| Objective : 1 In view of the real world study,Objective to evaluate the therapeutic effect of Ruangan Wan on hepatic reservational function and portal hypertension in patients with hepatitis B cirrhosis,through the changes of clinical symptoms before and after treatment in patients with chronic hepatitis B cirrhosis between the Ruangan Wan group and the non-Ruangan Wan group,such as albumin,cholinesterase,portal vein diameter,portal vein flow velocity,spleen thickness,spleen length and symptoms.2 The purpose is to evaluate the effect of Ruangan Wan and Biejiajian Wan in the treatment of hepatitis B cirrhosis,by comparison with the changes of clinical symptoms before and after treatment in patients with chronic hepatitis B cirrhosis between the Ruan Gan Wan group and the Biejiajian Wan group,for instance albumin,cholinesterase,portal vein diameter,portal vein flow velocity,spleen thickness,spleen length and symptoms.Methods:This research was a retrospective cohort study,which consisted of964 patients with hepatitis B liver cirrhosis who met the diagnostic criteria,and nonrandomly divided into different groups according to different treatment measures.1 According to whether the application of Ruangan Wan,the cases were divided into the Ruangan Wan group(372 cases)and non-Ruangan Wan group(592 cases),and after the propensity score matching,the Ruangan Wan group(30 cases)and non-Ruangan Wan group(30 cases).Focus on the outcome of those cases were matched by propensity score,including pretreatment,treatment for 3 months,for 6 months,for 9 months,for 12 months.2 According to the different types of medication,the cases were divided into the single Ruangan Wan group(71 cases)and the only Biejiajian Wan group(27 cases),and to observe the curative effect at before treatment,treatment for 3 months,for 6 months,for 9 months,for 12months?Results:1 After propensity matching,The results of the Ruangan Wan group and the non-Ruangan Wan group.1.1 The effect on albumin:At each time node,the two groups were compared within the group,the results showed that the two groups were able to enhance albumin(P < 0.05).The level of albumin was compared between the two groups and the results showed that,at the end of 12 months,the albumin level in the Ruangan Wan group was better(P < 0.05).1.2 The effect on cholinesterase:At the time of treatment for 6 months,for 9 months,for 12 months,Two groups of cholinesterase have varying degrees of improvement(P < 0.05).The level of albumin was compared between the two groups and the results showed that,at the end of 12 months,the cholinesterase level in the Ruangan Wan group was better(P < 0.05).1.3 The effect on portal vein diameter:At the time of treatment for 9months and for 12 months,the portal vein diameter of the Ruangan Wan group was decreased(P < 0.05).However,the portal vein diameter of the non-Ruangan Wan group was decreased(P < 0.05),at the end of treatment for 12 months.And there was no difference between the two groups in the reduction of portal vein diameter(P > 0.05).1.4 The effect on portal vein flow velocity:At the time of treatment for6 months,for 9 months,for 12 months,the portal vein flow velocity of the Ruangan Wan group increased in different degree(P < 0.05).However,the portal vein flow velocity of the non-Ruangan Wan group was increased(P <0.05),at the end of treatment for 12 months.The level of portal vein flow velocity was compared between the two groups and the results showed that,at the time of treatment for 9 months and 12 months,the portal vein flow velocity level in the Ruangan Wan group was better(P < 0.05).1.5 The effect on spleen thickness:At the time of treatment for 6 months,for9 months,for 12 months,the spleen thickness of the Ruangan Wan group had different degrees of retraction(P < 0.05).However,the spleen thickness of the non-Ruangan Wan group was also retracted(P < 0.05),at the time of treatment for 9 months and 12 months.The level of spleen thickness was compared between the two groups and the results showed that,at the time of treatment for 9 months and 12 months,the spleen thickness level in the Ruangan Wan group was better(P < 0.05).1.6 The effect on spleen length:At the time of treatment for 6 months,for 9months,for 12 months,the spleen length of the Ruangan Wan group had different degrees of retraction(P < 0.05).However,the spleen length of the non-Ruangan Wan group was also retracted(P < 0.05),at the time of treatment for 9 months and 12 months.However there was no difference between the two groups in the reduction of spleen length(P > 0.05).1.7 The effect on symptom score:At each time node,the two groups were compared within the group,the results showed that the two groups were able to reduce symptom score(P < 0.05).The level of symptom score was compared between the two groups and the results showed that,at the end of12 months,the symptom score level in the Ruangan Wan group decreased more significantly(P < 0.05).1.8 The effect on effective rate:After the treatment of 3 months,6 months,9months and 12 months,the effective rate of the Ruangan Wan group was respectively 30%,63.3%,73.3%,86.7%,and the non-Ruangan Wan group was respectively 20%,56.7%,60%,63.3%.However there was statistically significant deviation between two group at the end of 12 months.2 The result of the single Ruangan Wan group(71 cases)and the only Biejiajian Wan group(27 cases)2.1 The effect on albumin:The single Ruangan Wan group could enhance the degree of albumin at each time node(P < 0.05),but only the Biejiajian Wan group increased in the treatment of 6 months,9 months and 12 months(P <0.05).But at the end of treatment for 12 months,the albumin level of the single Ruangan Wan group is more obvious than the only Biejiajian Wan group(P < 0.05)2.2 The effect on cholinesterase:At each time node,the two groups were compared within the group,the results showed that the two groups were able to enhance cholinesterase(P < 0.05).The level of cholinesterase was compared between the two groups and the results showed that,at the end of12 months,the cholinesterase level in the Ruangan Wan group was better(P< 0.05).2.3 The effect on portal vein diameter:At the time of treatment for 6 months,for 9 months,for 12 months,The two groups were able to reduce the portal vein diameter(P < 0.05).And there was no statistical difference between the two groups(P> 0.05).2.4 The effect on portal vein flow velocity: At the time of treatment for 6months,for 9 months,for 12 months,the portal vein flow velocity of the single Ruangan Wan group increased in different degree(P < 0.05).However,the portal vein flow velocity of the only Biejiajian Wan group was increased(P < 0.05),at the end of treatment for 12 months.And there was no statistical difference between the two groups(P> 0.05).2.5 The effect on spleen thickness:At each time node,the spleen thickness of the single Ruangan Wan group had different degrees of retraction(P<0.05),but in the treatment of 6 months,9 months and 12 months,the spleen thickness of only the Biejiajian Wan group had different degrees of retraction(P< 0.05)).And at each time node,there was no significant difference between the two groups in the thickness of the spleen(P> 0.05).2.6 The effect on spleen length:At each time node,the two groups were compared within the group,the results showed that the spleen length of the two groups had different degrees of retraction(P< 0.05).But at each time node,there was no difference in spleen length between the two groups(P>0.05).2.7 The effect on symptom score : At each time node,the two groups were compared within the group,the results showed that the two groups were able to reduce symptom score(P< 0.05).But at each time node,the improvement of symptom score of the two groups had no difference(P> 0.05).2.8 The effect on effective rate:After the treatment of 3 months,6 months,9months and 12 months,the effective rate of the single Ruangan Wan group was respectively 28.2%,59.2%,69%,83.1%,and the only Biejiajian Wan group was respectively 25.9%,55.6%,66.7%,77.8%.However,at each time node,the effective rate of symptom score between the two groups had no difference(P> 0.05).Conclusion : 1 The Ruangan Wan can improve the symptoms and signs of patients with hepatitis B liver cirrhosis,improve the level of serum albumin and cholinesterase,also reduce the diameter of the portal vein,increase portal vein flow rate,reduce the spleen.2 The Ruangan Wan and the Biejiajian Wan can improve the symptoms and signs of patients with hepatitis B liver cirrhosis,improve the level of serum albumin and cholinesterase,also reduce the diameter of the portal vein,increase portal vein flow rate,reduce the spleen.But the Ruangan Wan in the promotion of albumin and cholinesterase effect is more obvious. |
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