Clinical Observation Of The Treatment Of Nourishing Kidney And Eliminating Toxicity And Soothing Liver In Chronic Hepatitis B Patients With Anxiety

Objective:1. To compare the clinical curative effect on CHB patients wihout anxiety and CHB patients with anxiety, cvaluate the influence of anxiety on CHB patients；2.To observate the clinical curative effect of the treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver in CHB patient s with anxiety, and explore the advantage of this treatment for CHB patients with anxiety.Methods:Prospeetie study for69patients who accord with inclusion criteria and come from the hepatitis and encephalopathy clinic of the first affilated hospital of Guangzhou university of Chinese medicine in March2011to September2011.First,to score patients with Hamilton Anxiety Scale,CHB patients without anxiety is A group, CHB patients with anxiety is B group.Then divid B group into three groups stochastically,they are B1group(The treatent of Nourishing Kidney and Eliminating Toxi city),B2group (The treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver), B3group (The treatment of Paroxetione.Foundation treatment: Chinese medicine is prescription of Nourishing Kidney and Eliminating Toxicity, Western medicine is Lamivudine.Among them,A group and B1group treated by Foundation treatment,B2gyoup treated by Foudation treatment and the medicine of soothing liver B3group treated by Lamivudine and Paroxetine. The four groups recived therapy last24weeks,and for the following three observation:①To observed the changes of TCM syndrome score,HBV-DNA,ALT,HBeAg of A group.B1group respectively before and after treatment,and compared the differences bewteen two groups after treatment.②To observed the changes of TCM syndrome score,HAMA,HBV-DNA,ALT,HBeAg of B1group.B2group respectively before and after treatment,and compared the di fferences bewteen two groups after treatment.③To observed the changes of TCM syndrome score,HAMA,HBV-DNA,ALT,HBeAg of B2group、B3group respect ively before and after treatment,and compared the differences bewteen two groups after treatment.Results:Chinical observation1:After24weeks treatment,①the TCM syndrome score, HBV-DNA,ALT of A group and B1group are both descend significantly；②the TCM syndrome score of.CHB patients without anxiety is lower than CHB patients with anxiety,but there is no significant differences were observed(P>0.05)；③the ALT of CHB patients without anxiety descended more obviously(P<0.05)；④the HBV-DNA of CHB patients without anxiety is lower than CHB patients with anxiety(P>0.05),but the HBeAg/anti-HBe serum conversion is higher(P<0.05)Clinical observation2:After24weeks treatment,①the TCM syndrome score, HAMA,HBV-DNA,ALT of two groups are both descend significantly:②the TCM syndrome Score and HAMA score of B2group(Nourishing Ki dney and Eliminating Toxicity and Soothing Liver) is lower than B1group(P<0.05):③HBV-DNA and ALT of B2group are lower,and the HBeAg／anti-HBe aerum conversion is higher (P<0.05)Clinical observation3:After24weeks treatment,①the TCM syndrome score, HAMA,HBV-DNA,ALT of two grooups are both descend significantly；②the TCM syndrome score of B2group (the treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver is lower than B3group(treat by Paroxetine)(P<0.05):③HAMA score of B3group is lower than B2group (P>0.05)④HBV-DNA of B2group is lower(P<0.05), also is ALT (P>0.05),HBeAg／anti HBe serum conversion is higher(P>0.05)Conclusion:1.Anxiety block ALT restore and HBeAg/anti HBe serum conversion for CHB patients;2. Both the treatment of Nourishing Kidney and Eliminating Toxicity and the treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver can improved the clinical symptoms of CHB patients obviously, but the curative effect of laster treatment is preferably method for CHB patients with anxiety。 Not only can it remission anxiety symptoms, but also can reduce HBV-DNA quantitation, prompt liver function recovery and HBeAg/anti-HBe serum conversion.3. The treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver is better than Paroxetine in remission TCM symptoms, but Paroxetine is preferably method for resistance to anxiety.4. The treatment of Nourishing Kidney and Eliminating Toxicity and Soothing Liver has obvious advantages in remission TCM symptoms, also has dominance to reduce HBV-DNA quantitation, in addition, it can prompt liver function recovery and HBeAg/anti-HBe serum conversion, with high security.