| Objective:(1)To evaluate the diagnostic value of hepatic fibrosis by collecting liver biopsy and Fibrotouch,and to evaluate the value of Fibrotouch in the diagnosis of hepatic fibrosis through the meta-analysis system.(2)In this study,the clinical effect of entecavir combined with soft shelled turtle liver slices in the treatment of liver depression and spleen deficiency and blood stasis obstructing the collateral syndrome of CHB liver fibrosis was observed with Fibrotouch as the breakthrough point.Methods:(1)Searchable database of published by computer Fibrotouch diagnosis of liver fibrosis related literature,the retrieval time for January 2013 to January 2018,by 2 evaluation personnel according to include and exclude standards to each of the studies in the literature,screening and according to the quality of diagnostic test evaluation tool in revman5.3 QUADAS-2 in the quality assessment.Data analysis was carried out by using the fixed effect model in metadisc software,and forest and SROC charts of statistical indicators were plotted.(2)72 cases from the liver disease department of the First Affiliated Hospital of Hunan University of Chinese Medicine were divided into two groups according to the random digital table method,that is,the test group(entecavir combined with the soft shelled turtle liver slice group)and the control group(entecavir group),each group was 36 cases,all were observed for 24 weeks,and the TCM syndrome scores of the two groups were observed before and after the treatment.Liver stiffness,liver function and HBV-DNA were measured.Results:1.The results of meta analysis:(1)the combined Sen by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 were 0.751,0.788 and 0.924;(2)the combined Spe by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 was 0.813,0.848,and 0.857;(3)the combined PLR by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 were 3.982,5.122,and 6.406;(4)the combined NLR by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 were 0.297,0.248,and 0.092;(5)the combined DOR by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 were 14.725,21.514,and 71.317;(6)the combined AUC by Fibrotouch diagnosising F ≥ 2,F ≥ 3 and F ≥ 4 were 0.8668,0.9198,and 0.9709.2.Clinical efficacy results:(1)evaluation of traditional Chinese medicine: the total effective rate of the experimental group was 88.89%,the total effective rate of the control group was 75.00%,the difference between the two groups was statistically significant(P<0.05);(2)the liver fibrosis response: the decrease of LSM value in the two groups was significantly higher than that before the treatment(P<0.01),and the decrease of the experimental group was greater than that of the control group,two groups.There was a significant difference between the groups(P<0.05);(3)the chemical response: in the group comparison,the two groups of ALT,AST and TBIL were significantly improved(P<0.01),but there was no significant change in ALB(P>0.05).The treatment group was better than the control group(P<0.05),AST,TBIL(P<0.05),AST,TBIL.There was no statistical difference between groups(P>0.05);(4)HBV-DNA response: there was no significant difference between the two groups(P>0.05).Conclusion:1.The Fibrotouch has a high diagnostic accuracy for liver fibrosis stage.At the same time,the accuracy of liver fibrosis was assessed with the increase of pathology grade.2.Entecavir combined with BIE long soft liver tablet can better improve the TCM syndrome score and liver fibrosis degree than that of entecavir alone in the treatment of CHB liver fibrosis. |
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