Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Department of Hepatology, Traditional Chinese Medicine Hospital of Dianjiang Chongqing, Chongqing, China.
Complement Ther Med. 2020 Jun;51:102446. doi: 10.1016/j.ctim.2020.102446. Epub 2020 May 16.
To assess the effects of traditional Chinese medicine (TCM) on the survival of patients with liver cirrhosis (LC) in Southwest China.
Single-center, ambispective cohort study conducted from 2012 to 2019.
Traditional Chinese Medicine Hospital of Dianjiang Chongqing, Southwest China.
The primary outcome was the effect of TCM on the survival of patients with LC, as assessed with survival analysis and Cox regression model.
Among the 691 patients with LC, 364 (52.68 %) received TCM treatment. The mean (standard deviation) follow-up period was 3.53 (1.62) years for non-TCM users and 4.17 (1.53) years for TCM users (P = 0.184). Multivariate analysis revealed that the use of TCM was associated with a significantly decreased risk of mortality (adjusted hazard ratio [HR] = 0.41, 95 % confidence interval [CI] = 0.30 - 0.54) compared with no TCM use. Similarly, the cumulative mortality rates were significantly lower among TCM users, across various subgroups of LC aetiologies. Among the commonly used TCM prescriptions, Xiao Chaihu Tang (XCHT, adjusted HR = 0.17, 95 % CI = 0.07 - 0.42), Yinchen Wuling San (adjusted HR = 0.31, 95 % CI = 0.14 - 0.66), Biejia Ruan Gan Jian (adjusted HR = 0.31, 95 % CI = 0.13 - 0.75), and Chaihu Shu Gan San (adjusted HR = 0.33, 95 % CI = 0.19 - 0.57) were the most effective in improving survival.
Our results provide evidence for supporting that adjunctive TCM therapy may potentially improve the survival of patients with liver cirrhosis, and XCHT was the most effective TCM prescription in this study.
评估中医药对中国西南地区肝硬化（LC）患者生存的影响。
2012 年至 2019 年进行的单中心、前瞻性队列研究。
中国西南地区垫江县中医院。
生存分析和 Cox 回归模型评估中医药对 LC 患者生存的主要影响。
在 691 例 LC 患者中，364 例（52.68%）接受了中医药治疗。非中医药使用者的平均（标准差）随访时间为 3.53（1.62）年，中医药使用者为 4.17（1.53）年（P=0.184）。多变量分析显示，与未使用中医药相比，使用中医药与死亡率显著降低相关（调整后的危险比[HR]=0.41，95%置信区间[CI]：0.30-0.54）。同样，在 LC 病因的各种亚组中，中医药使用者的累积死亡率也明显较低。在常用的中医药方剂中，小柴胡汤（XCHT，调整 HR=0.17，95%CI：0.07-0.42）、茵陈五苓散（调整 HR=0.31，95%CI：0.14-0.66）、鳖甲软肝煎（调整 HR=0.31，95%CI：0.13-0.75）和柴胡疏肝散（调整 HR=0.33，95%CI：0.19-0.57）在提高生存率方面最有效。
我们的研究结果为中医药辅助治疗可能提高肝硬化患者生存率提供了证据，在本研究中，XCHT 是最有效的中医药方剂。
