Clinical Observation On The Treatment Of Liver Depression And Spleen Deficiency Type CHB Combined With NAFLD With Xiaoyao Powder And Buzhong Yiqi Decoction

Objective: To evaluate the clinical efficacy of Xiaoyao powder combined with Buzhong Yiqi decoction in the treatment of chronic viral hepatitis B of liver stagnation and spleen deficiency combined with non-alcoholic fatty liver disease.Methods: Sixty-two patients with CHB and NAFLD who met the inclusion diagnostic criteria were selected and divided into control group and treatment group according to the random number table method,with 31 cases in each group.Due to the dropout of 2 cases,60 cases were finally included and divided into the control group(30 cases)and the treatment group(30 cases).Both groups were treated with tenofovir propofol fumarate tablets and lifestyle intervention.The control group was treated with silibinin capsule,and the treatment group was treated with Xiaoyaosan and Buzhongyiqi decoction.The body mass index(BMI),liver function(ALT,AST,GGT,TBA),blood lipids(TC,TG,HDL-C),insulin resistance index(HOMA-IR),superoxide dismutase(SOD),controlled attenuation coefficient(CAP),liver stiffness measurement(LSM),liver color ultrasound and TCM syndrome were observed and compared between the two groups before and after treatment Changes in syndrome score and adverse drug reactions.SPSS25.0software was used to analyze the observed data.Results: 1.Changes of liver function: the liver function indexes of the two groups were decreased compared with those before treatment(P<0.05).After treatment,ALT,GGT and TBA in the treatment group were significantly lower than those in the control group(P<0.05),and AST in the treatment group was not significantly improved compared with the control group(P<0.05).2.The changes of blood lipids: the TC and TG indexes of the two groups were lower than those before treatment(P<0.05),and HDL-C was higher than that before treatment(P<0.05);The TC and TG in the treatment group decreased more significantly than those in the control group after treatment(P<0.05),and HDL-C increased significantly than those in the control group(P<0.05).The treatment group was better than the control group in improving blood lipid levels.3.The changes of HOMA-IR,HOMA-IR index in the two groups were lower than those before treatment(P<0.05),HOMA-IR in the treatment group was significantly lower than that in the control group after treatment(P<0.05),the treatment group was more effective in improving insulin resistance.4.SOD changes,SOD levels in the two groups were increased compared with those before treatment(P <0.05),SOD levels in the treatment group increased more significantly than those in the control group after treatment(P<0.05)and the treatment group was better than the control group in improving liver inflammation.5.BMI and CAP values of the two groups were lower than those before treatment(P<0.05),and the BMI and CAP values of the treatment group were significantly lower than those of the control group(P<0.05).6.LSM changes: the LSM values of the two groups were not significantly improved compared with those before treatment(P<0.05),and there was no significant difference between the treatment group and the control group after treatment(P<0.05).7.changes in liver color Doppler ultrasound,the severity of fatty liver in the two groups after treatment were improved compared with before treatment,the effective rate of the treatment group was 66.67%,the control group was46.67%,the effective rate of the treatment group was significantly higher than that of the control group(P<0.05).8.TCM syndrome scores and curative effect of the two groups after treatment:in terms of improving TCM syndrome scores,the treatment group was significantly better than the control group,and the treatment group’s score decreased more significantly,the difference was statistically significant(P<0.05);The total effective rate was 83.33% in the treatment group and 53.33% in the control group(P<0.05).Conclusions: Xiaoyao powder combined with Buzhong Yiqi decoction in the treatment of CHB with liver stagnation and spleen deficiency combined with NAFLD has obvious advantages in effectively improving liver inflammation,bile acid metabolism,glucose and lipid metabolism,insulin resistance,superoxide dismutase and other levels of patients,reducing body weight and the degree of liver steatosis,and improving the clinical symptoms of traditional Chinese medicine and liver color ultrasound fatty liver grading.Compared with silibinin capsule,it is more effective and can effectively improve the quality of life of patients.