| Hepatitis B virus infection is a global public health problem. There are about ninety-three million people have been infected with HBV in China. Research has shown that positive HBeAg chronic HBV carriers whose ALT are in the normal (≦40IU/L)high limit and HBV DNA replicate itself on high level≧1×105copies/ml), have the risk of progression. So some guides change the normal value of ALT to male is30IU/L, female is19IU/L.It prompts that we would can improve the long-term prognosis of chronic HBV carriers if we further reduce the HBV DNA and ALT levels in such patients.Objective:To explore the effect of Shugan Jieyu Decoction to inhibit replication of HBV DNA, promote HBeAg seroconversion and improve ALT on chronic HBV carriers. At the same time to observe the improving of liver stagnation and spleen deficiency syndrome of TCM symptoms of these patients, and evaluate its curative effect. Method:A total of70chronic HBV carriers are observed. According to the random number table, the patients are divided into treatment group and control group. There are respective35cases in each group. We observed24weeks. The treatment group was given Shugan Jieyu Decoction. The control group was given vitamin C, each of the0.1g, taked3times a day. According to the specific circumstances, the data is analyzed by chi-square test or t test. The P value is the value of two-tailed test. When the P value is less than0.05, it has statistical difference. When the P value is less than0.01, it has statistically significant difference. Result:1.After24weeks of treatment, the changes of serum HBV DNA:In the treatment group,6cases (17.1%) have virological response (6cases were serum HBV DNA decreased more than21g, not any cases is serum HBV DNA negative); in control group, not any cases has virological response. By X2test, the value of P is equal to0.033.It is less than0.05, so the difference is statistically significant.2. After24weeks of treatment, the changes of serum HBeAg:Both the treatment group and the control group, there is not any patient who has HBeAg negative. There is no difference in the two groups.3. The changes of the level of ALT:At12weeks, there are13cases (accounted for37.1%) whose value of ALT decrease more than10IU/L in the treatment group. But there are only3cases (accounted for8.6%) in the control group. By the four table X2test, the value of P is equal to0.004. It is less than0.01, so it has statistically significant difference. At24weeks, there are19cases (accounted for54.3%) whose value of ALT decrease more than10IU/L in the treatment group. But there are only4cases (accounted for11.4%) in the control group. By the four table X2test, the value of P is equal to0.000. It is less than0.01, so it has statistically significant difference.4. The changes of TCM symptoms integral:Compared with the treatment group and the control group the P value of which TCM symptoms integral including epigastric distension, lassitude, irritability and lossed of appetite is less than0.01at4weeks, then it has statistically significant difference. At12weeks, the P value of which these symptoms integral except nausea in the treatment group compared with those in the control group is less than0.01, and it has statistically significant difference. At24weeks, the P value of which the symptoms integral but lossed of appetite in the treatment group compared with those in the control group is less than0.01, so it has statistically significant difference.5. The efficacy of TCM:In the treatment group, there are9cured cases,17markedly effective cases,8effective cases and1invalid case respectively. The total effective rate is97.1%. But in the control group, there are2cured cases,4markedly effective cases,7effective cases and22invalid cases respectively. The total effective rate is37.1%. According to X2test, the P value by comparing the total effectiveness of treatment group with control group is0.000, it also has statistically significant difference.Conclusion:After24weeks of treatment, the results show that Shugan Jieyu Decoction can reduce the ALT level of chronic HBV carriers, and it can certain inhibit HBV replication compared with control group. Furthermore it can improve the clinical symptoms of chronic HBV carriers who are accord with liver stagnation and spleen deficiency syndrome. Because the period of study is short, the observation of e antigen seroconversion rates and HBV DNA response rate is not sufficient. And the long term efficacy that it treats chronic HBV carriers isn’t enough. So the understanding of long-term effect isn’t systemic and objective. |
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