Hou Zhi-Jun, Zhang Jing-Hao, Zhang Xin, Ling Qi-Hua, Zheng Chao, Zhu Xiao-Jun, Zhou Zhen-Hua, Li Man, Kong Xiao-Ni, Sun Xue-Hua, Gao Yue-Qiu, Chen Jian-Jie
Department of Hepatopathy, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Laboratory of Cellular Immunity, Shanghai Key Laboratory of Traditional Chinese Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Evid Based Complement Alternat Med. 2020 Aug 3;2020:3826857. doi: 10.1155/2020/3826857. eCollection 2020.
To evaluate the impact of long-term Traditional Chinese Medicine (TCM) syndrome differentiation combined with antiviral therapy with Nucleos (t) ide analogues (NAs) on the incidence of cirrhosis in patients with chronic hepatitis B.
This retrospective cohort study included 521 patients with chronic hepatitis B who underwent a treatment course of ≥3 years from 1998-2019. Of the 521 patients, 261 were defined as TCM users while 260 were TCM nonusers (control group). All the enrolled subjects were followed up until February 2019 to measure the incidence and hazard ratio (HR) of cirrhosis, and the Cox proportional hazards regression model was used to analyze the independent factors affecting the occurrence of cirrhosis.
The cumulative incidence of TCM users and nonusers was 6.9% and 13.5%, respectively (=0.013). Results of the Kaplan-Meier analysis demonstrated that TCM users had a significantly lower cumulative incidence of cirrhosis than TCM nonusers (=0.011), and TCM users had a significantly lower liver cirrhosis risk than TCM nonusers (adjusted HR = 0.416, 95% CI, 0.231-0.749). The histological evaluation revealed improved fibrosis in 45.0% of TCM users and 11.1% of TCM nonusers (=0.033). The analysation of the prescriptions including total 119 single Chinese herbs medicinal demonstrated that "replenish qi and fortify the spleen," "clear heat and dispel dampness," and "soothe the liver and regulate qi" are the main treatment methods of TCM for CHB.
Our study demonstrated that long-term TCM use may attenuate liver cirrhosis risk in patients with chronic hepatitis B (CHB).
评估长期中医辨证联合核苷（酸）类似物（NAs）抗病毒治疗对慢性乙型肝炎患者肝硬化发生率的影响。
这项回顾性队列研究纳入了1998年至2019年接受≥3年治疗疗程的521例慢性乙型肝炎患者。在这521例患者中，261例被定义为使用中医治疗者，260例为未使用中医治疗者（对照组）。所有纳入的受试者均随访至2019年2月，以测量肝硬化的发生率和风险比（HR），并使用Cox比例风险回归模型分析影响肝硬化发生的独立因素。
使用中医治疗者和未使用者的累积发生率分别为6.9%和13.5%（P=0.013）。Kaplan-Meier分析结果表明，使用中医治疗者的肝硬化累积发生率显著低于未使用者（P=0.011），且使用中医治疗者患肝硬化的风险显著低于未使用者（调整后HR=0.416，95%CI，0.231-0.749）。组织学评估显示，45.0%的使用中医治疗者和11.1%的未使用者纤维化有所改善（P=0.033）。对总共119味单味中药方剂的分析表明，“补气健脾”“清热利湿”和“疏肝理气”是中医治疗慢性乙型肝炎的主要治法。
我们的研究表明，长期使用中医治疗可能会降低慢性乙型肝炎（CHB）患者的肝硬化风险。
