Clinical Study Of Jiawei Gexia Zhuyu Granule In The Treatment Of Hepatitis B Cirrhosis In Compensated Stage(Blood Stasis Blocking Collateral Type)

Objective:To observe the clinical efficacy of Jiawei Gexia Zhuyu Granules in the treatment of hepatitis B cirrhosis in the compensated stage(blood stasis blocking collateral type),and to evaluate its efficacy and safety.Methods:A total of 64 patients who met the inclusion criteria were collected.According to the principle of randomization and control,64 patients were randomly divided into the control group and the treatment group according to the ratio of 1:1,with 32 cases in each group.The two groups were treated with Entecavir Capsules combined with Jiawei Gexia Zhuyu Granules.The treatment course of both groups was 24 weeks.Liver function,four items of serum liver fibrosis,liver stiffness,abdominal color Doppler ultrasound(portal system),and traditional Chinese medicine were observed and recorded before and after treatment.Syndrome scores and changes in serological model(APRI,GPR)indices were used to evaluate its efficacy and safety.Results:(1)Clinical efficacy of traditional Chinese medicine: after 24 weeks of treatment,the symptoms of flank stinging pain and accumulation under the flank in the treatment group were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.05).The total effective rates in the control group and the treatment group were 68.75%and 87.50%,respectively,and the effective rate in the treatment group was higher than that in the control group(P<0.05).In terms of TCM syndrome scores: the symptoms of the two groups were improved compared with those before treatment(P<0.05),and the improvement degree of the treatment group was better than that of the control group(P<0.05).(2)Liver function(ALT、AST): after 12 weeks and 24 weeks of treatment,the liver functions(ALT and AST)of the two groups were decreased compared with those before treatment(P<0.05);the improvement of ALT and AST in the treatment group was significantly higher than that in the control group(P<0.05).(3)In terms of liver fibrosis indicators(serum liver fibrosis four items,liver stiffness value): after 12 weeks and 24 weeks of treatment,the serum liver fibrosis four items and liver stiffness value(LSM)indicators of the two groups of patients were better than those after treatment.The improvement of serum liver fiber four items and LSM in the treatment group was significantly higher than that in the control group(P<0.05).(4)Regarding the negative conversion of HBV-DNA: after 24 weeks of treatment,the negative conversion rates of HBV-DNA in the control group and the treatment group were 80% and 92.3% respectively.(P<0.05);There was no significant difference in the HBV-DNA negative conversion between the treatment group and the control group(P>0.05).(5)For liver hemodynamics: after 24 weeks of treatment,there was no significant difference in the improvement of spleen thickness and portal diameter between the treatment group and the control group,and there was no statistical significance in the test(P>0.05);the portal flow velocity in both groups were improved compared with before,and the improvement in the treatment group was more obvious than that in the control group(P<0.05).(6)Regarding serum fibrosis APRI and GPR indexes: after 24 weeks of treatment,APRI and GPR indexes of both groups were decreased compared with before(P<0.05);and the degree of decrease of APRI and GPR indexes in the treatment group was more obvious than that in the control group(P<0.05).Conclusions:1.The clinical efficacy of Jiawei Gexia Zhuyu Granules combined with Entecavir Capsules in the treatment of patients with hepatitis B cirrhosis due to blood stasis is better than that of Western medicine alone,and can improve liver function(ALT,AST),serum liver fibrosis,GPR Index,APRI index and other related indicators,reduce the liver stiffness value,improve the level of portal vascular hemodynamic parameters(portal flow velocity),effectively improve the patient’s intrahepatic microcirculation disorder,and delay the progression of liver cirrhosis.2.Modified Gexia Zhuyu Granules can effectively improve the clinical symptoms,signs and TCM syndrome scores of patients with hepatitis B cirrhosis due to blood stasis blocking collaterals,with good curative effect,good safety,and no obvious adverse reactions.