Research On The With Prediction Model Of Liver Cancer To Reduce The Risk Of Chronic Hepatitis B Patients Becoming Liver Cancer

Objective:Using prediction model of liver cancer to research on the alone or with antiviral therapy of Di wu yang gan capsule, reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer and the effect and influence factor.Methods:We use the randomized controlled method(RCT) to divide HBeAg negative chronic hepatitis B patients between2011and2013of our hospital outpatient service into three groups:Di wu yang gan capsule treatment group; antiviral treatment group; Di wu yang gan capsule combined with antiviral treatment group.146cases was included in the statistical analysis. Treatment observation period was6、12months. Before and after the treatment supervise the HBV DNA, liver function marker and the liver function change of each group members. At the same time, we use REACH-B liver cancer risk prediction model (Model parameters based mainly on gender, age, ALT, HBeAg, HBV-DNA and other factors) and Ma(Model parameters based mainly on gender, age, TBIL、GGT, HBV-DNA and other factors) respectively to evaluate the effects and relative factors of the risk of becoming liver cancer between the three treatment options before and after the treatment.Results:The result of REACH-B prediction model grading Di wu yang gan capsule reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer:When the patients started into the group, the REACH-B grades of Di wu yang gan capsule treatment group、 antiviral treatment group、Di wu yang gan capsule combined with antiviral treatment group were5.36±2.98,6.40±3.28,6.62±3.49. Compared between groups, after statistics processing, there was no significant difference, P>0.05.6or12months after the treatment, the REACH-B grades of Di wu yang gan capsule treatment group were (4.81±2.61,5.00±2.82), antiviral treatment group were (4.62±2.15,4.62±2.36), Di wu yang gan capsule combined with antiviral treatment group were (4.56±2.23,4.38±2.22) Compared with before treatment, the grade has decreased significantly of each group in REACH-B grade. Comparison among three groups with statistics processing, there was no significant difference, p>0.05.The result of Ma score grading Di wu yang gan capsule reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer:When the patients started into the group, the MA scores of Di wu yang gan capsule treatment group、antiviral treatment group、Di wu yang gan capsule combined with antiviral treatment group were7.97±6.62,9.79±9.10,11.80±10.46. Compared between groups, after statistics processing, there was no significant difference, P>0.05.6or12months after treatment, the MA scores of Di wu yang gan capsule treatment group were (6.59 ±6.27,6.63±8.18), antiviral treatment group were (6.90±6.57,6.21±5.85), Di wu yang gan capsule combined with antiviral treatment group were (3.00±7.61,6.00±6.64). Compared with before treatment, Ma grade of each group all decreased significantly, after statistics processing, there was a clear difference, P<0.05. Compared between groups, when treat after6months, the Ma grade of Di wu yang gan capsule combined with antiviral treatment group decreased significantly, After statistics processing compared with western medicine treatment group and Integrative Chinese and western medicine group, there was a clear difference, P<0.05. According to MA score of high risk, we divided the patients into three groups:high risk(score>10), moderate risk(score=7-19), low risk(score7). When the patients started into the group, the grades of "high risk/moderate risk/low risk", Di wu yang gan capsule treatment group were39/15/5, antiviral treatment group were22/14/6, Di wu yang gan capsule combined with antiviral treatment group were22/10/13. Compared with the number form of each group, after statistics processing, there was no significant difference, P>0.05. After the treatment of6months, the number of each group in every group were (41/14/4,29/10/3,38/5/2) After the treatment of12months, the number of each risk in every group were (26/7/2,18/7/1,32/2/1), P>0.05。After6、12months treatment, high risk and moderate risk in Di wu yang gan capsule combined with antiviral treatment group all declined, low risk increased compared with before. After statistics processing, there was a significant difference, P<0.05. Compared between three groups, after statistics processing, there was no significant difference of three group, P>0.05. The influence of independent danger effect of liver cancer of Di wu yang gan capsule treatment group; antiviral treatment group; Di wu yang gan capsule combined with antiviral treatment group. When the patients started into the group, the ALT levels of Di wu yang gan capsule treatment group、antiviral treatment group、Di wu yang gan capsule combined with antiviral treatment group were35.55±17.61、41.15±20.2、41.69±25.07. Compared with tree groups, after statistics processing, there was no significant difference, P>0.05.After the treatment of6、12months, the ALT levels of Di wu yang gan capsule treatment group were (28.05±28.80,28.86±12.10), antiviral treatment group were (27.40±13.71,24.50±6.14), Di wu yang gan capsule combined with antiviral treatment group were (26.74±13.32,24.43±14.74). After the treatment of6、12months, comparison among three groups with statistics processing, there was no significant difference p>0.05. To compare with the ALT levels before the treatment in each group, the grade has decreased significantly. After statistics processing, there was a significant difference, P<0.05. When the patients started into the group, the GGT levels of Di wu yang gan capsule treatment group、antiviral treatment group、Di wu yang gan capsule combined with antiviral treatment group were23.65±15.33、27.25±17.10、29.83±20.51respectively, after statistics processing, there was no significant difference, P>0.05. After the treatment6、12months, the GGT levels of Di wu yang gan capsule treatment group were (15.00±5.66,24.51±13.21), antiviral treatment group were (41.50±43.13,25.73±13.41), Di wu yang gan capsule combined with antiviral treatment group were(17.33±12.86,25.67±15.57).After6months treatment, compared in each group: the level of GGT have significantly decreased of Di wu yang gan capsule treatment group、and Di wu yang gan capsule combined with antiviral treatment group. After statistics processing, there was a significant difference, P<0.05. Compared between groups:compared with antiviral treatment group, after statistics processing, there was a significant difference,P<0.05. After12months treatment, compared in groups:antiviral treatment group、Di wu yang gan capsule combined with antiviral treatment group both have declined than before treatment. But after statistics processing, there was a significant difference, P<0.05. Compared among groups, after statistics processing,there was no significant difference, P>0.05.Conclus ions:Using REACH-B and Ma prediction model of liver cancer(Points system) to research on the alone or with antiviral therapy of Di wu yang gan capsule to reduce the risk of Chronic hepatitis B patients becoming liver cancer. The result is almost the same. During one year observation period, the effect of using Di wu yang gan capsule alone is similar to Di wu yang gan capsule combined with antiviral treatment group in reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer. Compared with before treatment, two groups both have some effect on reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer. But due to the changes of main parameters adopted by or different evaluation methods, the result is a little different. Compared the risk level by MA evaluation system, the effect of using Di wu yang gan capsule is similar to antiviral treatment in reducing the risk of HBeAg negative chronic hepatitis B patients becoming liver cancer. However, the effect of Di wu yang gan capsule combined with antiviral treatment are better than using Di wu yang gan capsule alone and antiviral treatment. Because of the REACH-B and Ma prediction model of liver cancer don’t include the improvement of Liver tissue and other more meaningful indicators in the impact parameters, the assessment result has certain limitations, remaining to be further perfect.