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中药治疗乙型肝炎病毒相关慢加急性肝衰竭有效性和安全性的多中心随机对照研究方案

Effectiveness and safety of Chinese herbal medicines for hepatitis B virus-related acute-on-chronic liver failure: study protocol for a multicenter randomized controlled trial.

机构信息

Integrated Traditional Chinese Medicine & Western Medicine Department, the Fifth Medical Center, General Hospital of PLA, Beijing 100039, China.

出版信息

J Tradit Chin Med. 2020 Dec;40(6):1052-1058. doi: 10.19852/j.cnki.jtcm.2020.06.017.

Abstract

OBJECTIVE

To conduct a multicenter randomized controlled trial of the efficacy of standardized Chinese herbal medicines (CHMs) against acute- on-chronic liver failure (ACLF) and provide reproducible and high-level evidence for clinical practice.

METHODS

This is a prospective, multicenter, centrally randomized controlled trial. Patients diagnosed with hepatitis B virus-related ACLF (n = 510) will be allocated to the standard medical therapy or CHM group at a 1∶1 ratio. Two CHMs will be used on the basis of the traditional Chinese medicine syndrome: Liangxue Jiedu granules for excess syndromes and Yiqi Jiedu granules for deficiency syndromes. The primary outcome is transplant-free survival at week 12. The secondary outcomes are (a) transplant-free survival at week 24, (b) liver function as assessed using the model for end-stage liver disease score at week 12, (c) liver function as assessed using the Child-Pugh score at week 12, and (d) the incidence of complications at week 12.

DISCUSSION

The effectiveness and safety of CHM formulations will be assessed following treatment for ACLF.

摘要

目的

开展一项针对慢性加急性肝衰竭(ACLF)的中药标准化制剂的多中心随机对照临床试验,为临床实践提供可重复的高水平证据。

方法

这是一项前瞻性、多中心、中心随机对照临床试验。将诊断为乙型肝炎病毒相关 ACLF 的患者(n=510)按 1:1 的比例随机分配至标准医学治疗组或中药组。基于中医证候,使用两种中药制剂:凉血解毒颗粒用于实证,益气解毒颗粒用于虚证。主要结局为 12 周时无移植生存率。次要结局为:(a)24 周时无移植生存率;(b)12 周时采用终末期肝病模型评分评估的肝功能;(c)12 周时采用 Child-Pugh 评分评估的肝功能;(d)12 周时并发症发生率。

讨论

将评估 ACLF 治疗后中药制剂的有效性和安全性。

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