Chen Long, Zhao Chaoqun, Yao Weili, Liu Wei, Zhang Hua, Mu Yongping, Cai Hong, Xue Dongying, Wang Chengbao, Wang Wan'e, Lin Yuehong, Chen Jiamei, Liu Ping
Institute of Liver Diseases, Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai, China.
J Clin Transl Hepatol. 2023 Feb 28;11(1):136-143. doi: 10.14218/JCTH.2021.00451. Epub 2022 Apr 8.
The aim was to evaluate the efficacy and safety of Yanggan Jian (YGJ) in HBV-infected patients with decompensated cirrhosis.
This randomized, double-blind controlled trial enrolled 160 patients with HBV-related decompensated cirrhosis who were already receiving or about to start antiviral therapy. Patients were randomly assigned to receive YGJ or placebo for 24 weeks, and were followed-up to 36 weeks. The primary outcome was the proportion of patients with a ≥2 point reduction in Child-Turcotte-Pugh (CTP) score from baseline at week 24. Secondary outcomes were CTP class and score, serum liver function indices, mortality, incidence of hepatocellular carcinoma and variceal bleeding.
The proportion of patients with a CTP score reduction ≥2 was significantly greater in the YGJ than in the placebo group (=0.009); the percentage of patients with CTP class C was significantly less than that in the placebo group (<0.05), and the YGJ group had a significantly greater mean change from baseline in CTP score at week 24 (=0.034). The improvement in measured values and change from baseline of prothrombin time, serum albumin, platelets, cholinesterase, international normalized ratio, and activated partial thromboplastin time were significantly better with YGJ than with placebo. Between-group differences in cumulative rates of variceal bleeding, hepatocellular carcinoma, death, or the frequency of any adverse event (AE), AEs related to treatment, or discontinuation because of AEs were not significant.
YGJ significantly improved CTP scores and hepatic synthetic and reserve function in patients with HBV-related decompensated cirrhosis, and was safe and well tolerated.
本研究旨在评估养肝煎(YGJ)对乙型肝炎病毒(HBV)感染失代偿期肝硬化患者的疗效及安全性。
本随机双盲对照试验纳入160例已接受或即将开始抗病毒治疗的HBV相关失代偿期肝硬化患者。患者被随机分配接受YGJ或安慰剂治疗24周,并随访至36周。主要结局指标为第24周时Child-Turcotte-Pugh(CTP)评分较基线降低≥2分的患者比例。次要结局指标包括CTP分级和评分、血清肝功能指标、死亡率、肝细胞癌发病率及静脉曲张出血发生率。
YGJ组CTP评分降低≥2分的患者比例显著高于安慰剂组(P=0.009);CTP C级患者的比例显著低于安慰剂组(P<0.05),且YGJ组在第24周时CTP评分较基线的平均变化显著更大(P=0.034)。与安慰剂相比,YGJ在凝血酶原时间、血清白蛋白、血小板、胆碱酯酶、国际标准化比值及活化部分凝血活酶时间的测量值改善及较基线的变化方面均显著更优。两组间在静脉曲张出血、肝细胞癌、死亡的累积发生率或任何不良事件(AE)、与治疗相关的AE或因AE停药的频率方面差异均无统计学意义。
YGJ可显著改善HBV相关失代偿期肝硬化患者的CTP评分及肝脏合成和储备功能,且安全性良好、耐受性佳。