| Objective: We conducted a long-term follow-up of patients with hepatitis B cirrhosis,and analyzed the effects of Western medicine and Western Medicine on liver function,liver fibrosis,coagulation function and the incidence of hepatic cell carcinoma(HCC)in patients with hepatitis B cirrhosis.To provide reference for the clinical treatment of hepatitis B cirrhosis.Methods: Retrospective analysis was used in this study to collect patients with hepatitis B cirrhosis who were hospitalized in Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine from January 2012 to January 2014.According to the different degree of exposure to traditional Chinese medicine,the patients were divided into western medicine group and Western medicine group.Western medicine group,continuous oral nucleoside(acid)analogue(nucleoside)Analogues(NAs)antiviral treatment,do not take or take anti fibrosis traditional Chinese medicine less than 1 month every year;Chinese and Western medicine group,on the basis of continuous oral NAs antiviral treatment,according to the syndrome differentiation plus one kind of drug treatment of Qianggan capsule,Fuzheng Huayu capsule,Compound Biejia Ruangan Tablet or rhubarb Yuchong pill,and take more than 6 months every year.Inclusion and exclusion shall be in accordance with the relevant standards of the guidelines for the prevention and treatment of chronic hepatitis B(2010 Edition).The liver function,liver fibrosis,coagulation function and the incidence of HCC in the two groups were compared before treatment,1 year,3 years and 5 years.Results: 1.488 patients were enrolled in the group,187 in the western medicine group and 301 in the western medicine group.There was no significant difference in the use of lamivudine,telbivudine,entecavir,adefovir dipivoxil,lamivudine and adefovir dipivoxil antiviral drugs between the western medicine group and the Chinese and Western medicine group;the cumulative time of taking traditional Chinese medicine preparation in the Chinese and Western medicine group was 7 months,the longest time was 60 months,and the median time was 36 months.2.Comparison of liver function indexes: in the first year,the third year and the fifth year of treatment,the TBIL,ALT and AST of liver function in the two groups were significantly reduced(P<0.05),ALB was significantly increased(P<0.05),and the improvement of liver function was more significant with the prolongation of treatment cycle;in the first year,the third year and the fifth year of treatment,the liver function in the Chinese and Western medicine group was significantly improved compared with that in the western medicine group(P<0.05).In the western medicine group,the Chinese and western medicine group,the rates of ALT recurrence were 65.56% and83.79%,91.03% and 93.05%,92.25% and 94.76%,respectively,in the first year,the third year and the fifth year,and 61.67% and 78.62%,82.07% and86.87%,91.70% and 93.04%,respectively.The rates of ALT and AST in the two groups were significantly different in the first year of treatment(P<0.05),and there was no significant difference in the third and fifth years.3.Comparison of liver fibrosis: in the first year,the third year and the fifth year of treatment,the four items of HA,PCIII,IV-C and LN of liver fibrosis in the two groups were significantly lower than those before treatment(P<0.01),and the four items of liver fibrosis decreased more significantly with the prolongation of treatment cycle;in the first year,the third year and the fifth year of treatment,the four items of liver fibrosis in the Chinese and Western medicine group were significantly improved compared with those in the western medicine group(P<0.05).In the first,third and fifth year of treatment,the indexes of non-invasive liver fibrosis,such as Apri,fib4 and LSM,were significantly lower than those before treatment(P The medical group improved significantly(P<0.05).4.Comparison of coagulation function: in the first,third and fifth year of treatment,compared with before treatment,Pt,APTT and TT of the two groups decreased significantly(P<0.05).With the prolongation of treatment cycle,the coagulation function of the two groups improved significantly.Compared with the western medicine group,Pt,APTT and TT in the first,third and fifth year of treatment were significantly lower(P<0.05).5.Comparison of the incidence of HCC: in the western medicine group,the western medicine group and the western medicine group,the canceration rates in the first,third and fifth years were 3.74%(7/187)and 3.74%(11/301),22.46%(42/187)and 13.95%(42/301),31.02%(58/187)and 23.59%(71/301),respectively,which were significantly lower than that in the western medicine group(P<0.05).In the compensatory period,the 5-year cumulative canceration rates of Western medicine group and Western medicine group were 25.86%(30/116)and 16.94%(31/183),respectively.The canceration rate of Western medicine group was significantly lower than that of Western medicine group(P<0.05).In the decompensated period,the 5-year cumulative canceration rates of Western medicine group and Western medicine group were 39.44%(28/71)and 33.90%(40/118),respectively.There was no significant difference between western medicine group and Western medicine group(P> 0.05).Conclusion: 1.Integrated treatment of traditional Chinese and western medicine has a good effect on improving the liver function of patients with hepatitis b cirrhosis,and the improvement degree is better than that of western medicine;2.Integrated treatment of traditional Chinese and western medicine has a good effect on the improvement of liver fibrosis in patients with hepatitis b cirrhosis,and the improvement degree is better than that of western medicine;3.Integrated treatment of traditional Chinese and western medicine has a good effect on improving the coagulation function of patients with hepatitis b cirrhosis,and the improvement degree is better than that of western medicine.4.Compared with western medicine,the 5 years cumulative incidence of HCC in patients with hepatitis b cirrhosis was significantly reduced.In addition,the integrated treatment of traditional Chinese and western medicine focuses more on reducing the incidence of HCC in patients with compensatory hepatitis b cirrhosis. |
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