Clinical Observation Of Acupoint Application Of Traditional Chinese Medicine Combined With Peginterferon Alfa-2b In The Treatment Of Chronic Hepatitis B With Liver Depression And Spleen Deficiency Syndrome

Objective:To evaluate the effect of acupoint application of traditional Chinese medicine combined with pegylated interferon alfa-2b(Peginterferon alfa-2b)on the quality of life,antiviral efficacy and reversible myelosuppression in patients with chronic hepatitis B(CHB)of liver depression and spleen deficiency syndrome.To investigate whether acupoint application can improve the quality of life of patients in the clinical application of PEG-IFNα-2b in the treatment of CHB and increase its antiviral efficacy to escort the smooth progress of antiviral treatment.Methods:A randomized controlled trial was conducted in this clinical study.The observed patients were recruited from the Liver Disease Center of Xiamen Hospital of Traditional Chinese Medicine from August 2019 to July 2020 and hospitalized CHB patients with liver depression and spleen deficiency syndrome who met the criteria.A total of 100 cases were included and randomly divided into the test group and the control group.50 cases in the test group were treated with PEG-IFNα-2b combined with acupoint application of traditional Chinese medicine,and 50 cases in the control group were treated with PEG-IFNα-2b.The course of treatment in both groups was 24 weeks.The changes of quality of life score,curative effect of traditional Chinese medicine,HBV serological test,HBV DNA,liver function and blood routine at 12 weeks and 24 weeks after treatment were observed and compared between the two groups.The differences of curative effect,antiviral efficacy and abnormal rate of blood routine between the two groups were evaluated.Results:(1)Efficacy of traditional Chinese medicine:The overall response rate of the test group at 12weeks and 24 weeks of treatment(93.6%and 95.7%,respectively)was higher than that of the concurrent control group(68.1%and 72.4%,respectively),and the difference was statistically significant(P<0.05).(2)CLDQ score:Within the group,the CLDQ score at 24 weeks of treatment in the test group was higher than that at 12 weeks of treatment and higher than that before treatment,and the difference had statistical significance(P<0.05);compared with the concurrent control group,the CLDQ score at 12 weeks and 24 weeks of treatment in the test group was significantly higher,and the difference had statistical significance(P<0.05).(3)HBs Ag quantification:There was no significant difference between the test group and the control group at 12 weeks of treatment(P>0.05);at 24 weeks of treatment,the test group was superior to the control group in reducing HBs Ag quantification and increasing HBs Ag≤2×10~4 IU/m L rate(P<0.05).(4)HBe Ag quantification:There was no significant difference in the amount of HBe Ag decrease or the rate of HBe Ag seroconversion between the test group and the concurrent control group at 12 and 24 weeks of treatment(P>0.05).(5)HBV DNA quantification:After 12 weeks and 24 weeks of treatment,both the amount of HBV DNA decrease and the rate of HBV DNA decrease≥2 log IU/m L in the test group were higher than those in the concurrent control group(P<0.05).(6)ALT,AST:There was no significant difference between the test group and the control group at 12 weeks of treatment(P>0.05);at 24 weeks of treatment,the recovery rate of ALT and AST in the test group was higher than that in the control group,and the difference had statistical significance(P<0.05).(7)Blood routine indicators:After treatment for 12 weeks,the test group was superior to the control group in improving the decrease level of NEUT and PLT and reducing the abnormal rate of NEUT and PLT(P<0.05),but had no advantage in WBC;after treatment for 24weeks,the test was superior to the control group in improving the decrease level of WBC,NEUT and PLT and reducing the abnormal rate of WBC,NEUT and PLT(P<0.05).Conclusion:(1)Acupoint application combined with PEG-IFNα-2b is more effective than PEG-IFNα-2b in the treatment of CHB,and can improve the quality of life of patients.(2)Acupoint application combined with PEG-IFNα-2b in the treatment of CHB can significantly reduce HBs Ag quantification,HBV DNA quantification,ALT and AST levels and other indicators,reduce the degree of liver injury,and improve antiviral efficacy.(3)Acupoint application combined with PEG-IFNα-2b antiviral therapy can effectively reduce the occurrence of WBC,NEUT,PLT abnormal rate,reduce the occurrence of interferon reversible myelosuppression and other adverse reactions,play a role in attenuation.(4)Acupoint application combined with PEG-IFNα-2b antiviral therapy revealed no significant adverse effects and had good safety.The treatment of chronic viral hepatitis B with integrated traditional Chinese and western medicine can complement each other,has a synergistic and attenuated effect,and has a broad application prospect,which is worthy of further study.