| Research purpose:To observe the clinical therapeutic effect of Ganshuang Granule combined with glutathione on Chronic Hepatitis B complicated with Nonalcoholic Fatty Liver Disease.Methods:A total of 58 patients with chronic hepatitis b complicated with non-alcoholic fatty liver disease who were diagnosed in the Department of Hepatobiliary and Pancreatic Medicine of The Second Hospital of Jilin University from January 2017 to December 2019 were included in the study.The patients were randomly divided into the combination treatment group(20 cases),the ganshuang granule group(19 cases)and the glutathione group(19 cases).The three groups of patients were treated with drug intervention on the basis of diet guidance and aerobic exercise.the ganshuang granule group was treated with Ganshuang Granules(1 bag,3 times/day),and the glutathione group was treated with Reduced Glutathione(4 tablets,3 times/day).The combined treatment group was treated with a combination of Ganshuang Granules and Glutathione(Ganshuang Granules: 1 bag,3 times/day,Glutathione: 4 tablets/time,3 times/day)treatment,12 weeks for 1 course of treatment.Biochemical indexes such as ALT,AST,TBIL and GGT were observed and recorded before treatment and at 4,8 and 12 weeks of treatment,respectively.Meanwhile,Liver stiffness measurement(LSM)in KPA 、Controlled attenuation parameter(CAP)in d B/m 、Body mass index(BMI)in kg/m2 were observed and recorded.Results:1.Liver function recovered before and after treatment In the combination treatment group,the Ganshuang granule group and the glutathione group,the improvement of ALT,AST,TBIL,GGT and other biochemical indicators in the three groups at different time points at 4,8 and 12 weeks after treatment was significantly decreased compared with that before treatment(p <0.05).At 4 weeks after treatment,the ALT and GGT levels in the combined treatment group were significantly lower than those in the Ganshuang granule group and the glutathione group(p <0.05),and the TBIL and AST levels were also significantly lower than those in the two monotherapy groups,but there was no statistically significant difference(p > 0.05).At 8 weeks of treatment,the decrease of GGT in the combination group was still significantly better than that in the two monotherapy groups(p <0.05).At 12 weeks of treatment,on the basis of adjusting diet and exercise,most of the patients in the 3 groups recovered ALT,AST,TBIL and GGT after drug intervention,but still had ALT higher than the upper limit of normal value: 5 patients in the combination treatment group,5 patients in the ganshuang granule group,and 4 patients in the glutathione group,with no significant difference between the groups(p >0.05).2.Liver function recovered at different time points before and after treatment At 4 weeks of treatment,5(26.32%)of the 19 patients in the ganshuang granule group had normal liver function,5(26.32%)of the 19 patients in the glutathione group had normal liver function,and 12(60%)of the 20 patients in the combined treatment group had normal liver function,with differences between the groups(p <0.05).At 8 weeks of treatment,10 patients(52.63%)in the ganshuang granule group recovered normal liver function,12 patients(63.16%)in the glutathione group recovered normal liver function,and 14 patients(70%)in the combined treatment group recovered normal liver function,with no difference between the groups(p >0.05).After 12 weeks,14(73.68%)cases of the ganshuang granule group and 15(78.95%)cases of the glutathione group returned to normal,and the number of cases of the combined treatment group returned to normal was 15(75%),with no difference between the groups(p >0.05).3.Changes of BMI and CAP before and after treatment BMI of the combined treatment group,the ganshuang granule group and the glutathione group decreased slightly at 4 weeks after treatment,with no difference within the group(p >0.05).BMI decreased significantly at 8 weeks and 12 weeks after treatment,with significant difference compared with before treatment(p <0.05),while there was no difference between the groups(p >0.05).At 4 weeks of treatment,the CAP value of the combined treatment group decreased significantly compared with that before treatment,with statistical significance(p <0.05),The glutathione group and ganshuang granules showed no significant decrease in CAP value compared with that before treatment(p >0.05).At 8 weeks and 12 weeks after treatment,there was a significant difference in the decrease of CAP value between the three groups compared with that before treatment(p <0.05).There was no statistical significance between the three groups(p >0.05).After treatment,there was a positive correlation between Changes in CAP and BMI in the three groups(r=0.545,p <0.05)。4.Changes in blood lipid before and after treatment After 12 weeks of treatment,TG and TC decreased to different degrees in all three groups,with statistically significant differences compared with those before treatment(p <0.05),Comparison between groups had no statistical significance(p > 0.05).5.The improvement of liver hardness before and after treatment At 4 weeks of treatment,the combined treatment group and the ganshuang granule group showed a decrease in liver hardness,which was not statistically significant compared with that before treatment(p > 0.05).At 8 weeks and 12 weeks after treatment,liver hardness decreased significantly,which was statistically significant compared with that before treatment(p <0.05).the decrease of liver hardness was not significant in the glutathione group,and there was no significant difference before and after treatment(p >0.05).At 12 weeks,there were significant differences between the combined treatment group,the ganshuang granule group and the glutathione group(p <0.05).Conclusion:1.Ganshuang granule combined with reduced glutathione in the treatment of chronic hepatitis b with non-alcoholic fatty liver disease was better than the single drug group in protecting liver and lowering enzyme and improving clinical biochemical indicators(p <0.05),with better therapeutic effect;2.Ganshuang granule combined with reduced glutathione treatment can effectively promote the improvement of CAP value in patients with chronic hepatitis b complicated with non-alcoholic fatty liver disease(p <0.05),the effect is not significant in the improvement of blood lipid(p > 0.05);3.The combination or single use of ganshuang granules significantly improved the liver fibrosis of the patients and significantly reduced the Liver stiffness measurement(LSM)(p <0.05);4.After the treatment of diet adjustment,aerobic exercise and drug intervention,the patients’ BMI and CAP values were significantly reduced,and the liver fat was significantly improved.In other words,the elevated transaminase caused by fatty liver was basically eliminated,ALT continues to be abnormal and effective antiviral therapy should be considered. |
PDF Full Text Request