FibroTouch Evaluation Of The Therapeutic Effect Of DaHuangZheChong Pill Combined With Nucleoside(Acid) Analogues On Hepatitis B Fibrosis

Objiectiv: Patients with chronic hepatitis B fibrosis were diagnosed by instantaneous elastography(FibroTouch),the degree of improvement in liver fibrosis was compared between the two treatment regimens of DaHuangZheChong Pill(DHZCP)combined with nucleoside(acid)analogs and nucleoside(acid)analogs alone.Methods: 1159 patients with chronic hepatitis B fibrosis were retrospectively collected from December 2015 to February 2018 in the Department of Liver Diseases,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine.When LSM ?7.4 kPa and ALT < 2 × UNL,the patients were regularly treated with DHZCP combined with nucleoside(acid)analogues or nucleoside(acid)analogues alone.Among them,49 cases were treated with DHZCP combined with nucleoside(acid)analogue and 49 cases were treated with nucleoside(acid)analogue alone as control group.The names,gender,age,course of disease,and LSM of the patients treated for 3 months and 6months were collected.Laboratory tests included ALT,AST,TBiL,ALB and GGT.The The changes of LSM values in the 3rd month of treatment and the 6th month of treatment were observed,and the difference between the 3rd and 6th months of treatment and before treatment was calculated respectively,and the degree and efficiency of the decrease of chronic hepatitis B fibrosis in the two groups were evaluated.Statistical analysis was made on the changes of laboratory examination indexes before and after 6 months of treatment to find out whether the two groups had any influence on liver function during the treatment.Results:(1)There was no significant difference in sex,age,course of disease and laboratory examination of ALT,AST,TBiL,ALB and GGT between the two groups before treatment.(2)Before treatment,there was a significant difference in LSM between the combined treatment group [12.8(10.15,17.9)] and the single drug treatment group [10.3(8.5,13.1)],P < 0.05.At 3 months after treatment,there was no significant difference in LSM between the combined treatment group [10.6(8.35,14.25)] and the single drug treatment group [8.8(7.85,9.8)],P > 0.05.Six months after treatment,there was no significant difference in LSM between the combined treatment group [10.25(7.75,14.05)] and the single drug treatment group[8.5(7.45,11.22)],P > 0.05.Perhaps because the LSM values before treatment were not at baseline,the LSM was not statistically significant at3 and 6 months of treatment.(3)The difference in LSM between the 3 months of treatment and the 6 months of treatment was compared with that before treatment.At 3months of treatment,it was found that there was no significant difference in the LSM decrease difference between the combined treatment group[1.9(0.6,4.9)] and the single drug treatment group [1.0(-0.65,3.375)],P > 0.05.Six months after treatment,the difference of LSM decrease between the combined treatment group [2.9(0.28,6.25)] and the single drug treatment group [1.05(-1.07,2.75)] was significant(P < 0.05).The combined treatment group was superior to the single drug treatment group in reducing LSM.There was no significant difference in LSM decrease between the combined treatment group and the single drug treatment group in the same group for 3 months and 6 months,P > 0.05.(4)At 3 months of treatment,the effective rate of the combined treatment group was 61.9%,and that of the single drug treatment group was 53.57%.At 6 months of treatment,the effective rate of the combined treatment group was 63.15%,and that of the single drug treatment group was 47.5%.(5)There was significant difference in LSM between ETV +DHZCP group and ETV group before treatment(P <0.05).There was no significant difference in LSM difference between the two groups before treatment and 3 months after treatment(P > 0.05).The difference of LSMbefore treatment and 6 months after treatment was statistically significant(P <0.05).(6)In the range of 17.5 kPa > LSM 7.4? kPa,the LSM values of the treatment group and the control group were compared.Compared with LSM values before treatment and 6 months after treatment,P < 0.05.Compared with LSM difference before treatment and 6 months after treatment,there was no significant(P > 0.05)difference between treatment group [2.5(-0.925,4.925)] and control group[1.05(-1.175,2.650)].Conclusion: DHZCP combined with nucleoside(acid)analogues is superior to nucleoside(acid)analogues alone in improving chronic hepatitis B liver fibrosis.With the prolongation of treatment time,both treatments can alleviate liver fibrosis,and the degree of improvement of liver fibrosis may be slowed down.