加味膈下逐瘀湯對肝硬化患者臨床療效之研究

高尚德
中國醫藥大學
病毒性肝炎是我國常見的疾病，肝炎病毒是導致肝纖維化、肝硬化的主要致病因子，特別是慢性B型、C型肝炎，其病機複雜纏綿難癒；尤其是B型肝炎、C型肝炎病毒複雜活躍，肝功能及A/G、γ-球蛋白長期反覆異常，肝臟蛋白質代謝異常嚴重，發展為肝硬化、肝癌。台灣地區慢性B型肝炎患者中約有20至25%未來轉變成硬化，之後每年有5%之機率會由肝硬化轉戀成肝癌，慢性C型肝炎患者約有50至80%會轉變成肝硬化。肝間質細胞主要是肝星狀細胞（HSC）的活化，轉化呈增生致細胞外基質（ECM）增多成為肝纖維化以致肝硬化的主要機轉。在肝硬化中，hyaluronic acid既反應肝間質活動性，更反應肝纖維化程度-肝竇毛細管化，procollagen Ⅲ主要反應Ⅲ型膠原合成的濃度與肝纖維增生的程度，Ⅳ collagen既能靈敏的反映肝纖維化程度又能反應肝間質活動性-炎症和壞死。Laminin被認為是肝竇毛細血管化的理想指標。
關鍵字：加味膈下逐瘀湯；肝硬化；門靜脈血液動力學；透明質酸；Ⅲ型前膠原；Ⅳ型膠原；層粘連蛋白

The clinical study of Ja-Wei-Ge-Xia-Zhu-Yu-Tang in liver cirrhosis

Shung-Te Kao
China Medical University
To observe the therapeutic effect of Ja-Wei-Ge-Xia-Zhu-Yu-Tang on human liver cirrhosis associated with chronic hepatitis B and chromic hepatitis C. There is a clinical need for noninvasive measurement of liver fibrosis both to diagnonis significantly liver fibrosis and to monitor the effects of therapy on fibrogensis and fibrolysis, serum markers include extracellular matrix protein such as procollagen III,collagen IV, hyaluronan, laminin, metalloproteinase and their inhibitors. Use of multiple markers has led to 90% sensitinity in diagnosis cirrhosis,but specificity is variable at about 60%. Automated systems to measure these markers are being evaluated for their ability to monitor fibrosis during and after therapy in multiple liver disease.Ja-Wei-Ge-Xia-Zhu-Yu-Tang , a Chinese traditional medicine , is a famous prescription to significantly treat liver cirrhocis.
關鍵字：Ja-Wei-Ge-Xia-Zhu-Yu-Tang；liver cirrhosis；procollagen；Ⅳ collagen；hyaluronic acid