Efficacy of Wuling Capsules on liver fibrosis with liver depression,spleen defiency and blood stasis type B hepatitis
Objective To explore the efficacy and safety of Wuling Capsules in treating liver fibrosis of hepatitis B with liver depression,spleen deficiency,and blood stasis type.Methods The patients who were admitted to Xi'an Eighth Hospital during May 2020 and May 2022 and met the inclusion and exclusion criteria were screened,and they signed the informed consent form.90 patients were randomized into 3 groups with different intervention regimens.Group A was treated with nucleotide analogues alone,including Entecavir Capsules or/and Tenofovir Disoproxil Fumarate Tablets,taken as required.Group B was treated with Wuling Capsules,5 capsules at a time,3 times a day,half an hour after meals.Group C was treated with Wuling Capsules combined with nucleotide analogues.The indexes were compared among groups,including traditional Chinese medicine(TCM)syndrome score,liver stiffness measurement(LSM),fibrosis 4 score(FIB-4),hyaluronic acid(HA),type Ⅲ procollagen(PCⅢ)and type Ⅳ Collagen(Ⅳ-C),liver function,alanine transaminase(ALT),aspartate transaminase bilirubin(TBiL),alkaline phosphatase(ALP),glutamyl transpeptidase(GGT),HBV DNA,and the images of ultrasound and electrocardiogram,etc..The changes of symptoms and related outcomes before and after treatment in each group were compared,and the safety was evaluated under the requirement of the Internal Ethics Committee of Xi'an Eighth Hospital.Results After 24 weeks of treatment,the TCM syndrome score of group C patients decreased from(19.25±6.12)points to(7.12±2.32)points,the LSM decreased from(13.2±2.48)kPa to(5.24±3.14)kPa,and the FIB-4 value decreased from(2.67±0.94)to(1.72±0.84),significantly better than group A and group B(P<0.05).The HA decreased from(126.42±64.28)ng·mL-1 to(66.72±21.26)ng·mL-1,PC Ⅲ decreased from(25.42±10.67)ng·mL-1 to(12.39±5.62)ng·mL-1,Ⅳ-C decreased from(109.78±30.4)ng·mL-1 to(65.70±16.26)ng·mL-1,LN decreased from(118.72±30.34)ng·mL-1 to(71.12±10.42)ng·mL-1,and the improvement was significantly better than that of Group A and Group B(P<0.05).The liver function of all 3 groups of patients improved significantly.The serum ALT of group C decreased from(86.13±16.72)U·L-1 to(36.68±14.25)U·L-1,AST decreased from(49.65±9.85)U·L-1 to(31.34±8.45)U·L-1,and ALP decreased from(104.69±13.28)U·L-1 to(62.53±9.56)U·L-1,with significant improvement compared with group A and group B(P<0.05).The HBV DNA of patients in Group C and Group A decreased significantly compared with before treatment,with no statistically significant difference between the 2 groups(P>0.05),but the both groups were significantly better than Group B(P<0.05).The inner diameter of the portal vein in Group C decreased from(13.21±1.11)mm to(10.85±0.68)mm,the inner diameter of the splenic vein decreased from(8.42±1.36)mm to(5.86±0.62)mm,the length of the spleen decreased from(126.45±3.26)mm to(114.21±4.15)mm,and the thickness of the spleen decreased from(45.13±2.19)mm to(38.24±1.46)mm.Conclusion For patients with hepatitis B liver fibrosis,Wuling Capsules with nucleoside analogues therapy can improve the clinical efficacy,improve the clinical symptoms,and reduce the TCM syndrome score.Wuling Capsules can reverse hepatic fibrosis by reducing the related indexes of hepatic fibrosis with high safety.
Wuling Capsuleshepatitis Bchronicliver fibrosisliver function
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