中西医结合疗法对慢性乙型肝炎患者发生肝硬化和肝细胞癌的影响

Effect of integrated Chinese and Western medicine on Hepatocarcinogenesis in Patients with Hepatitis B Related Liver Cirrhosis

目的:探究中西医结合疗法对慢性乙型肝炎(CHB)患者肝硬化肝细胞癌发生的影响。方法:选取2008年3月至2018年6月接受治疗和随访的CHB患者306例,按治疗方法分为中西医结合疗法组(简称结合组)和西药组,比较两组患者在治疗后的7、10年时其肝硬化和肝细胞癌的发生情况。结果:随访7和10年结合组患者肝硬化发生密度为0.64%、0.68%,肝细胞癌发生密度为0.39%、0.62%;西药组患者7年、10年肝硬化发生密度为1.48%、1.75%,肝细胞癌发生密度为1.59%、1.23%,组间差异有统计学意义(P<0.05)。结合组患者随访7和10年其肝硬化相对危险度(RR)值分别为0.57与0.48。随访7、10年其肝细胞癌RR值分别为0.41与0.66,中西医结合疗法与患者肝硬化、肝细胞癌的发生呈负相关(RR值<1)。结论:采用中西医结合疗法治疗CHB患者,能够有效地控制患者病情,延缓向肝硬化、肝癌发展的进程,并能降低肝硬化、肝细胞癌的发病密度。

Objective:To explore the effect of integrated Chinese and Western medicine on the occurrence of liver cancer in patients with chronic hepatitis B(CHB).Methods:A total of 306 patients with CHB who underwent treatment and follow-up from March 2008 to June 2018 were enrolled.The patients were divided into the Chinese and Western medicine combination therapy group(referred to as the combined group)and the western medicine group.The patients in the two groups were compared within 7 to 10 years after treatment.Results:The incidence of cirrhosis in the combined group was 0.64%,0.68%,and the density of hepatocellular carcinoma was 0.39%and 0.62%.The density of cirrhosis in the western medicine group was 1.48%and 1.75%.The density of hepatocellular carcinoma was 1.59%and 1.23%.The difference between the two groups were statistically significant(P<0.05).The relative risk(RR)values of cirrhosis were 0.57 and 0.48 in the two groups after 7 to 10 years of follow-up.The RR values of hepatocellular carcinoma were 0.41 and 0.66,respectively,after 7 to 10 years of follow-up.TCM syndrome differentiation was negatively correlated with cirrhosis and hepatocellular carcinoma(RR value<1).Conclusion:The treatment of CHB patients with integrated Chinese and Western medicine can effectively delay the progression of liver cirrhosis and liver cancer and reduce the density of disease.