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基于真实世界临床数据的“中医调控肝再生”治疗方案降低乙肝相关肝衰竭患者死亡率的研究

The "Traditional Chinese medicine regulating liver regeneration" treatment plan for reducing mortality of patients with hepatitis B-related liver failure based on real-world clinical data.

作者信息

Dai Ling, Gao Xiang, Ye Zhihua, Li Hanmin, Yao Xin, Lu Dingbo, Wu Na

机构信息

Institute of Liver Diseases, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, China.

Institute of Basic Theory of Chinese Medicine, Hubei Province Academy of Traditional Chinese Medicine, Wuhan, 430074, China.

出版信息

Front Med. 2021 Jun;15(3):495-505. doi: 10.1007/s11684-020-0790-9. Epub 2021 Jan 12.

Abstract

On the basis of real-world clinical data, the study aimed to explore the effect and mechanisms of the treatment plan of "traditional Chinese medicine (TCM) regulating liver regeneration." A total of 457 patients with HBV-related liver failure were retrospectively collected. The patients were divided into three groups: the modern medicine control group (MMC group), patients treated with routine medical treatment; the control group combining traditional Chinese and Western medicine (CTW), patients treated with routine medical treatment plus the common TCM formula; and the treatment group of "TCM regulating liver regeneration" (RLR), patients treated with both routine medical treatment and the special TCM formula of RLR. After 8 weeks of treatment, the mortality of patients in the RLR group (12.31%) was significantly lower than those in the MMC (50%) and CTW (29.11%) groups. Total bilirubin level significantly decreased and albumin increased in the RLR group when compared with the MMC and CTW groups (P < 0.05). In addition, there were significant differences in the expression of several cytokines related to liver regeneration in the RLR group compared with the MMC group. RLR treatment can decrease jaundice, improve liver function, and significantly reduce the mortality in patients with HBV-related liver failure. The mechanism may be related to the role of RLR treatment in influencing cytokines related to liver regeneration.

摘要

基于真实世界临床数据,本研究旨在探讨“中医调肝复元”治疗方案的疗效及机制。回顾性收集了457例HBV相关肝衰竭患者。将患者分为三组:现代医学对照组(MMC组),采用常规药物治疗;中西医结合对照组(CTW),采用常规药物治疗加常用中药方剂;“中医调肝复元”治疗组(RLR),采用常规药物治疗加RLR专用中药方剂。治疗8周后,RLR组患者死亡率(12.31%)显著低于MMC组(50%)和CTW组(29.11%)。与MMC组和CTW组相比,RLR组总胆红素水平显著降低,白蛋白水平升高(P<0.05)。此外,与MMC组相比,RLR组中几种与肝再生相关的细胞因子表达存在显著差异。RLR治疗可降低黄疸,改善肝功能,并显著降低HBV相关肝衰竭患者的死亡率。其机制可能与RLR治疗对肝再生相关细胞因子的影响有关。

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