| BackgroundChronic hepatitis B is an infectious disease caused by the hepatitis B virus. It is one of the major diseases which do harmful to health of human all over the world. About100million people worldwide die from liver failure, cirrhosis and hepatocellular carcinoma which are caused by HBV infection each year. Our country is endemic areas of HBV infection.The number of patient with hepatitis B surface antigen is approximately93million, the rate of the patient aged1to59with hepatitis B surface antigen carrier is7.18%. In recent years with the findings of antiviral drugs, the treatment of chronic hepatitis B get some breakthrough, but there are still relapse, the virus mutates, the high cost of treatment and other shortcomings after antiviral treatment. Therefore to find a safe and effective treatment method is important, how to improve the clinical effect become a research hotspot. In recent years, studies have shown that the clinical effect of Chinese medicine for chronic hepatitis B is indeed reliable. Some advantages and potentials reflected in the following aspects reversing liver fibrosis, anti-hepatitis B virus, reducing inflammation, protecting the liver cells, reducing transaminase, reducing bilirubin, improving protein metabolism, improving clinical symptoms and adjusting the immune function.Professor Naili Yao engaged in clinical research on digestive diseases for years.Study on the basis of the clinical experience of previous doctor, combined with his clinical practice, he did the theoretical and clinical research on the aspects as follow:risk factors, Syndrome regular and Pathogenesis of chronic hepatitis, liver fibrosis and cirrhosis. He has accumulated rich clinical experience and achieved good clinical efficacy in the treatment of chronic liver disease with TCM.PurposeTo summarize the clinical experience of Professor Naili Yao in the treatment of chronic hepatitis B, such as the basic understanding of pathogenesis, dialectical thinking and treatment, is to inherit academic thought of famous doctors of traditional chinese medicine better. While observing the clinical effect in patients with chronic hepatitis B by using formula with the fuction of harmonizing liver and spleen as well as resolving toxin and freeing network vessels, is to verify the effectiveness and practicality of his clinical experience. Summarizing the clinical experience in the treatment of Professor Naili Yao of chronic hepatitis B is to spred the clinical experience of famous doctors of traditional chinese medicine, to provide learning material among young doctors and the doctors in lower hospital, to highlight the advantages in the treatment of chronic hepatitis B with chinese medicine, to improve the clinical efficacy in the treatment of chronic hepatitis B with chinese medicine, to relieve pain for patients better.MethodThrough collecting outpatient medical records of the patients with chronic hepatitis B, doing Interview of professor Yao Naili, following him and recording the learning notes to study his clinical experience. By using the method of prospective self-control we did clinical observation in60cases of chronic hepatitis B patients.The course is6months. Using the formula with the fuction of harmonizing liver and spleen as well as resolving toxin and freeing network vessels to treat the patient, observed and recorded the clinical symptoms and signs, liver function, HBV DNA and related safety indicators respectively before treatment, treatment for3months, treatment for6months,3months after treatment.Then using the SPSS18.0statistical analysis software to analyze data, to evaluate its curative effect.ResultThe paper summarizes the clinical experience of the Professor Yao in treating chronic hepatitis B. In the understanding of the etiology and pathogenesis, Professor Yao describe the basic pathogens is"Liver stagnation and spleen deficiency, blood stasis,damp heat and epidemic toxin residues to damage liver collaterals". The damp heat and epidemic toxin is the promoter and continuous factors of the disease; The damage of the network vessel of liver is the key of the pathogenesis of the disease; the spleen disease after liver disease is the inevitable evolution mechanism of this disease. Combination of disease differentiation and syndrome differentiation to treat disease is one of the character of his clinical experience, the other one is to prevent disease from exacerbating.Harmonizing liver and spleen as well as resolving toxin and freeing network vessels is the basic treatment, combined with syndrome differentiation.Using the formula with the function of harmonizing liver and spleen as well as resolving toxin and freeing network vessels to treat chronic hepatitis B, can continue to improve symptoms and signs of the patient, promote the recovery of liver function. At the same time,the fomula can improve HBV DNA negative conversion. In the aspect of the improvement of symptoms, treatment for3months,6months,3months of follow-up, compared to the overall score on the baseline before treatment, there were statistically significant(P<0.01). After treatment for6months, except the signs of enlargement of liver and spleen, spider nevus and liver palms was not statistically significant, on the other symptoms and signs, there were statistically significant (P<0.01). The result shows that the method can improve the most symptoms of patients. In the improvement of liver function, the method of harmonizing liver and spleen as well as resolving toxin and freeing network vessels can reduce the ALT, AST, TBIL, GGT levels, the treatment for3months,6months, and3months follow-up, compared to the baseline before treatment, were statistically significant (P<0.01), and after treatment for3months,6months, and3months follow-up compared with baseline, statistically significant improvement in ALB (P<0.05); in the recovery rate of ALT,3months after treatment.The recovery rate of ALT was36.51%,6months treatment, the recovery rate of ALT was55.56%, in3months of follow-up, the recovery rate of ALT was60.32%.In the HBV DNA negative conversion rate, in14cases of HBeAg positive andHBV DNA≥1.00e+05patients, using the treatment for6months and3months of follow-up, the DNA negative rate was14.28%, in7cases of HBeAg positive and1.00e+05> HBV DNA≥1.00e+03patients. Using the treatment for6months and3months follow-up,the DNA negative rate was42.85%. In6cases of HBeAg negative and HBV DNA≥1.00e+04patients, the DNA negative rate was33.33%; in36cases of HBeAg negative and1.00e+04>HBV DNA≥HBV≥1.00e+03,6months treatment, the DNA negative rate was41.67%, and3months follow-up, the DNA negative rate was47.22%. ConclusionProfessor Yao use traditional Chinese medicine to treat chronic hepatitis B. His clinical experience has distinctive characteristics in the aspects of understanding of etiology and pathogenesis, diagnosis and treatment.Using the method of harmonizing liver and spleen as well as resolving toxin and freeing network vessels to treat of chronic hepatitis B, the clinical curative effect is reliable. |
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