中医药联合抗病毒治疗对乙型肝炎相关性肝硬变患者肝癌发生情况的影响  

Effect of TCM Combined with Antiviral Therapy on Occurrence of Liver Cancer of Patients with Hepatitis B-related Cirrhosis

作　　者：贾云飞 杨晋翔 王宪波[3] 贾玉[4] 陈泽慧[4] 邢恩龙 王瑞瑞[4] 

机构地区：[1]河南中医药大学第二附属医院/河南省中医院,河南郑州450002 [2]北京中医药大学第三附属医院,北京100029 [3]首都医科大学附属北京地坛医院,北京100015 [4]北京中医药大学,北京100029

出　　处：《中医学报》2017年第10期1814-1820,共7页Acta Chinese Medicine

基　　金：重大传染病防治协同创新中心(2011协同创新中心)项目(PXM2015-014226-000058);北京中医药大学优秀青年骨干教师专项计划(2016-JYB-QNJSZX013)

摘　　要：目的:观察中医药联合抗病毒治疗对乙型肝炎相关性肝硬变患者肝癌发生情况的影响。方法:回顾性分析于北京地坛医院就诊的513例乙肝相关性肝硬变患者的临床资料,分为西医组291例,中西医结合组222例,两组均予核苷类似物抗病毒治疗,中西医结合组根据辨证加用安络化纤丸、复方鳖甲软肝片、扶正化瘀胶囊和络舒肝片中的1种口服,比较两组患者肝癌的发生情况,以及不同CU-HCC风险分级、不同临床分期患者的肝癌发生情况。观察终点为确诊肝癌或随访时间达到5 a。结果:5 a内,中西医结合组肝癌发生率为26.6%,明显低于西医组的33.7%,两组比较,差异有统计学意义(P=0.034<0.05);CU-HCC高风险患者中,中西医结合组肝癌发生率(28.3%)明显低于西医组(36.6%),两组比较,差异有统计学意义(P=0.023<0.05);代偿期患者中,中西医结合组肝癌发生率(18.3%)明显低于西医组(33.1%),两组比较,差异有统计学意义(P=0.003<0.05)。结论:中医药联合抗病毒药物治疗乙型肝炎相关性肝硬变,可有效降低患者肝癌发生率,尤其对CU-HCC高风险评分患者更具优势,且可减少代偿期患者的肝癌发生。Objective：To observe the effect of TCM combined with antiviral therapy on occurrence of liver cancer in patients with hepatitis B-related cirrhosis.Methods：The clinical data of 513 patients with hepatitis B-related cirrhosis were analyzed retrospectively.The clinical data were divided into 291 cases of western medicine group and 222 cases of integrative medicine group.Both groups were treated with one kind of medicine of Anluo Huaxian pill,Compound Biejia Ruangan tablet,Fuzheng Huayu capsule and Luoshugan tablet.The incidence of liver cancer in the two groups was compared and the incidence of that in different CU-HCC risk classifications as well as in different clinical stages.The end point for the observation was the diagnosis of liver cancer or the follow-up time being 5 a.Results：The incidence of hepatocellular carcinoma was 26.6%in the Integrative medicine group,which was significantly lower than that（33.7%）of the western medicine group（P=0.034〈0.05）.The incidence of hepatocellular carcinoma（28.3%）in CU-HCC high risk patients was significantly lower than that（36.6%）of western medicine group（P=0.023〈0.05）.In patients in compensatory stage,the incidence of hepatocellular carcinoma（18.3%）was significantly lower than that（33.1%）of the western medicine group（P=0.003〈0.05）.Conclusion：Chinese medicine combined with antivira therapy for hepatitis B-related cirrhosis can effectively reduce the incidence of liver cancer in patients,especially for patients with high risk score of CU-HCC,and can reduce the occurrence of liver cancer in patients in compensatory stage.

关 键 词：乙型肝炎相关性肝硬变 肝癌 抗病毒治疗 中医药治疗 中西医结合 

分 类 号：R273.57[医药卫生—中西医结合]