another 4 weeks, respectively. Rats in the 3 groups were all executed at the end of the 8th week. The serum total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (A) and globulin (G) were determined and the serum hyaluronic acid (HA), laminin (LN) and collagen IV (IV-C) were measured. RESULTS: The rat model of liver fibrosis was successfully induced by DMN. It was found that the serum TBIL, AST and ALT and the liver fibrosis marks were declined in BSRGR-treated group as compared with those in the model group (P<0.01). The content of total serum protein and the A/G in BSRGR-treated group were both increased as compared with those in the model group (P<0.05). CONCLUSION: BSRGR can be used to treat hepatic fibrosis in rats.

[Effect of anti-fibrosis compound contained serum on procollagen Type I and IV, matrix metalloproteinase and its tissue inhibitor-1 gene expression in HSC-LI90 cell line].

OBJECTIVE: To study the effects of Anti-fibrosis Compound contained serum (AFCS) on procollagen type I and IV (ProC-I and ProC-IV), matrix metalloproteinase (MMP) and its tissue inhibitor (TIMP-1) gene expression in hepatic stellate cell line LI90 (HSC-LI90). METHODS: AFCS was prepared by gastric infusing different dosage (0.5 g/kg, 2.0 g/kg and 4.0 g/kg) of Anti-fibrosis Compound Recipe to rats. After HSC-LI90 cells were exposed to AFCS for 48 hrs, levels of ProC-I, ProC-IV, gene expression of MMP-2, MMP membrane type 1 (MT1-MMP) and TIMP-1 in the cells were detected by Northern blot, and gelatinase activity of MMP-2 was measured by zymography. RESULTS: AFCS of different concentrations could inhibit ProC-I and ProC-IV and TIMP-1 gene expression (P < 0.05 or P < 0.01), increase MT1-MMP gene expression (P < 0.01), but it showed no effect on gene expression and activity of MMP-2 (P > 0.05). CONCLUSION: Anti-fibrosis Compound Recipe has anti-liver fibrosis action, its effects in inhibiting TIMP-1 gene expression of HSC-LI90 cells and promoting degradation of collagen might be one of the mechanisms of the action.

[Therapeutic efficacy of combined application of lamivudine and bushen recipe in treating chronic hepatitis B and its influence on YMDD motif].

OBJECTIVE: To observe the effect of combined application of Lamivudine and Bushen recipe (BSR) in treating patients with chronic hepatitis B (CHB) and its influence on tyrosine-methionine-aspartate-aspartate (YMDD) motif. METHODS: Eighty-eight patients of CHB with positive HBV-DNA were divided into 3 groups, Group A treated with Lamivudine, Group B treated with Lamivudine plus BSR1 and Group C treated with Lamivudine plus BSR2, the serum HBV-DNA, hepatic biological parameters and YMDD motif mutation were observed. RESULTS: The positive rate of HBV-DNA (6.45%) and YMDD motif mutation (3.23%) in Group C were lower than those in Group A respectively, after 52 weeks treatment. CONCLUSION: Combined application of Lamivudine and BSR could enhance the therapeutic effect in treating CHB to certain extent, and could reduce the mutation of YMDD motif.