| Objective: Objective to evaluate the clinical effect of Tiaogan Huaxian pill combined with entecavir in the treatment of chronic hepatitis B with hepatic fibrosis.Methods: 90 patients were divided into control group(A: 30 cases),control group(B: 30 cases)and treatment group(30 cases).The control group was treated with antiviral entecavir,combined with Fuzheng Huayu capsule,and treatment group with Tiaogan Huaxian Pill on the basis of antiviral.The course of treatment was 24 weeks.The changes of hepatic function(ALT,AST,TBIL,HBV-DNA,ALB),hepatic fiber(HA,PC Ⅲ,Ⅳ-C,LN),liver stiffness measurement(LSM),TCM syndrome score,quality of life and other indexes were observed before and after treatment.Spss20.0 statistical analysis software was used for analysis,chi square test was used for measurement data,χ 2 test was used for comparison of count data,and Kruskal-Wallis test was used for rank data.Results: 1.Evaluation of the comprehensive efficacy of Western medicine: after the observation of the three groups,the total effective rate of the treatment group was 86.67%,significantly higher than that of entecavir group(56.67%)and Fuzheng Huayu group(70.00%).The total effective rate of the treatment group was significantly higher than that of the two groups(P<0.05).2.Evaluation of the results of hepatic function and HBV-DNA negative rate: after the observation of three groups of patients,compared with the two groups of control group,the treatment group was more significant in ALT and AST decline,the difference was statistically significant(P<0.05).There was no significant difference in the negative rate of HBV-DNA between the two groups(P>0.05).It shows that Tiaogan Huaxian pill combined with entecavir has obvious effect on improving ALT and AST,but it has no obvious advantage in improving TBIL,ALB and HBV-DNA negative rate.3.Evaluation of the improvement of hepatic fibrosis results: after the observation of three groups of patients,compared with the two groups of control group,after the treatment group,HA,PCⅢ,Ⅳ-C,LN,LSM decreased more significantly in the treatment group,the difference was statistically significant(P<0.05).It shows that Tiaogan Huaxian pill combined with entecavir has obvious advantages in improving hepatic fibrosis.4.to improve the evaluation of TCM clinical efficacy of patients: after three groups of patients were observed,after treatment,the hepatic fibrosis group and the two groups of control group,the symptom improvement was more significant,the difference was statistically significant(P< 0.05).The total effective rate was 93.33% in Tiaogan Huaxian group,73.33% in entecavir group and 86.67% in Fuzheng Huayu group.The difference was statistically significant(P< 0.05),indicating that Tiaogan Huaxian pill had more advantages in improving clinical symptoms.5.Evaluation of improving the quality of life of the patients: after the observation of the three groups,it was found that the quality of life scores of the three groups were improved,the difference was statistically significant(P<0.05);after treatment,the quality of life scores of the treatment group were(93.90±9.19),the quality of life scores of the two groups were(80.77±10.93)(83.17±8.99),the difference was statistically significant(P<0.05),It shows that Tiaogan Huaxian pill has more advantages in improving the quality of life of patients.Conclusion: 1.Tiaogan Huaxian pill combined with western medicine has a significant clinical effect in the treatment of hepatitis B hepatic fibrosis.It is superior to entecavir and Fuzheng Huayu group in improving hepatic function(AST,ALT,TBIL),reducing hepatic fibrosis index(HA,PCⅢ,Ⅳ-c,LN,LSM).2.In the aspect of comprehensive curative effect of traditional Chinese medicine,Tiaogan Huaxian pill combined with western medicine in the treatment of hepatic fibrosis of hepatitis B has obvious advantages in improving clinical symptoms.The treatment of traditional Chinese and Western medicine can effectively improve the treatment effect and improve the quality of life of patients.3.Through research and analysis,the syndrome of Tiaogan Huaxian pill is summarized as follows:(1)dull pain in the hepatic area;(2)dry mouth and bitter mouth;(3)fatigue;(4)nausea and vomiting;(5)tongue pulse: light or dark tongue,thin and white fur,fat and large tongue body,varicose sublingual veins,teeth marks on the edges,smooth or slow pulse strings.It provides a preliminary basis for the clinical application of Tiaogan Huaxian pill in the future. |
