扶正化瘀胶囊降低乙型肝炎引起的肝硬化患者肝癌的发生率

StephenW

Adjuvant Fuzheng Huayu Capsule Reduces the Incidence of Hepatocellular Carcinoma in Patients with Hepatitis B-Caused Cirrhosis
Ke Shi  1   2 , Yao Liu  1 , Xiaojing Wang  1 , Yuxin Li  1 , Qun Zhang  1 , Ying Hu  1 , Chongping Ran  1 , Yunyi Huang  1   2 , Jie Hou  1   2 , Xianbo Wang  1
Affiliations
Affiliations

    1
    Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
    2
    Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.

    PMID: 33178324 PMCID: PMC7644307 DOI: 10.1155/2020/8826091

Abstract

Aim: Fuzhenghuayu (FZHY) capsule can inhibit the progression of cirrhosis. This study explored whether FZHY can reduce the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy.

Methods: A retrospective review of 842 patients with HBC between 2011 and 2015 was performed, including 270 treated with FZHY combined with nucleos (t) ide analogues (NAs) and 572 with NAs alone. The incidence of HCC was compared between the FZHY (n = 259) and control (n = 259) groups using 1 : 1 propensity score (PS) matching. The incidence of HCC in patients with HBC with different Child-Turcotte-Pugh (CTP) classifications and Toronto HCC risk index (THRI) scores was analyzed using Kaplan-Meier curves.

Results: The 5-year cumulative incidence of HCC before and after PS matching was 151 (17.9%) and 86 (16.6%), respectively. In PS-matched samples, the multivariate Cox proportional-hazards model indicated that the FZHY group demonstrated a significantly lower risk for HCC than the control group (adjusted hazard ratio [aHR] = 0.32, 95% CI 0.19-0.53 P < 0.001). The risk of HCC diminished with increased duration of FZHY use. The stratified analysis revealed that the FZHY group, regardless of CTP classification, benefited significantly from FZHY therapy. Patients in the medium- and high-THRI risk groups were the dominant population for FZHY.

Conclusions: FZHY combined with NAs was associated with a significantly lower risk of HCC than NAs alone in patients with HBC, which supports the integration of FZHY with antiviral treatment into clinical practice.

Copyright © 2020 Ke Shi et al.

StephenW

扶正化瘀胶囊降低乙型肝炎引起的肝硬化患者肝癌的发生率
柯诗1 2，刘瑶1，王晓静1，李玉新1，张群1，胡颖1，崇平冉1，黄云怡1 2，侯杰1 2，王先博1
隶属关系
隶属关系

    1个
    首都医科大学附属北京地坛医院中西医结合中心
    2
    北京中医药大学东直门医院消化内科，北京

    PMID：33178324 PMCID：PMC7644307 DOI：10.1155 / 2020/8826091

抽象

目的：扶正化瘀（FZHY）胶囊可以抑制肝硬化的发展。这项研究探讨了FZHY是否可以降低接受抗病毒治疗的乙型肝炎引起的肝硬化（HBC）患者的肝细胞癌（HCC）发病率。

方法：回顾性分析2011年至2015年间842例HBC患者，包括270例FZHY联合核苷酸类似物（NAs）和572例单独使用NA。使用1：1倾向评分（PS）匹配比较FZHY（n = 259）和对照组（n = 259）组的HCC发生率。使用Kaplan-Meier曲线分析了具有不同Child-Turcotte-Pugh（CTP）分类和Toronto HCC风险指数（THRI）评分的HBC患者的HCC发生率。

结果：PS匹配前后5年的HCC累积发生率分别为151（17.9％）和86（16.6％）。在PS匹配的样本中，多元Cox比例风险模型表明FZHY组的HCC风险明显低于对照组（调整后的风险比[aHR] = 0.32，95％CI 0.19-0.53 P <0.001）。随着使用FZHY持续时间的增加，降低HCC的风险。分层分析显示，无论CTP分类如何，FZHY组均可从FZHY治疗中显着受益。中高THRI风险组的患者是FZHY的主要人群。

结论：FZHY联合NAs与HBC患者相比，单独使用NAs显着降低HCC风险，这支持FZHY与抗病毒治疗相结合的临床实践。

版权所有©2020 Ke Shi等。

StephenW

https://www.hindawi.com/journals/ecam/2020/8826091/