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中药作为辅助治疗降低结肠癌患者慢性肝炎发生率的效果:一项基于台湾人群的队列研究。

The use of Chinese herbal medicine as an adjuvant therapy to reduce incidence of chronic hepatitis in colon cancer patients: A Taiwanese population-based cohort study.

机构信息

Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan ROC; School of Chinese Medicine, China Medical University, Taichung, Taiwan ROC.

Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan ROC; School of Chinese Medicine, China Medical University, Taichung, Taiwan ROC; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan ROC.

出版信息

J Ethnopharmacol. 2017 Apr 18;202:225-233. doi: 10.1016/j.jep.2017.03.027. Epub 2017 Mar 19.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

There is a decided lack of in-depth studies to evaluate the effectiveness of Chinese Herbal Medicine (CHM) as an adjuvant therapy on the incidence of chronic hepatitis in patients with colon cancer.

AIM OF THE STUDY

The aim of this study is to assess whether CHM treatment decreased the incidence of chronic hepatitis in colon cancer patients who received conventional Western medical treatment.

MATERIALS AND METHODS

A Taiwanese nationwide population-based study of colon cancer patients receiving Western medicine treatment in conjunction with CHM treatment, using data provided by the National Health Insurance (NHI) Research Database, was conducted. A total of 61676 patients were diagnosed with colon cancer in Taiwan within the defined study period, from 1997 to 2010. After randomly equal matching for age, sex, excluding patients younger than 18 years of age, chronic hepatitis before colon cancer diagnosis date, receiving acupuncture and/or moxibustion and taking CHM for less than 30 days, data from 155 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence of CHM and the therapeutic potential of herbal products in treating patients with colon cancer.

RESULTS

CHM used for patients with colon cancer exhibited significantly decreased incidence rates of chronic hepatitis [hazard ratio (HR)=0.53; 95% confidence interval (CI):0.38-0.74], with multivariate adjustment, compared to those without CHM use. The protective effect of CHM treatment with statistical significance across the stratification of age, gender, co-morbidity and treatment modality was noted. The cumulative incidence of chronic hepatitis was also reduced in patients with colon cancer receiving CHM treatment during a five-year period. In this study, we provide the ten most used single herbs and herbal formulas that were prescribed for patients with colon cancer; moreover, we identify the eight single herbs and five formulas used in CHM treatment which significantly decreased incidence of chronic hepatitis among colon cancer patients.

CONCLUSIONS

This nationwide retrospective cohort study determined that therapy using CHM as an adjuvant modality may have a significant impact on liver protection in patients with colon cancer.

摘要

民族药理学相关性

目前,缺乏深入的研究来评估中药(CHM)作为辅助治疗对结肠癌患者慢性肝炎发生率的有效性。

研究目的

本研究旨在评估 CHM 治疗是否降低了接受常规西医疗法的结肠癌患者发生慢性肝炎的几率。

材料和方法

采用台湾全民健康保险研究数据库的数据,进行了一项关于接受西药联合 CHM 治疗的结肠癌患者的全国性回顾性队列研究。在研究期间(1997 年至 2010 年),台湾共有 61676 例患者被诊断患有结肠癌。经过年龄、性别随机等比例匹配(排除 18 岁以下患者、结肠癌诊断日期前患有慢性肝炎、接受针灸和/或艾灸以及服用 CHM 不足 30 天的患者),共分析了 155 例患者的数据。采用发病率的风险比(HR)来确定 CHM 对结肠癌患者的影响以及草药产品的治疗潜力。

结果

与未使用 CHM 的患者相比,使用 CHM 治疗结肠癌的患者慢性肝炎的发生率显著降低(HR=0.53;95%置信区间(CI):0.38-0.74),且经多变量调整后仍具有统计学意义。在年龄、性别、合并症和治疗方式的分层中均观察到 CHM 治疗的保护作用具有统计学意义。在接受 CHM 治疗的结肠癌患者中,慢性肝炎的累积发病率也在五年内降低。在这项研究中,我们提供了结肠癌患者处方中使用最多的十种单味草药和草药配方;此外,我们还确定了 CHM 治疗中八种降低结肠癌患者慢性肝炎发生率的单味草药和五种配方。

结论

这项全国性回顾性队列研究表明,CHM 作为辅助治疗模式可能对结肠癌患者的肝脏保护具有重要影响。

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