| Research objectivesOf this study is to through the clinical observation yiqi jiedu huoxue lafarge his own before and after treatment of liver fibrosis in patients with chronic hepatitis b patients serological HBV DNA,liver function and liver fibrosis indexes and multiple parameter model(APRI,FIB-4),liver and spleen ultrasound,liver hardness values and traditional Chinese medicine symptom integral and the change of each index,the objective evaluation of yiqi jiedu huoxue lafarge their liver fibrosis in patients with chronic hepatitis b clinical curative effect and security,so as to provide new treatment method for clinical prevention and treatment of the disease and is safe and effective drugs.Research methodsFrom February 2018 to September 2019,80 patients with chronic hepatitis b liver fibrosis who met the inclusion criteria were admitted to the hepatology department of hubei hospital of traditional Chinese medicine(huayuanshan district)and were randomly divided into treatment group and control group,with 40 patients in each group.With the control group patients give entecavir dispersible tablets 0.5 mg/time,1/d,oral,on the basis of the treatment group patients in the control group take yiqi jiedu huoxue lafarge his own(20 g,15 g atractylodes,radix pseudostellariae leaf beads under 15 g,bitter ginseng 10 g,salvia miltiorrhiza,15 g,peach kernel,10 g,poria cocos 15 g,huang jing 15 g,giant knotweed 15 g,20 g spreading hedyotis herb,radix curcumae 15 g,turtle shell 15 g,licorice root 6 g)200 ml/second,in the morning and once,a course of 24 weeks.To observe and record the changes of serum HBV DNA,liver function,liver fibrosis serological index and multi-parameter model(APRI,fib-4),liver and spleen color doppler ultrasound,liver hardness value and TCM syndrome score before and after treatment in the two groups.Excel software was used to establish the database of the examination results,and SPSS21.0 software was used for statistical analysis of the data.P<0.05 indicated that the difference was statistically significant,and the clinical efficacy of the two groups of patients was compared.Results1.The patient group general situation:the treatment group 40 cases,control group 40 cases,two groups of patients’ demographic characteristics(gender,age),vital signs,medical history,medical history,serological HBV DNA,liver function and liver fibrosis indexes and multiparameter model(APRI,FIB-4),liver and spleen ultrasound,liver hardness values and traditional Chinese medicine symptom integral and comparison,the indicators have no obvious difference,comparable.2.Changes in liver function and HBV DNA before and after treatment in the two groups:After 24 weeks of treatment,ALT(35.23±10.03 u/L)and AST(28.51±10.09 u/L)in the treatment group were significantly improved compared with ALT(103.40±17.49 u/L)and AST(76.31±13.38 u/L).GGT(40.03±6.98 u/L),TBil(16.38±8.10umol/L),HBV DNA(2.39±1.33 log10IU/ml)significantly decreased compared with GGT(52.94±12.06 u/L),TBil(22.81±8.17 umol/L)and HBV DNA(5.23±3.631og10IU/ml)before treatment,and the liver synthesis index ALB(42.65±3.24 g/L)increased compared with ALB(39.64±3.31g/L)before treatment.In the control group,ALT(51.11±20.74u/L)and AST(35.09±10.89u/L)were significantly improved compared with ALT(106.14±18.56 u/L)and AST(72.49±13.44 u/L)before treatment.GGT(47.51±5.43 u/L),TBil(18.67±5.96 umol/L),HBV DNA(3.29±0.61 log10IU/ml)significantly decreased compared with GGT(51.77±10.41 u/L),TBil(21.67±5.93 umol/L)and HBV DNA(5.36±3.34 log10IU/ml)before treatment,and the liver synthesis index ALB(42.29±2.30 g/L)improved compared with ALB(39.34±2.21 g/L)before treatment.The difference was statistically significant(p<0.05).Comparing the two groups after treatment,After treatment,serum ALT(35.23±10.03 u/L),AST(28.51±10.09 u/L),GGT(40.03±6.98 u/L),ALB(42.65±3.24 g/L),TBil(16.38±8.10 umol/L),HBV DNA(2.39±1.33 log10IU/ml)in the treatment group were significantly improved compared with ALT(51.11±20.74 ±/L),AST(35.09±10.89 ±/L),GGT(47.51±5.43 u/L),ALB(42.29±2.30 g/L),TBil(18.67±5.96 umol/L)and HBV DNA(3.29±0.61 log10IU/ml)in the control group,with statistically significant differences(p<0.05).No HBsAg negative transition was observed in both groups(p>0.05).3.Changes in serological indicators of liver fibrosis before and after treatment in the two groups:After 24 weeks of treatment,Treatment group patients with liver fiber four HA(75.63±33.01 ng/ml),P III NP(37.11±19.8 ng/ml),IV-C(37.29±17.31 ng/ml),LN(31.50±24.5 ng/ml)before the treatment HA(132.70±78.11 ng/ml),P III NP(59.67±41.72 ng/ml),IV-C(65.60±35.03 ng/ml),LN(45.07±41.50 ng/ml)obviously decreased;Four HA control group in patients with liver fiber(78.11±34.74 ng/ml),P III NP(40.09±20.89 ng/ml),IV-C(39.51±19.43 ng/ml),LN(34.29±26.30 ng/ml)before the treatment HA(133.14±79.56 ng/ml),P III NP(59.49±42.44 ng/ml),IV-C(66.77±36.41 ng/ml),LN(45.34±42.21 ng/ml)decreased obviously,The difference was statistically significant(p<0.05).Comparing the two groups after treatment,The treatment group after treatment in patients with liver fiber four HA(75.63±33.01 ng/ml),P III NP(37.11±19.8 ng/ml),IV-C(37.29±17.31 ng/ml),LN(31.50±24.5 ng/ml)compared with the control group in patients with liver fiber four HA(78.11±34.74 ng/ml),P III NP(40.09±20.89 ng/ml),IV-C(39.51±19.43 ng/ml),LN(34.29±26.30 mm Ng/ml)decreased significantly,and the difference was statistically significant(p<0.05).4.Changes of APRI and fib-4 before and after treatment in the two groups:After 24 weeks of treatment,APRI(0.6±0.38)and fib-4(1.7±1.39)in the treatment group were significantly lower than that before treatment(1.3±0.81)and fib-4(2.2±1.48).In the control group,APRI(0.8±0.45)and fib-4(2.0±1.44)decreased significantly compared with APRI(1.3±0.93)and fib-4(2.3±1.23)before treatment(p<0.05).After treatment,APRI(0.6±0.38)and fib-4(1.7±1.39)in the treatment group decreased significantly compared with APRI(0.8±0.45)and fib-4(2.0±1.44)in the control group(p<0.05).5.The two groups before and after treatment in patients with liver spleen ultrasonic changes:After 24 weeks after treatment,the treatment group patients with portal vein trunk diameter(10.79±0.50 mm),splenic vein diameter(5.±80.9 mm),thickness of spleen(38.21±4.32 mm)before the treatment portal venous trunk diameter(13.35±1.41 mm),splenic vein diameter(8.3±1.5 mm),thickness of spleen(46.76±6.45 mm)significantly reduced;In the control group,the main portal vein diameter(11.04±0.85mm),the splenic vein diameter(7.2±1.1mm)and the spleen thickness(39.47±4.72mm)were significantly reduced compared with the main portal vein diameter(13.23±1.34mm),the spleen vein diameter(8.4±1.4mm)and the spleen thickness(47.21±6.32mm)before treatment,with statistically significant differences(p<0.05).Comparison between the two groups after treatment,the treatment group after treatment in patients with portal venous trunk diameter(10.79±0.50 mm),splenic vein diameter(5.8±0.9 mm),thickness of spleen(38.21±4.32 mm)than the control group in patients with portal vein trunk diameter(11.04±0.85 mm),splenic vein diameter(7.2±1.1 mm),thickness of spleen(39.47±4.72 mm)improved more obviously,statistically significant difference(p<0.05).6.Changes of liver hardness value(LSM)before and after treatment in the two groups:After 24 weeks of treatment,liver hardness value(8.20±1.lOkpa)in the treatment group was significantly lower than that before treatment(10.46±1.41kpa).The liver hardness of patients in the control group(9.1±1.31 kPa)was significantly lower than that before treatment(10.42±1.34 kPa),and the difference was statistically significant(p<0.05).Compared with the control group(9.1±1.31 kPa),the liver hardness of the treatment group(8.20±1.10 kPa)decreased significantly(p<0.05).7.Comparison of quantified scores of TCM symptoms:After 24 weeks of treatment,the quantified scores of symptoms of flank pain,abdominal distension pain,loss of appetite,fatigue and fatigue,dry mouth and bitter mouth,loose stool,dull complexion,and large liver and spleen in the two groups decreased significantly compared with those before treatment,with statistically significant differences(p<0.05).The quantitative score of TCM symptoms in the treatment group was significantly lower than that in the control group after treatment,and the difference was statistically significant(p<0.05).In terms of other symptoms of liver palm and spider spider nevus,there was no statistically significant difference between the two groups before and after treatment(p>0.05).8.Comparison of the total score of TCM syndromes:After 24 weeks of treatment,the total score of TCM syndromes in the treatment group(4.12±3.63)was significantly lower than that before treatment(9.24±6.56).The total score of TCM syndromes in the control group(6.04±3.95)was significantly lower than that before treatment(9.29±7.12),and the difference was statistically significant.After treatment,the total score of TCM syndromes in the treatment group(4.12±3.63)was significantly lower than that in the control group(6.04±3.95),and the difference was statistically significant(p<0.05).9.Comparison of clinical comprehensive efficacy between the two groups:After 24 weeks of treatment,the clinical comprehensive efficacy of patients in the control group was 72.5%,and that of patients in the treatment group was 87.5%.The clinical comprehensive efficacy of the two groups was better than that of the control group(p<0.05).10.Safety indicators:the patient had a good tolerance,no adverse reactions,no clinically significant changes in blood,urine,feces,renal function and ecg before and after treatment.ConclusionYiqi jiedu huoxue method can obviously improve the clinical symptoms of patients with chronic hepatitis b liver fibrosis,and reduce the patient ’ s Chinese medicine symptom integral,improving liver function and liver fibrosis in patients with serological indexes,APRI,FIB-4 and liver hardness value,reduce portal vein trunk diameter,spleen vein diameter and thickness of spleen,further development of prevention and treatment of liver fibrosis.Yiqi jiedu huoxue method is a safe and effective treatment for chronic hepatitis b liver fibrosis,yiqi jiedu huoxue method is an effective prescription for the treatment of chronic hepatitis b liver fibrosis. |
PDF Full Text Request