目的 探討復(fù)方苦參注射液對(duì)丙型肝炎肝硬化患者的臨床療效及其機(jī)制。方法 將56例丙型肝炎肝硬化患者隨機(jī)分為治療組和對(duì)照組，每組28例，對(duì)照組根據(jù)病情采用一般保肝護(hù)肝處理，如使用維生素C、門冬氨酸鉀鎂等，治療組在對(duì)照組治療基礎(chǔ)上加用復(fù)方苦參注射液靜脈滴注，600 mg/次，1次/d。兩組3個(gè)月為1個(gè)療程，連續(xù)治療2個(gè)療程后評(píng)價(jià)療效、肝纖維化4項(xiàng)指標(biāo)和外周單核細(xì)胞分泌細(xì)胞因子變化情況，并對(duì)IL-10進(jìn)行mRNA檢測(cè)。結(jié)果 治療后治療組ALT復(fù)常率34.56%，HCV RNA陰轉(zhuǎn)率9.34%，與對(duì)照組（21.54%、6.53%）相比差異有統(tǒng)計(jì)學(xué)意義（P<0.01、0.05）。兩組治療后血清中透明質(zhì)酸（HA）水平均低于治療前，治療前后差異均有統(tǒng)計(jì)學(xué)意義（P<0.01），治療后兩組差異無(wú)統(tǒng)計(jì)學(xué)意義；PC-Ⅲ、IV-C治療前后差異均無(wú)統(tǒng)計(jì)學(xué)意義；治療后兩組層黏連蛋白（LN）均低于治療前，治療前后差異均有統(tǒng)計(jì)學(xué)意義（P<0.01），治療后，治療組LN下降程度更為明顯，與對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。治療后，治療組IL-10 mRNA水平上升，與治療前相比差異有統(tǒng)計(jì)學(xué)意義（P<0.01）；治療后治療組IL-10 mRNA顯著高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組治療前后IL-10 mRNA差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 在常規(guī)治療基礎(chǔ)上加用復(fù)方苦參注射液對(duì)丙型肝炎肝硬化患者有較好的臨床療效，其機(jī)制可能是通過(guò)影響外周單核細(xì)胞IL-10表達(dá)，調(diào)節(jié)機(jī)體促炎/抗炎平衡實(shí)現(xiàn)的。

Objective To explore the clinical efficacy of Compound Matrine Injection in patients with hepatitis C cirrhosis and mechanism. Methods Patients with hepatitis C cirrhosis (56 cases) were randomly divided into treatment group and control group, 28 cases in each group. The control group used general protecting liver according to the condition of disease, such as vitamin C, potassium aspartate magnesium, and the treatment group added Compound Matrine Injection, id, 600 mg/d. One treatment course was for 3 months, then the efficacy, liver fibrosis, peripheral mononuclear cells secreting cytokines, and mRNA of IL-10 were evaluated after continuous treatment for two courses. Results The recovery rate of ALT in the treatment group was 34.56%, and negative rate of HCV RNA was 9.34%, and those of the control group were 21.54% and 6.53%. There was statistically significant difference between two groups (P < 0.01, 0.05). The levels of HA of the two groups after treatment were lower than those before treatment. The difference between the two groups was statistically significant (P < 0.01), but there was no statistically significant difference after treatment. PC-Ⅲ and IV-C had no significant difference before and after treatment; The LN levels in the two groups after treatment were obviously lower than those before treatment, and the differences were statistically significant (P < 0.01). The LN level of the treatment group decreased more significantly after treatment. Compared to the control group, the difference was statistically significant (P < 0.01). IL-10 mRNA levels of the treatment group after treatment raised. Compared with that before treatment, the difference was statistically significant (P < 0.01). IL-10 mRNA of treatment group after treatment was significantly higher than that in control group, and there was significant difference between two groups (P < 0.05). IL-10 mRNA of the control group had no significant difference before and after treatment. Conclusion There is a better clinical effect of Compound Matrine Injection within the basis of conventional therapy on patients with hepatitis C cirrhosis, and its mechanism may be related to the influence of peripheral mononuclear cell IL-10 and regulating the body's inflammatory balanced realization.