Nie Hong-ming, Gao Yue-qiu, Chen Jian-jie
Department of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Zhong Xi Yi Jie He Xue Bao. 2011 Apr;9(4):365-73. doi: 10.3736/jcim20110404.
Chronic hepatitis C is one of the major causes of end-stage liver disease with a high incidence rate, amounting to a grave and serious problem of public health. Currently, interferon-based (with or without ribavirin) antiviral therapy has limited use due to its stringent indications, possible contraindications and side effects. Traditional Chinese medicine (TCM) may have advantages in the prevention and treatment of chronic hepatitis C and it is of significant value to discover the advantages. Through this research, a safe and effective treatment protocol of TCM or integrated TCM and Western medicine for chronic hepatitis C can be formed. To this end, during China's Eleventh Five-Year Plan, special research projects on acquired immune deficiency syndrome (AIDS), viral hepatitis and the other major infectious diseases were established. Our studies on chronic hepatitis C constitute one of the major special research topics.
Clinical information of patients with chronic hepatitis C will be first collected in a large, multicenter epidemiological survey. Positive symptoms will be analyzed by rapid cluster analysis, principal constituent analysis and factor analysis, and syndrome types will be diagnosed based on expert advice. Concurrently, a large, multicenter, randomized, parallel-group prospective study will be launched based on evidence-based medical principles to evaluate the effects and safety of the treatment protocol for chronic hepatitis C. The evaluated indexes will include the normalization rate of liver function, virological improvement and quality of life improvement for the short-term efficacy and the incidence of liver cirrhosis and (or) primary liver cancer and mortality for the long-term efficacy.
This study will investigate the TCM syndrome differentiation norms and the syndrome distribution rules of chronic hepatitis C and evaluate the efficacy and safety of a treatment protocol for chronic hepatitis C based on TCM theory or combined treatment of TCM and Western medicine. The study results will be helpful to developing a TCM treatment program for chronic hepatitis C.
The research program was registered in the Chinese Clinical Trial Registry in English and Chinese in January 2010.
ChiCTR-TRC-10000770.
慢性丙型肝炎是终末期肝病的主要病因之一,发病率高,是一个严重的公共卫生问题。目前,基于干扰素(联合或不联合利巴韦林)的抗病毒治疗因其严格的适应证、可能的禁忌证和副作用而应用有限。中医药在慢性丙型肝炎的防治中可能具有优势,发掘这些优势具有重要价值。通过本研究,有望形成一套安全有效的中医药或中西医结合治疗慢性丙型肝炎的方案。为此,在我国“十一五”期间,设立了获得性免疫缺陷综合征(艾滋病)、病毒性肝炎等重大传染病专项研究项目。我们对慢性丙型肝炎的研究是其中的主要专项研究课题之一。
首先在一项大型多中心流行病学调查中收集慢性丙型肝炎患者的临床信息。运用快速聚类分析、主成分分析和因子分析等方法对阳性症状进行分析,并根据专家意见诊断证型。同时,基于循证医学原则开展一项大型多中心、随机、平行组前瞻性研究,以评估慢性丙型肝炎治疗方案的疗效和安全性。评估指标包括肝功能正常化率、病毒学改善情况以及生活质量改善情况作为短期疗效指标,肝硬化和(或)原发性肝癌的发生率以及死亡率作为长期疗效指标。
本研究将探讨慢性丙型肝炎的中医辨证规范和证型分布规律,并基于中医理论或中西医结合治疗方案评估慢性丙型肝炎治疗方案的疗效和安全性。研究结果将有助于制定慢性丙型肝炎的中医药治疗方案。
该研究方案于2010年1月以中英文两种语言在中国临床试验注册中心注册。
ChiCTR - TRC - 10000770。