The Clinical Study Of Shugan Jiedu Decoction Combined With Entecavir In The Treatment Of Chronic Hepatitis B With Liver Depression And Spleen Deficiency Type

Objective: To observe the improvement of liver function index,HBe Ag conversion rate,HBV DNA negative conversion rate and TCM syndrome points in patients with chronic hepatitis B liver depression and spleen deficiency type by Shugan Jiedu decoction combined with entecavir,and to evaluate the efficacy of Shugan Jiedu decoction combined with entecavir in the treatment of chronic hepatitis B liver depression and spleen deficiency type.Methods: Choice in October 2016 to January 2018 in Chengdu university of traditional Chinese medicine hospital infection branch clinics,TCM syndrome type belong to liver depression and spleen deficiency type of 70 patients with chronic hepatitis B,were randomly divided into control group and trial group,each group of 35 cases patients of oral entecavir capsule 0.5 mg,once per day,at the same time take the Shugan Jiedu decoction,fried 300 ml water,100 ml,middle-late three points before taking half an hour after dinner.In the control group,entecavir capsules were taken orally 0.5mg once a day.Control group and trial group were treated for 48 weeks.The clinical effect of Shugan Jiedu decoction combined with entecavir on the improvement of liver function index(ALT?AST?AKP?GGT?TBIL),HBe Ag conversion rate,HBV DNA negative conversion rate and TCM syndrome score of chronic hepatitis B was evaluated.Results: 1.Liver function(ALT,AST,GGT,AKP,TBIL): ALT,AST,TBIL decreased after 12 weeks,24 weeks and 48 weeks of treatment in the two groups compared with that before treatment,P < 0.05 in the two groups,and the difference was statistically significant.At 12,24 and 48 weeks of treatment,ALT,AST and TBIL were compared between the two groups,and the difference was statistically significant(P < 0.05).GGT of the two groups was lower after treatment than before treatment,P < 0.05.GGT was compared between the two groups at 12 weeks of treatment,and the difference was not statistically significant(P > 0.05).GGT was significantly different between the two groups at 24 and 48 weeks(P < 0.01).After 12 weeks,24 weeks and 48 weeks of treatment,AKP in the two groups was lower than that before treatment,P < 0.05 in the group,and the difference was statistically significant.At 12,24 and 48 weeks of treatment,there was no significant difference in AKP between the two groups(P > 0.05).2.In terms of ALT recurrence,the recurrence rate of the control group was 64.7%,and that of the experimental group was 88.2% at 48 weeks.Statistical analysis showed that the difference was statistically significant(P<0.05).This indicated that the trial group had a significant advantage over the control group in the recovery of ALT.3.HBe Ag conversion rate: at 24 weeks of treatment,the conversion rate of HBe Ag in the control group was 8.8%,while that in the trial group was 29.4%.Statistical analysis showed that the difference was statistically significant(P<0.05).At 48 weeks of treatment,the conversion rate of HBe Ag was 14.7% in the control group and 38.2% in the trial group.This indicated that the trial group had an obvious advantage over the control group in the HBe Ag conversion rate.4.HBV DNA negative conversion rate: at 24 weeks of treatment,the HBV DNA negative conversion rate was 61.8% in the control group and 85.3% in the trial group,with statistical credits P<0.05.At 48 weeks of treatment,the HBV DNA negative conversion rate was 70.6% in the control group and 91.2% in the trial group,with statistical analysis P<0.05.This indicated that the trial group had an obvious advantage over the control group in the aspect of HBV DNA negative conversion.5.TCM syndrome score: both groups could significantly improve the overall TCM syndrome of patients after treatment,and the control group and the trial group were better than before treatment after 12 w,24w and 48w(P<0.05).After 12 w,24w and 48 w treatment,the improvement of TCM syndromes in the trial group was significantly better than that in the control group(P<0.01).6.Effective rate: the comparison of the effective rate of two groups of traditional Chinese medicine showed that P<0.05,the difference between the groups was statistically significant,the trial group was higher than the control group.7.Safety: no drug-related adverse reactions occurred in the control group and the trial group during the 48-week treatment course,and no abnormalities were found in blood routine,renal function,stool routine,urine routine,electrocardiogram,chest X-ray and other safety indicators.Conclusion: Shugan Jiedu decoction combined with entecavir in the treatment of chronic hepatitis B with liver depression and spleen deficiency type has positive efficacy,good safety and better efficacy than entecavir alone.