| ObjectiveTo evaluate the effect of TCM chronic disease management in chronic hepatitis B patients in community,further to achieve regular chronic disease management formation of the chronic hepatitis B chronic disease combinated with TCM theory in community and standardize the clinic diagnosis,treatment and follow-up,to obtain the goal of improving the effect of prevention and treatment of chronic hepatitis B patients in community,then to provide scientific basis for promotion of TCM chronic disease management in chronic hepatitis B patients in community.MethodsBy using non-randomized case control study,84 HBeAg positive CHB patients who participated in healthy check-up of follow-up and according to the standard of anti-virus in Tianhe district,Guangzhou from 2014 to 2016 were selected.According to the order of entries they were divided into two cohorts:Group TCM chronic disease management and Control Group.Control group:Anti-viral treatment plus conventional education.Group TCM chronic disease management:based on the control group,TCM chronic disease management was added.Both groups are followed up every 12 weeks,the course is 48 weeks.After treatment,the incidence of ALT recurrence rate,HBV DNA negative rate,antigen serology conversion rate,the change of TCN clinical syndromes and quality of life were observed.Results1.Baseline:84 patients were enrolled in this study,42 patients each group,no significance can be seen from gender distribution,age distribution,degree of education,marriage,family hepatic history,constitution distribution,course of disease,ALT,level of HBV DNA and HBeAg(P>0.05).After 24 week' s follow-up,1 patient fell off due to abroad in Group TCM chronic disease management.4 patients dropped out of this study in control group including two were non-compliant patients and two cases lost contact.At last,79 patients were included,including 41 patients in Group TCM chronic disease management and 38 in control group.2.Effect evaluation(1)The comparison in biochemical responses between two groups:After 12-week treatment,the incidence of hepatic recurrence rate in Group TCM chronic disease management is 37.14%,higher than 27.78%in control group,the difference was not statistically significant(P>0.05)At the end of 24 weeks,the incidence of hepatic recurrence rate in Group TCM chronic disease management is higher than that in control group(57.14%vs 33.33%),significant differences could be seen between the two cohorts(P<0.05).After 36 week treatment,the incidence of hepatic recurrence rate in Group TCM chronic disease management is 68.57%,higher than 55.55%in Control group,the difference was not statistically significant(P>0.05).At the end of 48 weeks,the incidence of hepatic recurrence rate in Group TCM chronic disease management is higher than that in control group(80.00%vs 72.22%),which is not statistically significant(P>0.05).(2)The comparison in serology between two groups:After 24 week treatment,Group TCM chronic disease management achieved 9.52%in antigen serology conversion rate,higher than 7.14%in control group,however,the difference was not statistically significant(P>0.05).At the end of 48 week,Group TCM chronic disease management achieved 29.27%,higher than 18.42%in control group,the difference between cohorts were not statistically significant(P>0.05)(3)The comparison in virology between two groups:In HBV DNA negative rate,after 24weeks and 48 week treatment,group TCM chronic disease management achieved 59.52%and 73.17%,which were both higher that those in control group(52.38%and 68.42%).however,the difference between groups were not statistically significant(P>0.005)(4)The comparison in symptom improvement between two groups:In comparison of the therapeutic effect of TCM syndrome,at the end of 48 weeks,the total effective rate was 95.12%in group TCM chronic disease management,higher than 55.26%in control group.The integral of TCM clinical syndrome was 3.66 ± 1.92,lower than 6.42±2.48 in control group,significant differences could be seen between the two cohorts(P<0.05).In cohort TCM chronic disease management easing the patients' symptoms and to decreasing integral of clinical symptoms were obviously better than the control group(P<0.05).(5)The comparison in quality of life between two groups:In quality of life,after 48 weeks,the total score of SF-36 scale in two groups increased compare to the baseline,the total score of SF-36 scale in group TCM chronic disease management was 550.75±54.24,which was higher than that in control group which total score of SF-36 scale was 491.08±54.21,the difference was statistically significant(P<0.05).Compare to control group,in way of role limitation because of physical problem(RP),role limitation caused by emotional problem emotional(RE),mental health(MH),physical component summary(PCS)and mental component summary(MCS),each score was higher that in another group,the difference between groups were statistically significant(P<0.05).ConclusionTCM chronic disease management mode can enhance the effect of anti virus and obviously improve the TCM clinic symptoms and quality of life,which deserve to be promoted in community. |
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