Effect of Chinese Patent Medicine on the Progression of Severe Alcoholic Hepatitis into Acute-on-chronic Liver Failure

Haoyu WANG; Hui QUAN; Yuyong JIANG; Huimin LIU; Yixin HOU; Hao YU; Zhiyun YANG; Xianbo WANG

doi:10.13288/j.11-2166/r.2022.02.009

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Effect of Chinese Patent Medicine on the Progression of Severe Alcoholic Hepatitis into Acute-on-chronic Liver Failure

更新时间：2022-01-14

- Effect of Chinese Patent Medicine on the Progression of Severe Alcoholic Hepatitis into Acute-on-chronic Liver Failure
- Journal of Traditional Chinese Medicine Vol. 63, Issue 2, Pages: 143-148(2022)
- 作者机构：
  
  1.首都医科大学附属北京地坛医院，北京市朝阳区京顺东街8号，100015
  2.北京中医药大学东直门医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2022.02.009
  CLC：
- Received：13 June 2021，
  
  Revised：2021-10-29，
  
  Published：17 January 2022
- 稿件说明：
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王浩宇,全卉,江宇泳等.中成药对重症酒精性肝炎患者慢加急性肝衰竭发生率的影响[J].中医杂志,2022,63(02):143-148.

WANG Haoyu,QUAN Hui,JIANG Yuyong,et al.Effect of Chinese Patent Medicine on the Progression of Severe Alcoholic Hepatitis into Acute-on-chronic Liver Failure[J].Journal of Traditional Chinese Medicine,2022,63(02):143-148.
王浩宇,全卉,江宇泳等.中成药对重症酒精性肝炎患者慢加急性肝衰竭发生率的影响[J].中医杂志,2022,63(02):143-148. DOI： 10.13288/j.11-2166/r.2022.02.009.

WANG Haoyu,QUAN Hui,JIANG Yuyong,et al.Effect of Chinese Patent Medicine on the Progression of Severe Alcoholic Hepatitis into Acute-on-chronic Liver Failure[J].Journal of Traditional Chinese Medicine,2022,63(02):143-148. DOI： 10.13288/j.11-2166/r.2022.02.009.

摘要

目的

探讨中成药联合西医内科治疗对于重症酒精性肝炎（SAH）患者发生慢加急性肝衰竭（ACLF）的干预效果。

方法

回顾性收集SAH患者258例，根据是否联合使用中成药治疗分为中药组95例及非中药组163例。非中药组给予西医内科治疗，中药组给予西医内科治疗联合利湿退黄类、理气活血类、清热解毒类中成药。记录患者一般资料、实验室指标、Child-Turcotte-Pugh（CTP）评分、终末期肝病模型（MELD）评分、中成药使用情况，结局指标为SAH患者住院期间是否发生ACLF。并以SAH患者是否进展为ACLF为二分类变量，对两组患者匹配前后的临床资料进行Cox单因素回归分析，探讨SAH进展为ACLF影响因素。

结果

两组患者基线资料总胆红素（TBiL）、肌酐（Cr）、白蛋白（ALB）、血红蛋白（Hb）水平差异存在统计学意义（

＜0.05），不具有可比性。因此，对入组患者进行1

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1倾向性评分匹配后获得每组各83例患者。匹配前服用利湿退黄类中成药77例，服用理气活血类中成药38例，服用清热解毒类中成药16例；服用单一种类的中成药70例，联合服用两类或两类以上中成药25例，以利湿退黄类+理气活血类13例居多。匹配后中药组发生ACLF 20例（24.1%），非中药组发生ACLF 39例（46.9%），中药组ACLF发生率低于非中药组（

=0.002）。中药组及非中药组患者均以肝功能衰竭发生最多，分别为13例（15.7%）及28例（33.7%），组间差异有统计学意义（

＜0.05）。匹配后中药治疗（OR=0.463，95%

：0.261-0.823，

=0.009）为患者发生ACLF的独立影响因素。

结论

SAH患者在西医内科治疗基础上联合使用利湿退黄、理气活血、清热解毒类中成药能够降低住院期间ACLF发生率。

Abstract

Objective

To explore the effect of Chinese patent medicine （CPM） combined with Western internal medicine on the progression of severe alcoholic hepatitis （SAH） to acute-on-chronic liver failure （ACLF）.

Methods

Clinical data of 258 hospitalized SAH patients was collected for retrospective study. Patients were divided into CPM group （95 cases） and non-CPM group （163 cases） according to whether taking CPM for treatment or not. Patients in the CPM group were treated with Western internal medicine plus CPM having function of draining dampness and removing jaundice， regulating

and invigorating blood， clearing heat and resolving toxins， while those in the non-CPM group received Western internal medicine alone. The patients' baseline characteristics， laboratory indicators， Child-Turcotte-Pugh （CTP） score， model for end-stage liver disease （MELD） score and the use of Chinese patent medicine were recorded. The outcome measurement was whether ACLF occurs in SAH patients during the hospitalization. Whether ACLF occurs was taken as a binary variable， and Cox univariate analysis was performed to explore the risk factor of SAH progression into ACLF.

Results

The baseline data of the total bilirubin （TBiL）， creatinine （Cr）， albumin （ALB）， and hemoglobin （Hb） levels were significantly different between groups （

＜0.05）， which were not comparable. Therefore， prospensity score matching at ratio of 1

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1 were performed， and 83 patients in each group were matched. Before matching， 77 patients took dampness-draining and jaundice-removing CHM； 38 patients took

-regulating and blood-invigorating CHM； 16 patients took heat-clearing and toxins-resolving CPM； 70 patients took single type of CHM， while 25 patients received two or more types of CPM， of which dampness-draining and jaundice-removing CPM in combination of

-regulating and blood-invigorating CPM was mostly seen in 13 cases. After matching， there were 20 cases （24.1%） of ACLF in CPM group， significantly lower than 39 cases （46.9%） in non-CPM group （

=0.009）. Liver failure occurred mostly in both CPM （13， 15.7%）and non-CPM group （28， 33.7%）， with significant difference between groups （

＜0.05）. After matching， CPM treatment was an independent factor for progression into ACLF （OR=0.463， 95%

：0.261-0.823，

=0.009） .

Conclusion

The use of CPM with function of draining dampness and removing jaundice， regulating

and invigorating blood； clearing heat and resolving toxins plus Western internal medicine can reduce the incidence of ACLF in SAH patients during hospitalization.

关键词

Keywords

references

WANG W ， XU Y ， JIANG C ， et al . Advances in the treatment of severe alcoholic hepatitis ［J］. Curr Med Res Opin ， 2019 ， 35 （ 2 ）： 261 - 273 .

MICHELENA J ， ALTAMIRANO J ， ABRALDES JG ， et al . Systemic inflammatory response and serum lipopolysaccharide levels predict multiple organ failure and death in alcoholic hepatitis ［J］. Hepatology ， 2015 ， 62 （ 3 ）： 762 - 772 .

SERSTÉ T ， CORNILLIE A ， NJIMI H ， et al . The prognostic value of acute-on-chronic liver failure during the course of severe alcoholic hepatitis ［J］. J Hepatol ， 2018 ， 69 （ 2 ）： 318 - 324 .

周文伟，王邦才 . 中医药治疗酒精性肝病研究进展［J］. 辽宁中医药大学学报， 2017 ， 19 （ 2 ）： 118 - 121 .

中华医学会肝病学分会脂肪肝和酒精性肝病学组，中国医师协会脂肪性肝病专家委员会 . 酒精性肝病防治指南（2018年更新版）［J］. 临床肝胆病杂志， 2018 ， 34 （ 5 ）： 939 - 946 .

SINGAL A ， BATALLER R ， AHN J ， et al . ACG clinical guideline： alcoholic liver disease ［J］. Am J Gastroenterol ， 2018 ， 113 （ 2 ）： 175 - 194 .

MOREAU R ， JALAN R ， GINES P ， et al . Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis ［J］. Gastroenterology ， 2013 ， 144 （ 7 ）： 1426 - 1437 .

PUGH RN ， MURRAY-LYON IM ， DAWSON JL ， et al . Transection of the oesophagus for bleeding oesophageal varices ［J］. Br J Surg ， 1973 ， 60 （ 8 ）： 646 - 649 .

KAMATH PS ， WIESNER RH ， MALINCHOC M ， et al . A model to predict survival in patients with end-stage liver disease ［J］. Hepatology ， 2001 ， 33 （ 2 ）： 464 - 470 .

SEITZ HK ， BATALLER R ， CORTEZ-PINTO H ， et al . Alcoholic liver disease ［J］. Nat Rev Dis Primers ， 2018 ， 4 （ 1 ）： 16 .

GUSTOT T ， JALAN R . Acute-on-chronic liver failure in patients with alcohol-related liver disease ［J］. J Hepatol ， 2019 ， 70 （ 2 ）： 319 - 327 .

SARIN SK ， CHOUDHURY A . Acute-on-chronic liver failure： terminology， mechanisms and management ［J］. Nat Rev Gastroenterol Hepatol ， 2016 ， 13 （ 3 ）： 131 - 149 .

TREBICKA J ， FERNANDEZ J ， PAPP M ， et al . PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis ［J］. J Hepatol ， 2021 ， 74 （ 5 ）： 1097 - 1108 .

姚志山，吴云，张文静，等 . 酒精性肝病患者的中医体质特征分析［J］. 中西医结合肝病杂志， 2021 ， 31 （ 3 ）： 213 - 215 .

张小瑞，赵文霞 . 全国名老中医赵文霞教授诊治肝性脑病的经验总结［J］. 光明中医， 2020 ， 35 （ 13 ）： 1979 - 1982 .

谭桢，刘爱明，罗敏，等 . 茵栀黄注射液抗胆汁淤积药效成分的筛选及其作用机制研究［J］. 中国中药杂志， 2016 ， 41 （ 6 ）： 1113 - 1118 .

李晓永，张国顺 . 扶正化瘀胶囊联合异甘草酸镁治疗失代偿期肝硬化患者的临床效果［J］. 中国医药导报， 2019 ， 16 （ 11 ）： 138 - 141 .

周文君，缪虹雨，李萌，等 . 当飞利肝宁胶囊对急性肝损伤模型小鼠肝组织锌指蛋白A20表达及NF-κB信号通路的影响［J］. 中医杂志， 2020 ， 61 （ 22 ）： 2004 - 2009 .

黄灵跃，施维群，孟庆宇 . 复方鳖甲软肝片抗肝纤维化的现状及展望［J］. 江西中医药大学学报， 2015 ， 27 （ 4 ）： 97 - 99，107 .

杨宇，赵月涵，庄海，等 . 复方鳖甲软肝片防治大鼠肝纤维化作用及机制［J］. 贵州医科大学学报， 2018 ， 43 （ 12 ）： 1380 - 1385 .

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