| Objective:Spleen hyperactivity(hypersplenism),referred to as Spleen hyperthyroidism,is one of the serious complications of portal hypertension during decompensated cirrhosis.Patients may suffer from obvious blood cell reduction,spleen enlargement,palpitations,dizziness and other symptoms,causing anemia,bleeding and other complications,increasing the risk of hemodynamic changes,aggravate hepatic fibrosis,and the condition of patients with cirrhosis,but also increase the difficulty of treatment.At present,the main methods of surgical treatment of spleen hyperactivity by western medicine are splenectomy,interventional therapy,etc.But the surgical trauma can be severe,there are many risks of postoperative complications,and the effect of spleen resection on the patient's immune system cannot be ignored.The purpose of this project is to observe the clinical symptoms and changes of blood cell number,prothrombin activity,liver function,portal vein width,and the thickness of spleen in patients with hepatitis B cirrhosis before and after treatment by Yiqi Jiedu Tongluo method combined with Entecavir.To verify the efficacy and advantages of this method in the treatment of hepatitis B cirrhosis spleen hyperactivity.Methods:The subjects of this study were patients with hepatitis B cirrhosis and spleen hyperactivity that are treated at Dongzhimen Hospital from December 2017 to January 2019.A total of 32 cases,all using Yiqi detoxification Tongluo method along with entecavir for 12 months.Recording the changes of blood routine,liver function,liver ultrasound and then compare the TCM syndrome before and after treatment,and the statistical data were statistically analyzed by SPSS 22.0 statistical analysis software.Results:(1)After 12 months of treatment,the symptom of fatigue was decreased(P<0.01),abdominal distension,daze,pain,skin itching and epistaxis symptoms were decreased(P<0.05),the reduction of the symptoms of the body was significant(P<0.01).Liver disease face,liver palm,scaly dry skin and the hepatomegaly of splencmegaly were the same(P>0.05)(2)After the treatment,the WBC and PLT in blood routine were not increased(P>0.05).The RBC has increased(P<0.05).(3)The indexes in liver function before and after treatment were significantly better than before(P<0.01).(4)The coagulation function of 6 months is better than before(P<0.05).Compared with 6 months of treatment,the coagulation function was not further improved(P>0.05),and there was no significant improvement in PT and PTA numbers before and after the treatment(P>0.05),and there was no statistical difference during these 12 months.(5)The indexes of spleen thickness and portal vein width decreased after the treatment,and the difference was statistically significant(P<0.05).(6)APRI scores decreased before and after treatment(P<0.05).(7)The HBV-DNA positive and negative ratio were different before and after treatment(? 2=11.093,P<0.05),and the HBV-DNA negative conversion rate was 73.68%Conclusion:Yiqi Jiedu Tongluo method combined with Entecavir is effective in the treatment of hepatitis B cirrhosis with spleen hyperactivity,which can effectively improve liver function,increase the number of red blood cells,reduce portal vein pressure,reduce spleen enlargement and decrease the Amino transferase-Platelet Ratio Index(APRI)of aspartic acid,etc.Although the increase on leukocytes and platelets is not obvious,further study can be made with larger sample and longer observation time.Yiqi Detoxification Tongluo Method provides a new idea for clinical treatment of hepatitis B cirrhosis with spleen hyperactivity. |
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