中西医结合治疗对乙肝肝硬化代偿期患者逆转情况的队列研究

A cohort study on the reversal of patients with hepatitis B liver cirrhosis during the treatment of integrated Chinese and Western medicine

目的 :探讨中西医结合治疗对乙肝肝硬化代偿期患者广义和狭义逆转的作用。方法 :通过队列研究,以中医药治疗为暴露因素,将乙肝肝硬化代偿期患者分为高暴露、低暴露和无暴露3个队列,每12±2月随访一次,比较治疗前后及治疗后各组间患者狭义和广义逆转的相关指标变化。结果 :入组患者99例(高暴露组54例、低暴露组23例、无暴露组22例),治疗后三组APRI评分、Knodell积分、中医征候积分降低,有统计学意义;高暴露组治疗后Child评分、B超积分较治疗前下降;治疗后组间比较Knodell积分、APRI评分、Child评分、B超积分、中医证侯积分有统计学意义;乙肝肝硬化代偿期患者广义逆转率高、低、无暴露组分别为92.59%、82.61%、77.27%;狭义逆转率高、低、无暴露组分别为26.67%、12.5%、0%。结论 :中西医结合治疗能提高乙肝肝硬化代偿期患者广义和狭义逆转率。

Objective To explore the effect of integrated traditional Chinese and Western medicine on the generalized and narrow sense reversal of patients with hepatitis B liver cirrhosis.Methods Through the cohort study,with TCM treatment as the exposure factor,the patients with compensated HBV cirrhosis were divided into three groups:high exposuregroup,low exposure groupand no exposuregroup,followed up every 12±2 months.Before and after treatment,changes in related indicators of narrow and generalized reversals among patients in each group were recorded.Results A total of 99 patients were enrolled in the study(54 in the high exposure group,23 in the low exposure group,and 22 in the no exposed group).After the treatment,the APRI score,Knodell score,and TCM sign scores of the three groups decreased,showing statistical significance;After treatment,Child score and B-ultrasonic score decreased compared with before treatment.After treatment,Knodell score,APRI score,Child score,B-ultrasound score,and TCM syndrome score were statistically significant among groups.The generalized reversal rate of patients with compensatory phase of hepatitis B liver cirrhosis in the high,low,and no exposure groups were 92.59%,82.61%,and 77.27%,respectively.The narrow reversal rates in the high,low,and no exposure groups were 26.67%,12.5%,and 0%,respectively.Conclusion The combination of TCM and western medicine can improve the generalized and narrow sense reversal rate of patients with hepatitis B liver cirrhosis.