Efficacy Of Tenofovir Alafenamide Fumarate Combined With Fuzhenghuayu As Treatment For Compensatory Period Of Hepatitis B Cirrhosis In Tibet

Objective: To compare and analyze the efficacy of tenofovir alafenamide fumarate combined with Fuzheng Huayu and tenofovir alafenamide fumarate alone in the treatment of compensatory period of hepatitis B cirrhosis after 48 weeks of treatment in Tibet,objectively evaluate the efficacy and safety of the two groups of drugs,and provide a new scientific idea for the clinical treatment of compensatory period of hepatitis B cirrhosis.Method: This study is a retrospective study.60 patients with compensatory period of hepatitis B cirrhosis.who were admitted to the outpatient Department of infectious diseases,Tibet Autonomous Region People’s Hospital from January 2021 to December 2022 were selected and divided into two groups according to their treatment methods.The observation group receiving tenofovir alafenamide fumarate combined with Fuzheng Huayu treatment included a total of 30 cases.Patients treated with tenofovir alafenamide fumarate alone were the control group.During the treatment period,non-invasive liver fiber examination,liver function,kidney function,blood routine,alpha-fetoprotein,HBV DNA quantification were performed regularly in all patients.Liver stiffness measurement(LSM),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),alpha-fetoprotein(AFP)and HBV DNA(HBV-DNA)were collected before treatment,24 weeks and 48 weeks of treatment.The data were collated to analyze the differences between the two groups during and before treatment.Results:(1)Comparison of LSM between the two groups: at 24 weeks of treatment,there was no significant difference in LSM between the two groups(P =0.08 > 0.05),and at 48 weeks of treatment,there was significant difference in LSM between the two groups(P < 0.01).These results indicated thattenofovir alafenamide fumarate combined with Fuzheng Huayu reduced the level of LSM significantly better than tenofovir alafenamide fumarate alone after 48 weeks of treatment.(2)Comparison of aminotransferase between the two groups: the ALT of the two groups was compared.At 24 weeks of treatment,there were significant differences between the two groups compared with profol tenofovir fumarate(P = 0.008 < 0.05),and at 48 weeks of treatment,there were significant differences in ALT between the two groups(P = 0.035 < 0.05);Compared with AST between the two groups,there was no significant difference in AST between the two groups at 24 weeks of treatment(P = 0.170 > 0.05),and no significant difference in AST between the two groups at 48 weeks of treatment(P = 0.055 > 0.05).These results indicated that after 48 weeks of treatment,tenofovir alafenamide fumarate combined with Fuzheng Huayu was significantly better than tenofovir alafenamide fumarate alone in reducing ALT levels,but there was no difference between the two treatments in reducing AST levels.(3)Comparison of TBIL between the two groups: at 24 weeks of treatment,there was no significant difference in the decrease level of TBIL between the two groups(P= 0.460 > 0.05),and at 48 weeks of treatment,there was no significant difference in the decrease level of TBIL between the two groups(P = 0.362 > 0.05).These results indicated that tenofovir alafenamide fumarate combined with Fuzheng Huayu strengthening and removing blood stasis had no better effect on reducing TBIL than tenofovir alafenamide fumarate alone.(4)Comparison of AFP between the two groups: at 24 weeks of treatment,there was no significant difference in AFP between the two groups(P = 0.492 > 0.05);at 48 weeks of treatment,there was no significant difference in AFP between the two groups(P = 0.894 > 0.05).These results indicated that tenofovir alafenamide fumarate combined with Fuzheng Huayu strengthening and removing blood stasis had no better effect on reducing alpha-fetoprotein than tenofovir alafenamide fumarate alone.(5)Comparison of negative conversion rate of HBV-DNA between the two groups: there was no significant difference in negative conversion of HBV-DNA between the two groups in terms of medication B=0.473 > 0 and P=0.376.After 48 weeks of treatment,HBV-DNA turned negative significantly different from that after24 weeks of treatment,B=1.961 > 0 and P < 0.01.It indicates that the negative conversion rate of HBV-DNA will increase with the extension of treatment time.(6)Comparison of curative effect between the two groups: B=1.256,OR=0.285,P < 0.01,compared with 24 weeks of treatment and 48 weeks of treatment,indicating that the curative effect of 24 weeks of treatment is 28.5% of the curative effect of 48 weeks of treatment,the difference is significant.The treatment method can significantly affect the curative effect.The equal rating B=1.769 > 0 and P=0.01 <0.05.The efficacy of combination therapy was 3.025 times that of single therapy(B=1.769 > 0,OR=3.025,P=0.01 < 0.05).These results indicated that tenofovir alafenamide fumarate combined with Fuzheng Huayu had higher overall efficacy than propofol tenofovir fumarate alone.(7)Adverse reactions of patients in the two groups: No adverse reactions were reported in the two groups.Conclusions: Tenofovir alafenamide fumarate combined with Fua Zheng Hua Yu and removing blood stasis in the compensatory period of hepatitis B cirrhosis is significantly superior to tenofovir alafenamide fumarate alone in terms of reducing LSM level,ALT level,AST and LSM.There is no significant difference between tenofovir alafenamide fumarate combined with Fua Zheng Hua Yu and tenofovir alafenamide fumarate alone in terms of reducing TBIL and AFP and improving the negative conversion rate of HBV-DNA.In terms of the overall therapeutic effect,the observation group was superior to the observation group.There were 2 cases of adverse reactions in the observation group,which were significantly improved after the adjustment of medication time.In general,the combination of tenofovir alafenamide fumarate and Fuzheng Huayu for the treatment of compensatory period of hepatitis B cirrhosis is worthy of clinical recommendation,which can delay the progression of the disease with high safety,and with the extension of the course of treatment,the benefit of patients is more obvious,with high safety,worthy of clinical recommendation.