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中药降低乙型肝炎病毒感染患者急性肝炎恶化:台湾的病例对照研究。

Chinese herbal medicine reduces acute hepatitis exacerbation in patients with hepatitis B virus infection: A case-control study in Taiwan.

机构信息

Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.

出版信息

Complement Ther Med. 2019 Feb;42:248-254. doi: 10.1016/j.ctim.2018.11.024. Epub 2018 Dec 1.

Abstract

OBJECTIVES

Little information is available about the impact of Chinese herbal medicine (CHM) treatment on acute exacerbation of hepatitis. This study aimed to assess the risk of acute exacerbation of hepatitis and subsequent cirrhosis and hepatoma in HBV patients with and without CHM use.

DESIGN AND SETTING

This population-based case-control study used data from the Taiwan Longitudinal Health Insurance Database from 2000 to 2013. Newly diagnosed HBV patients had acute exacerbation of hepatitis and subsequent cirrhosis and hepatoma as the case group, while another patients had no acute exacerbation of hepatitis and cirrhosis and hepatoma as the control group. To correct the differences in sociodemographic factors and Western medication use between the two groups, propensity score matching was used at a 1:1 ratio, and resulted in a comparison of 1306 and 805 patients per group, respectively.

MAIN OUTCOME MEASURES

Occurrence of acute exacerbation of hepatitis and subsequent cirrhosis and hepatoma.

RESULTS

Overall rate of acute exacerbation of hepatitis and subsequent cirrhosis and hepatoma was 7.9% and 4.8%, respectively. Patients receiving CHM had a significantly lower risk of acute exacerbation of hepatitis (adjusted odds ratio [aOR] =0.20, 95% confidence interval [95%CI]: 0.13-0.31) and subsequent cirrhosis and hepatoma (aOR = 0.29, 95%CI: 0.18-0.49) than those not receiving CHM after adjusting for relevant covariates. However, no dose-dependent relationship was exhibited for either incidence of acute exacerbation of hepatitis and cirrhosis and hepatoma.

CONCLUSION

These findings highlight that the use of CHM was associated with a significantly reduced risk of acute exacerbation of hepatitis and subsequent cirrhosis and hepatoma in patients with HBV. Future research could further explore the benefit of CHM therapies for treatment of acute hepatitis exacerbation.

摘要

目的

有关中药(CHM)治疗对乙型肝炎急性加重的影响的信息很少。本研究旨在评估 CHM 治疗对 HBV 患者急性肝炎加重以及随后发生肝硬化和肝癌的风险。

设计和设置

本基于人群的病例对照研究使用了 2000 年至 2013 年来自台湾纵向健康保险数据库的数据。新诊断的 HBV 患者出现急性肝炎加重和随后的肝硬化和肝癌为病例组,而另一组患者则没有急性肝炎加重和肝硬化和肝癌为对照组。为了校正两组间社会人口统计学因素和西药使用的差异,采用倾向评分匹配以 1:1 的比例进行匹配,结果分别为每组 1306 例和 805 例患者。

主要观察指标

急性肝炎加重和随后的肝硬化和肝癌的发生情况。

结果

总体急性肝炎加重和随后的肝硬化和肝癌的发生率分别为 7.9%和 4.8%。接受 CHM 治疗的患者发生急性肝炎加重的风险显著降低(调整后的优势比[aOR] = 0.20,95%置信区间[95%CI]:0.13-0.31)和随后的肝硬化和肝癌(aOR=0.29,95%CI:0.18-0.49),与未接受 CHM 治疗的患者相比,在调整了相关协变量后。然而,急性肝炎加重和肝硬化和肝癌的发生率均未表现出剂量依赖性关系。

结论

这些发现强调了 CHM 的使用与 HBV 患者的急性肝炎加重和随后的肝硬化和肝癌风险显著降低相关。未来的研究可以进一步探讨 CHM 治疗对急性肝炎加重的治疗益处。

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