| Objective:In this study,the data mining methods were used to systematically summarize and comb the formula law of the treatment of chronic h epatitis B(CHB)liver fibrosis And the retrospective cohort study was carried out based on the composition rules summarized via data mining to analyze the curative effect in the combined treatment of traditional Chinese and western medicine and the treatment of hepatitis B and liver fibrosis by Western medicine alone,in order to verify the conclusion of data mining.Methods:1.CNKI,Weipu,Wanfang databases were used to search the literatures of Fuzheng Huayu treatment of hepatitis B liver fibrosis,and the prescriptions and drugs which met the requirements were extracted and standardized,to form a data set of Chinese herbal compound prescription for the treatment of CHB liver ibrosis,data mining techniques such as frequency analysis,apriori analysis,complex network analysis and cluster analysis were used to analyze the drug use of Fuzheng Huayu method.2.Based on the conclusions of data mining study,a retrospective cohort study was carried out.The data of patients with CHB liver fibrosis in 2015 and 2021 were en rolled into the study.According to whether these patients used th e treatment of Fuzheng Huayu,they were divided into exposure group and control group.With relevant information collected,the study mainly evaluate the effect of treatment in three dimensions:non-invasive diagnostic indexes(LSM,serum fibrosis markers),virus-related indexes(HBsAg,HBeAg,HBV DNA decline rate and negative conversion rate)and liver function-related indexes(serum biochemical indexes and coagulation-related indexes).Results:1.Results of the data mining section(1)89 Chinese herbal compound prescriptions of Fuzheng Huayu method were selected.A total of 173 kinds of Chinese medicines were involved,with a total frequency of 951.The medicin es with higher frequency were:Salvia miltiorrhiza,radix astragali,radix paeoniae alba,radix bupleuri,atractylodes rhizome,etc.,the main channel is liver and spleen.(2)Apriori algorithm screened out 24 core Chinese medicine compatibility,in which Huangqi-Danshen,Baishao-Danshen,Baishao-Bupleurum support the highest.(3)Network analysis screened out 121 edges with weight≥10,involving 18 flavors of traditional Chinese medicine,which was basically consistent with Apriori algorithm and frequency analysis.(4)Cluster analysis of 25 herbs with frequency≥10 was carried out and 5 drug combinations were obtained.2.Results of the Clinical Research Section:(1)Inclusion status:there were 131 cases of chronic hepatitis B with liver fibrosis,more males than females,the ratio was about 8:5.Most cases were aged from 35 to 55 years old,and HBeAg positive was less than negative,the ratio is about 4:6.(2)LSM analysis:64 cases were analyzed ①after 24 weeks of treatment,the decrease of LSM in the Fuzheng Huayu treatment group was better than that in the conventional treatment group(P<0.05),② LSM in both groups decreased after treatment(P<0.01),ALT in exposed group decreased after 24 weeks compared with 0 weeks(P<0.05),TBIL in control group decreased after 24 weeks compared with 0 weeks(P<0.01),③based on LSM value,the relative efficiency of traditional Chinese medicine and Western medicine was calculated as RRLSM≈2.33(P<0.05).(3)An alysis of serum liver fibrosis index:99 cases participated in the an alysis.①after 24 weeks of treatment,the median number of HA in both groups was higher than before,and the overall level of HA in the exposed group was lower than that in the control group(P<0.05),the level.of Median PIIIP in the exposed grou p was lower than that in the exposed group,and the level of Median PIIIP in the control group was higher than that in the exposed group(P<0.05).The level of TBIL in the control group was lower than that in the exposed group(P<0.05),②the levels of Alt,AST and GGT in.the exposed group decreased after 24 weeks of treatment(P<0.05),in the control group,the level of TBIL in the 24th week was lower than that in the 0th week(P<0.01).③the relative effective rate of RR≈1.75(P<0.05)was calculated based on the indexes of serum fibrosis(4)Analysis of virological indexes:both the traditional Chinese and Western medicine treatment group and the routine treatment group had certain effective rates in reducing HBsAg,HBeAg and HBV DNA levels and turning negative,the relative effective RR values were 0.60,0.91 and 1(P>0.05),respectively.(5)Liver function related index analysis:after 24 weeks of treatment,APRI index of exposed group,fibrin-4 index of two groups,Alt,AST,GGT and other indexes reflecting the level of liver inflammation and the degree of fibrosis were all lower than before,however,the difference between the two groups did not reach the test level(P>0.05),the PLT level decreased and PTA level increased,but there was no significant difference between the two groups(P>0.05),the degree of decrease in TBiL level in the control group was more obvious than that in the exposed group(P<0.05).Conclusion:The traditional Chinese medicines used in the method of Fuzheng Huayu are mainly effective in tonifying deficiency,promoting blood circulation and removing blood stasis.To promote blood circulation and remove blood stasis.Supporting the body to benefit qi and spleen,nourishing blood and liver,promoting blood circulation and removing blood stasis with bitter taste,cold and cool in nature,can be compatible with Qingre Lishi and liver and spleen soothing drugs.Fuzheng Huayu therapy combined with Western medicine treatment is more effective than Western medicine treatment alone in improving the non-invasive index of liver fibrosis. |
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