Clinical Observation Of Jiedu Tongli Prescription Combined With Western Medicine In The Treatment Of Chronic Hepatitis B With Damp-heat Jaundice

Objective:To investigate comprehensively the clinical efficacy of Jiedu Tongli prescription combined with western medicine in the treatment of chronic hepatitis B with damp-heat jaundice,and to observe the safety of Jiedu Tongli prescription.Methods:From January 2018 to June 2019,patients diagnosed as chronic viral hepatitis B who were hospitalized or outpatient in Hainan Hospital of Traditional Chinese Medicine(Hainan Hospital of Traditional Chinese Medicine)affiliated to Guangzhou University of Traditional Chinese Medicine.The subjects included in this project were randomly divided into two groups:the Chinese and Western medicine group(treatment group)which contained 78 cases and the Western medicine group(control group)which contained 78 cases.Finally,the patients completed the study there were 76 cases in the chinese and western medicine group(treatment group)and 75 cases in the western medicine group(control group).The treatment group was treated with Jiedu Tongli prescription combined with western medicine,while the control group was treated with western medicine alone.The patients were followed up for 3 months after treatment.The improvement of TCM syndromes was assessed by TCM syndrome score.The TCM syndromes were evaluated before treatment,2 weeks after treatment,4 weeks after treatment and follow-up for 3 months.Total bilirubin(T-BIL),direct bilirubin(D-BIL),total bile acid(TBA),glutamic oxaloacetic transaminase(AST),glutamic pyruvic transaminase(ALT)and glycocholic acid(CG)were used to evaluate the improvement of liver function.The various indexes were measured before treatment,2 weeks after treatment,4 weeks after treatment and follow-up for 3 months.Hepatitis B virus DNA quantification(HBV DNA)was used to evaluate the frequency of the virus.HBV DNA markers were measured before treatment and follow-up for 3 months.Results:There was no significant difference in age,sex and duration between the two groups(P>0.05).There was no significant difference in TCM syndrome scores between the two groups before treatment(P>0.05).There was no significant difference in TCM syndrome score between the treatment group and the control group after 2 weeks of treatment(P>0.05).The TCM syndrome score of the treatment group was lower than that of the control group after 4 weeks of treatment and 3 months of follow-up(P<0.01).After 2 weeks of treatment,after 4 weeks of treatment and 3 months of follow-up,the scores of TCM syndromes were significantly different from those before treatment(P<0.01).After 4 weeks of treatment,there was significant difference in the curative effect of TCM syndromes between the treatment group and the control group(P<0.05).There was no significant difference in liver function indexes(T-BIL,D-BIL,TBA,AST,ALT,CG)between the two groups before treatment(P>0.05).After 2 weeks of treatment,T-BIL,D-BIL,TBA,AST and ALT in the treatment group were lower than those in the control group(P<0.05 ?0.01),but there was no significant difference in CG(P>0.05);liver function indexes(T-BIL,D-BIL,TBA,AST,ALT,CG)in the treatment group were lower than those in the control group after 4 weeks of treatment and 3 months of follow-up(P<0.01).There were significant differences in liver function indexes(T-BIL,D-BIL,TBA,AST,ALT,CG)after 2 weeks of treatment,4 weeks of treatment and 3 months of follow-up compared with those before treatment(P<0.05 ? 0.01).After 3 months of follow-up,the negative rate of HBV DNA in treatment group was 36.8%,which was significantly higher than that in the control group which was 21.3%(P<0.05).Conclusion:There are satisfied improvement of TCM syndromes,liver function and HBV DNA in Jiedu Tongli prescription combined with Western Medicine in the treatment of patients with chronic hepatitis B with damp-heat jaundice,and the safety is good.