AIM To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis(SAH).METHODS We performed a retrospective cohort study in consecutive patients diagnosed with SAH...AIM To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis(SAH).METHODS We performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury beforeand after treatment. Additionally, the 3-and 12-mo survival rates and the occurrence of complications were analyzed.RESULTS One hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients' baseline characteristics(P > 0.05). However, significant improvements of 90-d survival rate [56/68(82.4%) vs 27/60(45.0%), P = 0.0000] and 365-d survival rate [48/68(70.6%) vs 13/60(21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group(P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant(P < 0.05). No significant differences in complications and adverse effects were found between the two groups.CONCLUSION Gutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.展开更多
BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated fo...BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated for clinical treatments,and their effects are accurate,but with a high incidence of side effects,such as nausea,vomiting,constipation,and other conditions.Acupuncture is a traditional Chinese medicine therapy.There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain.However,which of these methods is the most effective method is still unclear.AIM To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.METHODS Eligible studies were retrieved from eight databases(the Cochrane Library,PubMed,EMBASE,Medline,CNKI,CBM,Chongqing VIP,and Wan Fang Database)up to March 31,2021 and screened based on the established inclusion and exclusion criteria.The quality of the include studies was evaluated.Stata software was applied for statistical analyses.Publication bias of the included studies was also determined.Finally,the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.RESULTS A total of eight randomized controlled trials were included in the network metaanalysis.Eight trials(covering 5 treatments and 734 patients)provided data suitable for analysis.Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias,commonly associated with lack of blinding(which was sometimes impossible to achieve).End of treatment results showed that four interventions,including wrist-ankle acupuncture,triple puncture and remaining needle acupuncture,Tian Yuan acupuncture,and block acupuncture,produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy.The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.CONCLUSION The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.展开更多
文摘AIM To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis(SAH).METHODS We performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury beforeand after treatment. Additionally, the 3-and 12-mo survival rates and the occurrence of complications were analyzed.RESULTS One hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients' baseline characteristics(P > 0.05). However, significant improvements of 90-d survival rate [56/68(82.4%) vs 27/60(45.0%), P = 0.0000] and 365-d survival rate [48/68(70.6%) vs 13/60(21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group(P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant(P < 0.05). No significant differences in complications and adverse effects were found between the two groups.CONCLUSION Gutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.
文摘BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated for clinical treatments,and their effects are accurate,but with a high incidence of side effects,such as nausea,vomiting,constipation,and other conditions.Acupuncture is a traditional Chinese medicine therapy.There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain.However,which of these methods is the most effective method is still unclear.AIM To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.METHODS Eligible studies were retrieved from eight databases(the Cochrane Library,PubMed,EMBASE,Medline,CNKI,CBM,Chongqing VIP,and Wan Fang Database)up to March 31,2021 and screened based on the established inclusion and exclusion criteria.The quality of the include studies was evaluated.Stata software was applied for statistical analyses.Publication bias of the included studies was also determined.Finally,the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.RESULTS A total of eight randomized controlled trials were included in the network metaanalysis.Eight trials(covering 5 treatments and 734 patients)provided data suitable for analysis.Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias,commonly associated with lack of blinding(which was sometimes impossible to achieve).End of treatment results showed that four interventions,including wrist-ankle acupuncture,triple puncture and remaining needle acupuncture,Tian Yuan acupuncture,and block acupuncture,produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy.The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.CONCLUSION The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.
