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中草药疗法与合并肝硬化的慢性乙型肝炎患者的死亡风险:一项基于全国人口的队列研究。

Chinese herbal medicine therapy and the risk of mortality for chronic hepatitis B patients with concurrent liver cirrhosis: a nationwide population-based cohort study.

作者信息

Tsai Tzung-Yi, Hung Tsung-Hsing, Livneh Hanoch, Lin I-Hsin, Lu Ming-Chi, Yeh Chia-Chou

机构信息

Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi 62247, Taiwan.

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan.

出版信息

Oncotarget. 2018 Apr 6;9(26):18214-18223. doi: 10.18632/oncotarget.24383.

Abstract

Chronic hepatitis B (CHB) is increasingly recognized as a public health problem in Taiwan. After affected patients are diagnosed with contaminant liver cirrhosis (LC), adverse clinical outcomes, especially death, are common. This study aimed to investigate the effect of Chinese herbal medicine (CHM), an essential branch of Traditional Chinese medicine (TCM), on the mortality risk among CHB patients with contaminant LC. This longitudinal cohort study used the Taiwanese National Health Insurance Research Database to identify 1522 patients 20-70 years of age with newly diagnosed CHB with LC during 1998-2007. Among them, 508 (33.37%) had received CHM products after the onset of CHB (CHM users), and the remaining 1014 patients (66.63%) were designated as a control group (non-CHM users). All enrollees were followed until the end of 2012 to determine deaths during the study period. We applied the Cox proportional hazards regression model to compute the hazard ratio for the association of CHM use and the subsequent risk of death. During the follow-up period, 156 CHM users and 493 non-CHM users died. After controlling for potential confounders, CHM users were found to have a significantly reduced risk of death compared with non-CHM users by 56%, and the effect was predominantly observed among those treated with CHM for > 180 days. CHM therapy lowered the risk of death among CHB patients with contaminant LC, which supported CHM might provide further treatment options for those with chronic liver diseases.

摘要

慢性乙型肝炎(CHB)在台湾日益被视为一个公共卫生问题。受影响的患者被诊断为代偿性肝硬化(LC)后,不良临床结局,尤其是死亡,很常见。本研究旨在调查中药(CHM)这一传统中医(TCM)的重要分支对代偿性LC的CHB患者死亡风险的影响。这项纵向队列研究使用台湾国民健康保险研究数据库,确定了1998年至2〇〇7年间1522例年龄在2〇至7〇岁之间新诊断为CHB合并LC的患者。其中,5〇8例(33.37%)在CHB发病后使用了中药产品(中药使用者),其余1〇14例患者(66.63%)被指定为对照组(非中药使用者)。所有参与者均被随访至2〇12年底,以确定研究期间的死亡情况。我们应用Cox比例风险回归模型来计算使用中药与随后死亡风险之间关联的风险比。在随访期间,156例中药使用者和493例非中药使用者死亡。在控制了潜在混杂因素后,发现中药使用者的死亡风险与非中药使用者相比显著降低了56%,且这种效果主要在接受中药治疗超过18〇天的患者中观察到。中药治疗降低了代偿性LC的CHB患者的死亡风险,这支持了中药可能为慢性肝病患者提供更多治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c0/5915067/98ec2ed13195/oncotarget-09-18214-g001.jpg

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