Clinical Study Of Dahuang Zhechong Pill Combined With Entecavir In The Treatment Of Hepatitis B Fibrosis

Objective:To observe the therapeutic effect of rhubarb Zhezhong pill combined with entecavir in the treatment of chronic hepatitis B liver fibrosis with blood stasis and collaterals obstruction,so as to provide reliable theoretical basis and evidence-based medical evidence for the treatment of hepatitis B liver fibrosis with the combination of traditional Chinese and Western medicine.Method:According to the patient’s visit number,a randomized parallel control method was used to select the outpatients of infection department,TCM outpatients and inpatients from the Affiliated Hospital of Binzhou Medical College.The clinical diagnosis was in line with the guidelines for the prevention and treatment of chronic hepatitis B(Updated in 2015);TCM syndrome differentiation conforms to the consensus opinion of integrated diagnosis and treatment of traditional Chinese and Western Medicine on liver fibrosis(2017),100 cases of chronic hepatitis B fibrosis patients with blood stasis syndrome were randomly divided into two groups:control group and experimental group.The observation period of treatment was 12 weeks.The liver function(AST,ALT),HBV-DNA,liver fibrosis,LSM,single syndrome score and total score of Chinese medicine were observed before,at the 6th and 12th weeks.During the treatment,all patients need a low salt and low fat diet,appropriate aerobic exercise,and keep in a good mood.Analysis of the same time point group comparison,different time point group comparison resultsResult:(1)Before and after the test,the patients in the two groups were improved the routine serum,biochemical,liver elasticity test(LSM)and TCM syndrome comparison.There was no difference in clinical evaluation between the two groups.There was no significant difference in AST,alt,HBV-DNA,ha,PCIII,IV-C,LN,LSM and TCM syndromes(P>0.05).(2)Comparison of the clinical efficacy of the two groups:after the 6th week of treatment,the clinical efficacy of the two groups was compared by rank sum test,and there was no difference between the two groups.After the 12th week of treatment,rank sum test was used to compare the total effective rate between the two groups.The effective rate of the control group was lower than that of the test group(P<0.01).(3)Comparison of TCM syndrome scores between the two groups.There was no statistical difference between the two groups in the scores of individual syndromes and total scores before treatment,P>0.05 by chi square test.There was no significant difference and it was comparable.At the 6th and 12th week of treatment,the difference between different groups was statistically significant(P<0.01).The difference between the two groups was statistically significant(P<0.05).(4)Comparison of liver function changes between the two groups:compared between the two groups,at the 6th week of the treatment,the glutamic oxaloacetate transaminase and glutamic pyruvate transaminase in the two groups were significantly reduced,the reduction effect of the experimental group was better than that of the control group,the difference between the two groups was not statistically significant(P>0.05);at the 12th week of the treatment,the glutamic oxaloacetate transaminase and glutamic pyruvate transaminase in the two groups were lower than that before the treatment,and the experimental group was larger than the control group.(5)The changes of HBV-DNA in the two groups were compared:at the 6th week of treatment,HBV-DNA in the two groups decreased,but there was no significant difference between the two groups(P>0.05),but the change of HBV-DNA in the pure control group was the smallest;at the 12th week of treatment,HBV-DNA in the two groups decreased compared with that before treatment,compared with the control group and the experimental group There was no statistical significance(P>0.05).(6)Four changes of liver fibrosis in the two groups were compared:in the sixth week of treatment,the four indexes of liver fibrosis in the two groups were reduced,and there was no statistical significance between different groups(P>0.05);in the twelfth week of treatment,the indexes of liver fibrosis in the two groups were decreased compared with those before treatment,and there was no statistical significance between different groups(P>0.05).At the same time point,there was no significant difference between the two groups before treatment,6 weeks after treatment and 12 weeks after treatment.(7)The changes of liver elasticity(LSM)in the two groups were compared:at the 6th week of treatment,LSM in the two groups decreased,but there was no significant difference between the two groups(P>0.05);at the 12th week of treatment,LSM in the two groups decreased compared with that before treatment,and there was no significant difference between the two groups(P>0.05).(8)During the treatment,there were no adverse drug reactions such as allergy,poor appetite and diarrhea in the two groups.The safety indexes of the two groups before and after treatment were tested,and no abnormality was found before and after treatment.Conclusion:(1)Dahuang Zhezhong pill combined with entecavir in the treatment of liver fibrosis of blood stasis and collateral obstruction type is more effective than western medicine in improving the TCM symptom score and liver function.(2)Dahuang Zhezhong pill combined with entecavir has high safety in the treatment of liver fibrosis of blood stasis and collaterals blocking type B,and has no obvious hepatorenal toxicity in clinical application.(3)Dahuang Zhezhong pill combined with entecavir in the treatment of hepatitis B fibrosis reflects the clinical effect and advantages of traditional Chinese and Western medicine,which is worthy of clinical application..