Clinical Observation Of Entecavir Combined With Gan Ning Fang On Hepatic Fibrosis In Chronic Hepatitis B

Objective: To evaluate the clinical efficacy and safety of entecavir by observing it’s clinical efficacy combined with traditional Chinese medicine Gan Ning Fang on hepatic fibrosis in chronic hepatitis B,and try to discusse and explaine their mechanism of action on hepatic fibrosis in chronic hepatitis B preliminarily,then seek an effective method of integrated traditional Chinese and western medicine to prevent and treat on hepatic fibrosis and reduce the incidence of cirrhosis.Methods: 90 cases of standard chronic hepatitis B patients with liver fibrosis were randomly divided into 3 groups according to the random number table method: Integrated traditional Chinese and western medicine treatment group(A group),western medicine control group(B group)and TCM control group(C group),and 30 cases in each group.A group were received entecavir dispersible tablets 0.5mg/d orally,and taking the Gan Ning Fang;while B control group patients were given only entecavir dispersible tablets 0.5mg/d orally,C control group were given only Gan Ning Fang.Pretreatment of 3 groups patients were given liver protection enzyme therapy,and their treatment course was 6 months.The scale of the three groups of patients were used to evaluate the psychological status,social function and TCM syndrome scores before and after treatment,and three groups of basic demographic data were collected.Biochemical indicators(virology,liver function and liver fibrosis four items)before and after treatment,the incidence of liver cirrhosis,safety factors and adverse reactions were compared and analyzed.SPSS19.0 statistical software was used to compare the data of each index.Measured data were expressed as mean±standard deviation.The comparison of two means was t-test.P<0.05 indicated that the difference was statistically significant.Results: 1.Comparison of improvement in mental status: comparisons within grou Ps: the scores in various fields of the 3 groups were lower than those before the treatment,and the difference was statistically significant(P<0.05);comparison between groups: compared with western medicine control group and/or TCM control group,the effect of integrated traditional Chinese and western medicine treatment group on improving the mental status was obvious,and the difference was statistically significant(all P<0.05).2.Comparison of improvement in Social Function Scores(SDSS total scores): comparisons within groups: the SDSS total scores of the 3 groups were lower than those before the treatment,and the difference was statistically significant(P<0.05);comparison between groups: compared with western medicine control group and/or TCM control group,the effect of integrated traditional Chinese and western medicine treatment group on improving the social function was obvious,and the difference was statistically significant(all P<0.05).3.ComParison of improvement in TCM Syndrome Scores: in the aspect of TCM symptom curative effect,by X2 test,the cure rate(recovery+ effective)of three groups was significantly different(X2=13.441,P=0.001 <0.05),among the 3 groups of patients,integrated traditional Chinese and western medicine treatment group had the most significant effect on improving the TCM symptoms.4.Comparison of improvement in liver tissue fibrosis staging(Ishak scoring system)efficiency: in the main biochemical indicators: comparisons within groups: the main biochemical indicators of the 3 groups were significantly improved than those before the treatment,and the difference was statistically significant(P<0.05);comparison between groups: compared with western medicine control group and/or TCM control group,the effect of integrated traditional Chinese and western medicine treatment group on improving the main biochemical indicators was obvious,and the difference was statistically significant(all P<0.05).In the stage of liver fibrosis effect: by X2 test,the cure rate(recovery+effective)of three groups was significantly different(X2=6.473,P=0.039<0.05),among the 3 groups of patients,integrated traditional Chinese and western medicine treatment group had the most significant effect on improving the liver tissue fibrosis staging.5.Comparison of improvement in type-B ultrasonic classification efficiency: by X2 test,the cure rate(recovery+effective)of three groups was significantly different(X2=7.401,P=0.025<0.05),among the 3 groups of patients,integrated traditional Chinese and western medicine treatment group had the most significant effect on improving the type-B ultrasonic classification.6.Comparison of improvement in Fibro Scan efficient: by X2 test,the cure rate(recovery+effective)of three groups was significantly different(X2=6.547,P=0.038<0.05),among the 3 groups of patients,integrated traditional Chinese and western medicine treatment group had the most significant effect on improving the Fibro Scan efficient.Conclusions: Entecavircombined with Gan Ning Fang on hepatic fibrosis in chronic hepatitis B has good overall efficacy and reliable safety,it could significantly improve the general condition,clinical symptoms and indicators of liver fibrosis of patients,and delay or even block the development of hepatic fibrosis to cirrhosis;it cloud also achieve comprehensive consideration and dialectical treatment by combining the advantages of TCM and western medicine,provide an unprecedented clinical train of thought for development and application of new Chinese medicine and ethnical medicine and the prevention and treatment of chronic hepatitis B liver fibrosis to cirrhosis development.Therefore,it can be popularized in clinical application.