Observation On The Efficacy Of Sanjie Decoction Combined With Entecavir In The Treatment Of Liver Fibrosis Nodules In Chronic Hepatitis

Purpose:To observe the clinical effect of Sanjie Decoction on patients with chronic hepatitis B liver fibrosis accompanied by small hepatic nodules.It is expected to provide new ideas and methods for the subsequent treatment of intrahepatic nodules.Material and method:The subjects were patients with chronic hepatitis B fibrosis with intrahepatic nodules treated in the outpatient department of Liaoning University of Traditional Chinese Medicine Affiliated Hospital from June 2013 to September 2020.According to the inclusion criteria,60 patients with chronic hepatitis B fibrosis complicated with intrahepatic nodules with complete data of "liver stagnation and blood stasis type" were selected and randomly divided into two groups.Control group(30 cases)received entecavir0.5mg orally once a day for 12 weeks.The treatment group(30 cases)received sanjie Decoction plus or minus,mainly composed of: Turtle shell 30 g,Bupelhu 20 g,Yujin 15 g,Oyster 30 g,Ligusticum chuanxiong 10 g,Radix paeoniae rubra 10 g,Sanleng 15 g,Zedoary turmeric 15 g,luffa gourd 10 g,Angelica 10 g,Xuanshen 10 g,Chinese medicine decoction100 ml orally three times a day,combined with entecavir 0.5mg orally once a day,continuous12 weeks.Changes in the number and size of hepatic nodules,spleen thickness,APRI value,FIB-4 value,liver function(ALT,AST,TBIL,ALB),platelet(PLT)and TCM symptoms were observed before and after treatment in 2 groups,and the efficacy of Sanjie Decoction was systematically evaluated.Results:1.Efficacy indicators: After treatment,the comprehensive efficacy indicators of the treatment group and the control group were 90% and 20%,respectively,and the total effective rate of TCM symptom scores were 90% and 17%,respectively.The overall comparison between the two groups showed that the total efficacy indicators of the treatment group were significantly better.In the control group,the test P<0.01,there is significant statistical significance.2.Imaging indicators: both the treatment group and the control group can reduce the size of intrahepatic nodules and the thickness of the spleen(P<0.01),and the treatment group is better than the control group.However,the control group could not significantly reduce the number of nodules(P>0.05),and the treatment group significantly reduced the number of intrahepatic nodules(P<0.01).3.Serological indicators: the levels of ALT,AST and GGT in serum were significantly decreased in the treatment group(P<0.05),and there was no significant change in the control group before and after treatment;there were differences in ALT and GGT between groups after treatment,P<0.05,indicating that the treatment The curative effect of the group in reducing the levels of ALT and GGT was better than that of the control group.The level of PLT in the treatment group and the control group increased,and there was a difference between the groups after treatment,p=0.000<0.01,indicating that the treatment group could significantly improve the level of PLT.There was no significant difference in ALB and TBIL levels within and between groups,indicating that both groups had no effect on ALB and TBIL levels.4.Serum non-invasive diagnostic model: the level of FIB-4 in the treatment group was significantly decreased(P<0.01),and there was no significant difference in the control group before and after treatment;the APRI level in the two groups could be reduced after treatment(P<0.01),and The curative effect of the treatment group was better than that of the control group(P<0.01).Conclusion:1.Sanjie Decoction significantly improved the TCM clinical symptoms of patients with chronic hepatitis B liver fibrosis complicated with intrahepatic nodules,and had a good comprehensive effect.2.Sanjie Decoction can significantly reduce spleen thickness and the number and size of intrahepatic nodules.3.Sanjie Decoction can reduce the content of ALT and GGT and increase the content of PLT in serum of patients,but has no significant effect on ALB and TBIL.4.Sanjie Decoction significantly decreased APRI value and FIB-4 value in serum of patients with noninvasive diagnostic model,and delayed the progression of liver fibrosis.