回顧性研究：長期中藥結合NA抗病毒治療對慢性乙型肝炎患者

StephenW

Long-Term Traditional Chinese Medicine Combined with NA Antiviral Therapy on Cirrhosis Incidence in Chronic Hepatitis B Patients in the Real-World Setting: A Retrospective Study
Zhi-Jun Hou  1 , Jing-Hao Zhang  1 , Xin Zhang  2 , Qi-Hua Ling  1   3 , Chao Zheng  1   3 , Xiao-Jun Zhu  1   3 , Zhen-Hua Zhou  2 , Man Li  2 , Xiao-Ni Kong  4 , Xue-Hua Sun  1   3 , Yue-Qiu Gao  1   3   2 , Jian-Jie Chen  1   3
Affiliations
Affiliations

    1
    Department of Hepatopathy, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
    2
    Laboratory of Cellular Immunity, Shanghai Key Laboratory of Traditional Chinese Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
    3
    Shanghai Traditional Chinese Medicine Clinical Center of Hepatopathy, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
    4
    Central Laboratory, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.

    PMID: 32831863 PMCID: PMC7424525 DOI: 10.1155/2020/3826857

Abstract

Objective: To evaluate the impact of long-term Traditional Chinese Medicine (TCM) syndrome differentiation combined with antiviral therapy with Nucleos (t) ide analogues (NAs) on the incidence of cirrhosis in patients with chronic hepatitis B.

Methods: This retrospective cohort study included 521 patients with chronic hepatitis B who underwent a treatment course of ≥3 years from 1998-2019. Of the 521 patients, 261 were defined as TCM users while 260 were TCM nonusers (control group). All the enrolled subjects were followed up until February 2019 to measure the incidence and hazard ratio (HR) of cirrhosis, and the Cox proportional hazards regression model was used to analyze the independent factors affecting the occurrence of cirrhosis.

Results: The cumulative incidence of TCM users and nonusers was 6.9% and 13.5%, respectively (P=0.013). Results of the Kaplan-Meier analysis demonstrated that TCM users had a significantly lower cumulative incidence of cirrhosis than TCM nonusers (P=0.011), and TCM users had a significantly lower liver cirrhosis risk than TCM nonusers (adjusted HR = 0.416, 95% CI, 0.231-0.749). The histological evaluation revealed improved fibrosis in 45.0% of TCM users and 11.1% of TCM nonusers (P=0.033). The analysation of the prescriptions including total 119 single Chinese herbs medicinal demonstrated that "replenish qi and fortify the spleen," "clear heat and dispel dampness," and "soothe the liver and regulate qi" are the main treatment methods of TCM for CHB.

Conclusions: Our study demonstrated that long-term TCM use may attenuate liver cirrhosis risk in patients with chronic hepatitis B (CHB).

Copyright © 2020 Zhi-Jun Hou et al.
Conflict of interest statement

The authors declare that they have no conflicts of interest.

StephenW

回顧性研究：長期中藥結合NA抗病毒治療對慢性乙型肝炎患者肝硬化發生率的回顧性研究
侯志軍1，張景豪1，張欣2，凌啟華1 3，鄭徵1 3，朱曉軍1 3，周振華2，週曼麗2，孔小妮4 ，孫學華1 3，高月秋1 3 2，陳建傑1 3
隸屬關係
隸屬關係

    1個
    上海中醫藥大學附屬曙光醫院肝病科，上海201203
    2
    上海中醫藥大學附屬細胞免疫研究中心，上海市中醫藥重點實驗室，上海201203
    3
    上海中醫藥大學附屬上海肝病中醫臨床研究中心，上海201203
    4
    上海中醫藥大學附屬曙光醫院中心實驗室，上海201203

    PMID：32831863 PMCID：PMC7424525 DOI：10.1155 / 2020/3826857

抽象

目的：評估長期中醫（TCM）綜合徵辨證結合抗核苷（t）ide類似物（NAs）抗病毒治療對慢性乙型肝炎患者肝硬化發生率的影響。

方法：這項回顧性隊列研究納入了521例1998年至2019年接受≥3年治療的慢性乙型肝炎患者。在521名患者中，有261名被定義為中醫使用者，而260名是中醫非使用者（對照組）。對所有入選受試者進行隨訪直至2019年2月，以測量肝硬化的發生率和危險比（HR），並使用Cox比例風險回歸模型分析影響肝硬化發生的獨立因素。

結果：中醫使用者和非使用者的累計發病率分別為6.9％和13.5％（P = 0.013）。 Kaplan-Meier分析的結果表明，中醫使用者的肝硬化累積發病率顯著低於非中醫使用者（P = 0.011），中醫使用者的肝硬化風險明顯低於中醫使用者（校正後的HR = 0.416，95％CI ，0.231-0.749）。組織學評估顯示，中醫使用者中45.0％的纖維化得到改善，而中醫非使用者中11.1％的纖維化得到改善（P = 0.033）。對包括119種中草藥在內的處方進行的分析表明，“補氣健脾”，“清熱利濕”，“理肝通氣”是中藥治療CHB的主要方法。

結論：我們的研究表明，長期使用中藥可能會減輕慢性乙型肝炎（CHB）患者的肝硬化風險。

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利益衝突聲明

作者宣稱他們沒有利益衝突。

StephenW

http://downloads.hindawi.com/journals/ecam/2020/3826857.pdf