中医学认为,肝脏与脾脏、胃腑,在生理上互相为用、互相协调;病理上互相影响、互相传变,肝脏疾病的病位在肝,还涉及脾胃,历代医家持此观点和论述的数不胜数.<金匮要略>首条便提出"见肝之病,知肝传脾,当先实脾",而后"肝病实脾"理论即为历代医家传承,并得以发掘创新.清代医家柯韵伯提出的"实则阳明,虚则太阴"的理论,在肝脏疾病辨治过程中,也具有十分重要的指导意义.

Objective:To study the effects of Artemisia Argyi extracting solution on expression of transforming growth factor-β1(TGF-β1) in immunological hepatic fibrosis rats.Methods:Seventy-two experimental Wister rats were randomly divided into normal control group,hepatic fibrosis model group,Artemisia Argyi extracting solution low,middle and high-dose group,and Danshen control group.Rat liver fibrotic models were established by intraperitoneal injection with pig serum,and the degrees of liver fibrosis of each group were identified by hematoxylin and eosin(HE).Besides,the TGF-β1 levels of rats’ serum were detected by ELISA,and the mRNA and protein levels of TGF-β1 in rats’ liver were detected by Real-time PCR and Western blot,respectively.Results:Compared with the hepatic fibrosis model group,the degree of hepatic fibrosis in rats of Artemisia Argyi extracting solution therapeutic groups reduced significantly,and the contains of TGF-β1 protein in rats’ serum,TGF-β1 mRNA and protein expression levels in liver tissues decreased significantly at the same time.Conlusion:Artemisia Argyi extracting solution can protect rats liver suffered with immunological hepatic fibrosis by the way of reducing TGF-β1 synthesis and secretion.

Objective To investigate the clinical reducing effect of midnight-midday ebb flow Acupuncture on HBV-YMDD mutation.Methods Two hundred and twenty patients were randomly allocated to a control group of 88 cases and a treatment group of 132 cases.Both groups took Lamivudine orally.In addition, the treatment group received midnight-midday ebb flow acupuncture for 24 months.In the patients, the ALT normalization rate, HbeAg negative conversion rate and HBV-DNA negative conversion rate were examined after different periods of treatment respectively and the YMDD mutation rate, after 12, 18 and 24 months of treatment.Results The ALT normalization rate, HbeAg negative conversion rate, HBV-DNA negative conversion rate and after-24 month treatment YDMM mutation rate were all significantly better in the treatment group than in the control group(P0.05).Conclusion The combined treatment of chronic hepatitis B with midnight-midday ebb flow acupuncture and Lamivudine plays a good role in improving the hepatic function of the patients and the inhibitory effect of Lamivudine on virus replication and can reduce viral YMDD mutation.

黄疸是高胆红素血症的临床表现,即血中胆红素浓度升高,使皮肤、粘膜、巩膜及其他组织和体液发生黄染的现象.正常人血清中总胆红素浓度为1.7～17.1umol/L.如果血清总胆红素在34.2umol/L以上,临床上即表现为有黄疸,如血清胆红素超过正常值而无肉眼可见的黄疸时,则称为隐性黄疸,此时血清胆红素浓度常小于34.2umol/L.

黄疸是一种常见的临床症状和体征,由于血清内胆红素浓度大于17.1mol/L,使人体皮肤、粘膜、体液及其它组织出现不同程度的黄染.现代医学主要分为溶血性、肝细胞性、胆瘀性、先天性、非溶血性及混合性.