The Efficacy and Mechanism of Xuefu Zhuyu Decoction Combined with Tenofovir Dipyrfurate Fumarate Tablets in The Treatment of Liver Depression and Blood Stasis Type Hepatitis B Cirrhosis

2021 ◽  
Vol 7 (6) ◽  
pp. 6402-6409
Author(s):  
Wangyi Xuan ◽  
Zhou Jin ◽  
Yi Qiu ◽  
Qiao Chen ◽  
Zhujun Wu ◽  
...  

Background: Cirrhosis is a chronic progressive liver disease. Hepatocyte injury leads to liver dysfunction. At present, antiviral drugs are mainly used to inhibit the replication of hepatitis virus to block liver fibrosis. Tenofovir disoproxil fumarate is a novel nucleotide reverse transcriptase inhibitor, which can eliminate hepatitis B virus and control the deterioration of chronic hepatitis B. Objective To investigate the efficacy and mechanism of Xuefu Zhuyu Decoction combined with tenofovir disoproxil fumarate tablets in the treatment of hepatitis B cirrhosis of liver depression and blood stasis. Methods A total of 150 patients with hepatitis B cirrhosis who were treated in our hospital from January 2019 to June 2021 with the dialectical type of "liver stagnation and blood stasis" were selected and divided into groups according to their treatment plan. 75 cases in the control group were given Fu Tenofovir disoproxil marate tablets were treated, and 75 patients in the observation group were treated with Xuefu Zhuyu Decoction combined with tenofovir disoproxil fumarate tablets. Count the total effective rates and adverse reactions of the two groups, record the scores of TCM syndromes, liver hemodynamics, fibrosis, liver function, hepatitis B virus deoxyribonucleic acid (HBV-DNA), MMP1, TIMP1, TIMP1/MMP1 changes. Results The curative effect of the observation group was higher than that of the control group, which was statistically significant (P<0.05). Compared with before treatment, the portal vein flow rate (PW) and intrahepatic circulation time (HV-HA) of the two groups increased (P<0.05), the portal vein congestion index (PV-CI) decreased (P<0.05), and the portal vein diameter (PVD) Compared with before treatment, the difference was not statistically significant (P>0.05). After treatment, PW and HV-HA in the observation group were higher than those in the control group (P<0.05), and PV<I was lower than that in the control group (P<0.05). Compared with the control group, the difference was not statistically significant (P>0.05). Compared with before treatment, the scores of the two groups of chest and hypothermia distended, abdominal distension, mental fatigue, depression, irritability, and amitrati decreased (P<0.05). The scores of TCM syndromes of the observation group were lower than those of the control group (P<0.05). P<0.05). Compared with before treatment, the two groups of matrix metalloproteinase 1 (MMP1) increased (P<0.05), laminin (LV), type IV collagen (IV-C), type III procollagen (PCIHT, hyaluronic acid (P<0.05) HA), tissue inhibitor of matrix metalloproteinase 1 (TIMP1), TIMP1/MMP1, alanine aminotransferase (ALT), aspartate aminotransferase (AST), HBV-DNA decreased (P<0.05), observe After treatment, MMP1 in the group was higher than that in the control group (P<0.05), and fibrosis indexes, liver function indexes, TIMP1, TIMP1/MMP1, and HBV-DNA were lower than those in the control group (P<0.05). The adverse reactions between the two groups were not statistically significant (P>0.05). Conclusion Xuefu Zhuyu Decoction combined with tenofovir disoproxil fumarate tablets is effective in treating hepatitis B cirrhosis of liver depression and blood stasis, and its mechanism may be related to improving liver hemodynamics, regulating fibrosis, liver function and other indicators related.

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Weiwei Fu

Objective: To explore the effect of entecavir on patients with decompensated chronic hepatitis B cirrhosis. Methods: From October 2007 to December 2019, 100 patients with decompensated chronic hepatitis B cirrhosis who were treated in our hospital were selected to carry out this study. The clinical data of the patients were analyzed. According to whether entecavir treatment was carried out, 100 patients were divided into two groups, 50 cases in the control group and 50 cases in the observation group. The control group was treated with conventional drugs, and the observation group was treated with entecavir. Liver function indexes, liver fibrosis indexes, HBV-DNA negative conversion rate and incidence of adverse reactions were compared between the two groups. Results: Compared with the control group, the liver function indexes of the observation group were lower, P < 0.05; Compared with the control group, the observation group was better, P < 0.05; The negative rate of HBV-DNA in the observation group was lower than that in the control group (P < 0.05); There was no difference in the incidence of adverse reactions between the two groups, P > 0.05. Conclusion: Entecavir can not only improve the liver function, but also enhance the short-term treatment effect, without increasing adverse reactions, and has high safety, which is worthy of recommendation.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1437.1-1438
Author(s):  
A. Fazaa ◽  
H. Boussaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
L. Souabni ◽  
...  

Background:In the recent decades, biological disease-modifying antirheumatic drugs (bDMARDs) have significantly improved management and quality of life in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).However, bDMARDs have also a strong influence on the immune system, leading to a risk of serious infection. Reactivation of hepatitis B (HBV) and C (HCV) virus is one of the most redoubtable complications of these immunosuppressive agents.Objectives:The aims of this study were to determine the screening rate for hepatitis B and C before starting a biological treatment and to examine the prevalence of their markers in patients with RA or SpA.Methods:Our study evaluated all patients included in the Tunisian registry BINAR (Biologic National Registry) since 2018 who had RA (ACR/EULAR 2010) or SpA (ASAS criteria) aged with more than eighteen years old and receiving their first bDMARDs during the two past years.The following information were retrieved from the registry: demographic data on the patients, disease parameters, medication, HBV surface antigen (HBs Ag), antibody to HBs Ag (Anti HBs), antibody to HBV core antigen (Anti HBc), HBV-DNA, antibody to HCV (anti HCV) status and liver function tests (AST: aspartate aminotransferase; ALT:alanine aminotransferase).Results:A total of 298 patients was included, 111 men and 178 women, with a mean age of 49.2 ± 14.1 years old [18-79]. Among them, 58.7% were diagnosed with RA and 41.3% were diagnosed with SpA. The mean disease duration was 6.7±3.5 years [1-12] in patients with RA and 6.5±3 [1-12] in patients with SpA. The mean Disease Activity Score (DAS28) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were respectively of 4.9±1.5 [1-8] and 4.1±1.8 [0-9].Therapeutically, 167 patients (56%) were on Prednisone at a mean daily posology of 8.2±5.4 mg [4-60] and 70.3% on conventional synthetic disease modifying antirheumatic drug (csDMARD) in association with bDMARDs. It was about Tumor Necrosis Factor alpha antibodies (anti TNF a) in 87.9% of cases, Tocilizumab in 10.4% of cases and Rituximab in 5% of cases.A screening of HBV was performed in 286 patients (96%). Ag HBs was positive in two cases (0.7%), and anti-HBc was positive in 16 cases (6.4%) which indicate a prior HBV infection. Fifteen patients (6%) were immunized with positive anti HBs. HBV-DNA was measured in 177 cases (66.8%) and was positive in 15 patients (6%).HCV infection was searched in 282 patients (94.6%) and anti-HCV was negative in all cases.AST and ALT mean rates were respectively of 18.3 [2-108] and 17.9 UI/l [2-74]. A perturbation of these liver function tests was observed in 13 patients (4.4%).Conclusion:Screening for hepatitis B and C were performed respectively in 96% and 94% of our Tunisian patients before receiving any bDMARDs. This should be systematic to avoid HBV reactivation which can lead to fulminant hepatic failure with a severe prognosis.Disclosure of Interests:None declared


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Xiao-Jun Zhu ◽  
Xue-Hua Sun ◽  
Zheng-Hua Zhou ◽  
Shun-Qing Liu ◽  
Hua Lv ◽  
...  

Objective. To determine the efficacy and safety of Lingmao Formula combined with entecavir for HBeAg-positive chronic hepatitis B patients with mildly elevated alanine aminotransferase (ALT).Methods. 301 patients were randomly assigned to receive Lingmao Formula combined with entecavir (treatment group) or placebo combined with entecavir (control group) for 52 weeks. The outcomes of interest included the reduction of serum HBV DNA level, HBeAg loss, HBeAg seroconversion, ALT normalization, and histological improvement.Results. The mean decrease of serum HBV DNA level from baseline and the percentage of patients who had reduction in serum HBV DNA level ≥2 lg copies/mL in treatment group were significantly greater than that in control group (5.5 versus 5.4 lg copies/mL,P=0.010; 98.5% versus 92.6%,P=0.019). The percentage of HBeAg loss in treatment group was 22.8%, which was much higher than a percentage of 12.6% in control group (P=0.038). There was no significant difference between the two groups in histological improvement. Safety was similar in the two groups.Conclusions. The combination of Lingmao Formula with entecavir could result in significant decrease of serum HBV DNA and increase of HBeAg loss for HBeAg-positive chronic hepatitis B patients with mildly elevated ALT without any serious adverse events. Clinical trial registration number isChiCTR-TRC-09000594.


1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Zhang Xiuqin

Objective: To observe the clinical efficacy of octreotide and thrombin in the treatment of patients with liver cirrhosis, and to explore the mechanism of octreotide and thrombin. Methods: 53 patients with cirrhosis were randomly divided into control group and observation group from January 2014 to January 2016. The control group of 26 patients, given octreotide treatment. Observation group of 27 cases, given octreotide and thrombin combination therapy. Comparison of two groups of patients with clinical efficacy and changes in liver function before and after treatment. Results: The effective rate (88.89%) in the observation group was significantly higher than that in the control group (65.38%), the difference was statistically significant (p < 0.05). Before treatment, the difference of liver function between the two groups was not statistically significant (p > 0.05). After treatment, the liver function indexes of the two groups were improved, and the observation group was superior to the control group, the difference was statistically significant (p < 0.05).


2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Huaide Lin

Objective: To investigate the clinical effect of combination treatment of Chinese medicine Baogan Lishui decoction and western medicine on hepatitis B cirrhosis related refactory ascites.Method: Control group was given conventional western medicine therapy while the observation group was given same conventional western medicine therapy with additional of Chinese medicine Baogan Lishui decoction.Result: The total effective of clinical treatment on hepatitis B cirrhosis related refractory ascites in observation group was higher than that of the control group which was 88.89% compared to 71.11%, respectively and it was significant different (p<0.05).Conclusion: The combination treatment of Chinese medicine Baogao Lishui decoction and conventional western medicine can significantly increased the treatment effect on hepatitis B cirrhosis refractory ascites, and thus increases the quality and safety of life.


2020 ◽  
Author(s):  
Jiaxin Wu ◽  
Yongliang Feng ◽  
Zhiqing Yang ◽  
Ruijun Zhang ◽  
Dandan Wang ◽  
...  

Abstract Background: Many hepatitis B virus (HBV) substances could inevitably enter fetuses and occurred neonatal intrauterine transmission. HBV often occurs mutation, especially S gene, and may lead to different outcomes on intrauterine transmission. We explored the associations between HBV S gene mutations of hepatitis B surface antigen positive (HBsAg-positive) mothers and intrauterine transmission. Methods: A total of 399 HBsAg-positive mothers and neonates were recruited and their general demographic information was collected between June 2011 and July 2013. The mothers with HBV DNA levels ≥ 106 IU/ml were selected, 22 mothers whose neonates occurred HBV intrauterine transmission were in the HBV intrauterine transmission group (GT) and 22 mothers were randomly selected from the remaining controls were in the control group (GC). Maternal whole-genome HBV DNA was extracted, amplified, cloned, and sequenced. Obtained sequences were adjusted, genotyped, and analyzed for mutation rates. A case-control study was designed to analyze the relationship between mutations in the S gene of HBV and intrauterine transmission. Results: Fifty-five neonates were found to have experienced intrauterine transmission (13.78%). Genotype B (4.55%), genotype C (88.64%) and inter-genotype B/C (6.81%) were found in the 44 HBsAg-positive mothers. The mutation rates of the S gene, in both genotypes B (0.58% vs 1.41%, P = 0.040) and C (7.56% vs 14.71%, P<0.001), were lower in group T than in group C. Missense substitutions such as L84I, P47S, K10Q, A41P, M133L, A60V, and I42T only existed in group C. The mutation rates of G73S, I126T, and I126S in group C were higher (P < 0.001, P < 0.001, P = 0.010). Deletions occurred in the S gene. The occurrence of intrauterine transmission with maternal mutation A90V was higher (P < 0.001). This may have increased the risk of neonatal HBsAg expression (P = 0.022). Conclusions: The HBV S gene mutations of HBsAg-positive mothers may reduce the occurrence of HBV intrauterine transmission. It is possible for HBsAg-positive mothers infected with A90V to develop HBV chronic infection and transmit it to the fetus during pregnancy, resulting in neonatal HBV infection.


2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Weiwei Zhang ◽  
Mujian Teng ◽  
Baochi Liu ◽  
Qiling Liu ◽  
Xin Liu ◽  
...  

Objective. This study is aimed at examining the impact of repeated intraportal autologous bone marrow transfusion (ABMT) in patients with decompensated liver cirrhosis after splenectomy. Methods. A total of 25 patients with decompensated liver cirrhosis undergoing splenectomy were divided into ABMT and control groups. The portal vein was cannulated intraoperatively using Celsite Implantofix through the right gastroomental vein. Both groups were given a routine medical treatment. Then, 18 mL of autologous bone marrow was transfused through the port in the patients of the ABMT group 1 week, 1 month, and 3 months after laminectomy, while nothing was given to the control group. All patients were monitored for adverse events. Liver function tests, including serum albumin (ALB), alanine aminotransferase (ALT), total bilirubin (TB), prothrombin activity (PTA), cholinesterase (CHE), α-fetoprotein (AFP), and liver stiffness measurement (LSM), were conducted before surgery and 1, 3, and 6 months after surgery. Results. Significant improvements in ALB, ALT, and CHE levels and decreased LSM were observed in the ABMT group compared with those in the control group (P<0.05). TB and PTA improved in both groups but with no significant differences between the groups. No significant changes were observed in AFP in the control group, but it decreased in the ABMT group. No major adverse effects were noted during the follow-up period in the patients of either group. Conclusions. Repeated intraportal ABMT was clinically safe, and liver function of patients significantly improved. Therefore, this therapy has the potential to treat patients with decompensated liver cirrhosis after splenectomy. This trial was registered with the identification number of ChiCTR-ONC-17012592.


BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Lin Jia ◽  
Ran Xue ◽  
Yueke Zhu ◽  
Juan Zhao ◽  
Juan Li ◽  
...  

Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a severe condition with high mortality due to lack of efficient therapy. Until now, the use of methylprednisolone (MP) in HBV-ACLF is still controversial. We aimed to evaluate the efficacy and safety of MP in HBV-ACLF. Methods Totally 171 HBV-ACLF patients from three medical centers were randomly allocated into MP group (83 patients treated with MP intravenously guttae for 7 days plus standard treatment: 1.5 mg/kg/day [day 1–3], 1 mg/kg/day [day 4–5], and 0.5 mg/kg/day [day 6–7]) and control group (88 patients treated with standard treatment). The primary endpoints were 6-month mortality and prognostic factors for 6-month survival. The survival time, cause of death, adverse events, liver function, and HBV DNA replication were analyzed. Results The 6-month mortality was significantly lower in MP group than control group [32.4% vs. 42.5%, P = 0.0037]. MP treatment was an independent prognostic factor for 6-month survival [HR (95% CI) 0.547(0.308–0.973); P = 0.040]. Factors associated with reduced 6-month mortality in MP group included HBV DNA and lymphocyte/monocyte ratio (LMR) (P < 0.05). Based on ROC curve, LMR+MELD had a better predictive value for prognosis of HBV-ACLF under MP treatment. No significant difference in HBV DNA replication was observed between groups (P > 0.05). Conclusions MP therapy is an effective and safe clinical strategy in HBV-ACLF, increasing the 6-month survival rate. Clinical trials registered at http://www.chictr.org.cn as ChiCTR-TRC-13003113 registered on 16 March 2013.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xianwen Tang ◽  
Jinguo Yang ◽  
Zhong Feng ◽  
Jingyu Piao ◽  
Quanhao Yan ◽  
...  

Angina pectoris (AP) with coronary heart disease (CHD) is one of the common cardiovascular diseases in clinical practice, which can be classified as “chest paralysis” in Chinese medicine according to its symptoms, and it is described in many ancient documents. Ancient Chinese medicine believes that the main pathogenesis of the disease is poor blood flow leading to paralysis of the heart and veins, so it is often treated by activating blood and removing blood stasis. In this study, 120 patients with AP of CHD of Qi stagnation and blood stasis type were randomly divided into the observation (n = 60) and the control group (n = 60). In the control group, basic care, conventional treatment, and unselected copper acupuncture scraping were used, while in the observation group, copper acupuncture scraping was performed at the right time of the heart meridian (11 : 00–13 : 00) on the basis of the control group, and all patients received the treatment for a total duration of 4 weeks. We collected data on the traditional Chinese medical (TCM) syndrome score, frequency and duration of angina attacks, nitroglycerin dosage, inflammatory factor levels, and hematological indices pretreatment and posttreatment in both groups. Patients’ adverse effects during treatment were recorded, and the clinical efficacy and ECG efficacy in both groups were evaluated after 4 weeks. We used SPSS.20 statistical software to statistically analyze the above data, and the results showed that the clinical efficacy and ECG efficacy of the observation group were significantly higher than the control group posttreatment. After treatment, the TCM symptom score, angina attack frequency, attack duration and nitroglycerin dosage, serum interleukin-8 (IL-8), hypersensitive C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α) levels, whole blood viscosity (WBV), plasma viscosity (PV), fibrinogen (FIB), and hematocrit (Hct) were significantly lower in both groups compared with those posttreatment. And the observation group showed a greater decrease when compared with the control group. The results also showed that the overall incidence of adverse reactions was lower in both groups during the treatment period. The above results indicate that while ensuring high safety, the copper stone based on theory of midnight-noon ebb-flow can more effectively improve the symptoms and inflammatory response of the body and reduce the viscosity of the blood in AP with CHD of Qi stagnation and blood stasis, and it has better therapeutic effects.


Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 371
Author(s):  
Jorge Gutiérrez Sáenz de Santa María ◽  
Borja Herrero de la Parte ◽  
Gaizka Gutiérrez-Sánchez ◽  
Inmaculada Ruiz Montesinos ◽  
Sira Iturrizaga Correcher ◽  
...  

Liver resection remains the gold standard for hepatic metastases. The future liver remnant (FLR) and its functional status are two key points to consider before performing major liver resections, since patients with less than 25% FLR or a Child–Pugh B or C grade are not eligible for this procedure. Folinic acid (FA) is an essential agent in cell replication processes. Herein, we analyze the effect of FA as an enhancer of liver regeneration after selective portal vein ligation (PVL). Sixty-four male WAG/RijHsd rats were randomly distributed into eight groups: a control group and seven subjected to 50% PVL, by ligation of left portal branch. The treated animals received FA (2.5 m/kg), while the rest were given saline. After 36 h, 3 days or 7 days, liver tissue and blood samples were obtained. FA slightly but significantly increased FLR percentage (FLR%) on the 7th day (91.88 ± 0.61%) compared to control or saline-treated groups (86.72 ± 2.5 vs. 87 ± 3.33%; p < 0.01). The hepatocyte nuclear area was also increased both at 36 h and 7days with FA (61.55 ± 16.09 µm2, and 49.91 ± 15.38 µm2; p < 0.001). Finally, FA also improved liver function. In conclusion, FA has boosted liver regeneration assessed by FLR%, nuclear area size and restoration of liver function after PVL.


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