Clinical effect of chronic disease management with traditional Chinese medicine characteristics in community patients with chronic hepatitis B

Objective To investigate the clinical effect of chronic disease management with traditional Chinese medicine ( TCM) characteristics in community patients with chronic hepatitis B ( CHB) . Methods A non-randomized case-control study was performed for 84 CHB patients who visited Tianhe Community in Guangzhou from 2014 to 2016. These patients were divided into TCM chronic disease management group and control group, with 42 patients in each group. The patients in the TCM chronic disease management group were given oral entecavir tablets ( 0. 5 mg, once a day) combined with TCM chronic disease management, and those in the control group were given entecavir tablets, education on disease knowledge, and instructions on medication. The two groups were compared in terms of alanine aminotransferase ( ALT) normalization rate, HBeAg seroconversion rate, HBV DNA clearance rate, TCM symptom score, and quality-of-life score after 48 weeks of treatment. The two-independent-samples t test was used for comparison of normally distributed continuous data between groups, and the paired t-test was used for comparison before and after treatment; the non-parametric test was used for comparison of non-normally distributed continuous data between groups. The chi-square test was used for comparison of categorical data between groups, and the Fisher's exact test was used when more than 20% of the cells have an expected frequency of less than 5. Results After 48 weeks of treatment, the TCM chronic disease management group had a significantly lower clinical syndrome score and a significantly higher overall quality-of-life score than the control group ( clinical syndrome score: 3. 66 ± 1. 92 vs 6. 42 ± 2. 48, t = 5. 563, P < 0. 001; overall quality-of-life score: 550. 75 ± 54. 24 vs 491. 08 ± 54. 21, t =-4. 888, P < 0. 001) . Compared with the control group, the TCM chronic disease management group had slightly higher 48-week ALT normalization rate ( 80. 00% vs 72. 22%, χ2= 0. 590, P = 0. 443) , HBV DNA clearance rate ( 73. 17% vs 68. 42%, P > 0. 05) , and HBeAg seroconversion rate ( 29. 27% vs 18. 42%, P > 0. 05) . Conclusion In community patients with CHB, chronic disease management with TCM characteristics can improve their clinical symptoms, quality of life, and antiviral outcome and thus holds promise for clinical application in community.