Study On The The Regularity Of Syndrome Type And Treatment And Clinical Efficacy Of Chronic Hepatitis B Based On Literature Research And Data Mining

Objective:Firstly,the distribution structure of chronic viral hepatitis B(CHB)syndrome types and the characteristics of its commonly used treatment methods and prescriptions were analyzed by literature collation and data mining on the ancient and modern treatment of CHB to determine the leading direction of treatment of traditional Chinese medicine of CHB and provide a certain basis and reference for the treatment of CHB.Secondly,we explored the effectiveness and safety of Chinese herbal compound in the treatment of CHB by doing systematic review to confirm the effectiveness of Chinese herbal compound in the treatment of CHB,to provide direction for clinical syndrome differentiation and treatment of CHB,and to provide reference and basis for the standardized treatment program of CHB.Methods:Firstly,we retrieved the literature of TCM compound prescription for CHB in the past 10 years through the network database.The following databases were searched:China national knowledge internet(CNKI),VIP,China biomedical literature service system(Sino MED),Wanfang database,Chinese Science Citation Database(CSCD),National Library of Medicine(MEDLING),PubMed,Cochrane Library,EMbase,Web of Science,with "chronic hepatitis B"as the key words,and "traditional Chinese medicine" as the secondary searching words.The name and frequency of prescriptions,related TCM etiology,treatment distribution and prescription application information of different treatment methods were summarized and analyzed.In addition,the efficacy and safety of Chinese herbal compound in the treatment of CHB were systematically evaluated.We Searched both Chinese and English databases.Chinese databases included:CNKI,Sino MED,VIP,Wanfang database.Foreign databases included:PubMed,Cochrane Library,Web of Science and EMbase.The retrieval time limit was from the establishment of the database to June 18,2022.The key words were "chronic hepatitis B","CHB","jaundice","hypochondriac pain","accumulation","traditional Chinese medicine","Decoction","herbal medicine","random","control","RCT","CCT" and "blind method".We screened documents according to the inclusion and excluding criteria.We used RevMan 5.3 to evaluate the methodological quality of the literature and analyzed the outcome indicators by Stata 14.0 software.Results:1.The results of this study showed that the common syndromes of CHB were "liver-gallbladder dampness-heat,liver qi stagnation and spleen deficiency,yin-deficiency dampness-heat,liver qi stagnation,liver kidney yin deficiency and qi stagnation and blood stasis".2.The results showed that "clearing heat and removing dampness,strengthening the spleen and replenishing qi,soothing liver and harmonizing stomach,supplementing qi and nourishing yin,promoting blood circulation and removing blood stasis" were the common therapeutic methods of CHB.3.The results showed that Xiaoyao Powder,Yinchenhao Decoction,Ganlu Xiaodu Dan,Chaihu Jiedu Decoction,Qinggan Huoxue Decoction,Longdan Xiegan decoction,Jiedu Decoction,Haoqin Qingdan decoction,chaishaoliujunzi decoction,Chaiping Decoction and Shenling Baizhu powder were common prescriptions for treating CHB.4.The results of this study concluded the commonly used drugs of the six common types of CHB.The top 10 drugs in the frequency of liver-gallbladder dampness-heat syndrome were Herba Artemisiae Scopariae,Radix Glycyrrhizae,Fructus Gardeniae,Poria cocos,Hedyotis diffusa,rhubarb,Magnolia officinalis,Fructus Schisandrae,Radix Isatidis and Rhizoma Atractylodis.The top 10 drugs in the frequency of liver qi stagnation and spleen deficiency syndrome were Bupleurum,Rhizoma Atractylodis,Rhizoma Atractylodis Alba,Rhizoma Atractylodis Paeonia lactiflora,Angelica sinensis,Salvia miltiorrhiza,Codonopsis pilosula,Citrus peel,bergamot,Pinellia ternata and toosendan.The top 10 drugs in the frequency of yin-deficiency dampness-heat syndrome were:Paeonia lactiflora,plantain seed,licorice,Rehmannia root,Scutellaria barbata,Salvia miltiorrhiza,Polygonum cuspidatum,Yinchen,Sophora flavescens and Atractylodes.The top 10 drugs in the frequency of liver qi stagnation syndrome were:Atractylodes macrocephala macrocephala,Bupleurum Radix Paeoniae Alba,Mint,Poria cocos,Ginger,Radix Isatidis and Melia azedarach.The top 10 drugs in the frequency of liver kidney yin deficiency syndrome were:Radix Paeoniae Alba,Angelicae sinensis,Lycium barbarum,Yinchen,Salvia miltiorrhiza,Habitat,Hedyotis diflora,Tortoise shell,Lotus ellis and Ligustrum lucidum.The top 10 drugs in the frequency of qi stagnation and blood stasis syndrome were:Angelica sinensis,Radix Paeoniae Alba,Radix Bupleuri,Radix Salviae Glycyrrhiza uralensis,turtle shell,Astragalus membranaceus,Radix Isatidis and Radix Paeoniae Rubra.5.According to the research and analysis,the types and frequency of the commonly used drugs in the clinical treatment of CHB were as follows:36 kinds of tonic drugs,37 kinds of antipyretic drugs,15 kinds of diuresis drugs,15 kinds of blood-activating and stasis-removing drugs,8 kinds of qi-regulating drugs,6 kinds of phlegm-resolving cough and Asthma-relieving drugs,6 kinds of surface-relieving drugs,5 kinds of dampness-removing drugs,5 kinds of antiastringent drugs,5 kinds of antifeedant drugs,3 kinds of antirheumatic drugs.There are 3 kinds of hemostatic drugs,2 kinds of drugs for dispelling internal cold,2 kinds of drugs for inducing resuscitation,1 kind of purgating drug,1 kind of tranquilizer,1 kind of drug for idetoxicating,destroying parasites and relieve itching.Among the above commonly used drugs,the specific drugs with more frequent occurrences were as follows:licorice 3060 times(4.94%),Paeonia lactiflora 2825 times(4.56%),Bupleurum 2770 times(4.47%)and Salvia miltiorrhiza 2673 times respectively,Herba Artemisiae Scopariae 2545 times(4.10%).6.The results of this study showed that in the aspect of four Qi,drugs for treating CHB were mainly cold,warm and flat.The five flavors were mainly bitter,sweet and pungent and the meridians mainly belonged to liver,spleen and heart meridians.7.This Meta-analysis included 37 studies,involving 4435 patients.The results showed that compared with conventional western medicine,traditional Chinese medicine was more conducive to improve the liver function indexes of CHB patients:serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),liver fibrosis:hyaluronic acid(HA),type Ⅲ procollagen(PCⅢ),type Ⅳ collagen(Ⅳ-C)and laminin(LN),and the differences were statistically significant(P<0.05).The effective rate,the negative conversion rate of HBV-DNA and the negative conversion rate of HBeAg in patients with CHB by using traditional Chinese medicine were better than those by using conventional western medicine,and the differences were statistically significant(P<0.05).Conclusion:1.Liver-gallbladder dampness-heat,liver qi stagnation and spleen deficiency,yin-deficiency dampness-heat,liver qi stagnation,liver kidney yin deficiency and qi stagnation and blood stasis were the main syndromes of CHB.in the aspect of four Qi,drugs for treating CHB were mainly cold,warm and flat.The five flavors were mainly bitter,sweet and pungent and the meridians mainly belonged to liver,spleen and heart meridians.2.The current evidence shows that traditional Chinese medicine can significantly improve the liver function of patients.3.This study summarized the rules of Chinese medicine in the treatment of CHB,evaluated the safety and effectiveness of treatment of CHB by traditional Chinese medicine,provided the basis for further development of standardized treatment scheme of CHB by traditional Chinese medicine,and provided guidance and reference for rational selection of drugs in the clinical treatment of CHB.