Beneficial Effects of Traditional Chinese Medicine Fuzheng Huayu on the Occurrence of Hepatocellular Carcinoma in Patients with Compensated Chronic Hepatitis B Cirrhosis Receiving Entecavir:A Multicenter Retrospective Cohort Study  

作　　者：Haina Fan Shujuan Lei Zhimin Zhao Yan Huang Hui Wang Xudong Liu Xiaodong Li Min Xu Wei Zhang Kewei Sun Huichun Xing Yang Mei Jiaquan Huang Chuanwu Zhu Kejun Zhang Yali Zong Xizhong Shen Qing Xie Chenghai Liu 

机构地区：[1]Institute of Liver Diseases,Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,Key Laboratory of Liver and Kidney Diseases(Ministry of Education),Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,China [2]Department of Infectious Diseases,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China [3]Department of Infectious Diseases,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning,Guangxi,China [4]Institute of Liver Diseases,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan,Hubei,China [5]Department of Infectious Diseases,Huaian Fourth People’s Hospital,Huai’an,Jiangsu,China [6]Institute of Liver Diseases,Shijiazhuang Fifth Hospital,Shijiazhuang,Hebei,China [7]Department of Liver Diseases,The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China [8]Center of Hepatology,Capital Medical University Affiliated Beijing Ditan Hospital,Beijing,China [9]Department of Hepatology,The Fifth People’s Hospital of Anyang,Anyang,Henan,China [10]Department and Institute of Infectious Disease,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,China [11]Department of Hepatology,The Fifth People’s Hospital of Suzhou,Suzhou,Jiangsu,China [12]Department of Gastroenterology,The First People’s Hospital of Jingmen,Jingmen,Hubei,China [13]Department of Integrated Traditional and Western Medicine,The Ninth Hospital of Nanchang,Nanchang,Jiangxi,China [14]Department of Gastroenterology,Zhongshan Hospital,Fudan University,Shanghai,China

出　　处：《Journal of Clinical and Translational Hepatology》2024年第5期505-515,共11页临床与转化肝病杂志（英文版）

基　　金：supported by the Shanghai Key Specialty of Traditional Chinese Clinical Medicine(grant number shslczdzk01201);the National Science and Technology Major Project(grant number 2018ZX10302204);Shanghai University of Traditional Chinese Medicine(grant number ZYJK FW201811013).

摘　　要：Background and Aims:The application of antifibrotic drugs to treat patients with chronic liver diseases who are receiving antiviral therapies for hepatocellular carcinoma(HCC)has not been established.Here,we aimed to assess the impact of the Traditional Chinese Medicine Fuzheng Huayu(FZHY)on the occurrence of HCC in patients with hepatitis B virus-related compensated cirrhosis receiving the antiviral drug entecavir(ETV).Methods:A multicenter retrospective cohort study was performed.Compensated liver cirrhosis patients were divided into the ETV+FZHY group or the ETV group according to treatment.The cumulative incidence of HCC was analyzed using Kaplan-Meier and log-rank tests.Propensity score matching was used for confounding factors.Stratified analysis and Cox regression were used to determine the effects of FZHY on the occurrence of HCC and liver function decompensation.Results:Out of 910 chronic hepatitis B patients,458 were in the ETV+FZHY group and 452 were in the ETV group.After propensity score matching,the 5-year cumulative incidence of HCC was 9.8%in the ETV+FZHY group and 21.8%in the ETV group(p<0.01).The adjusted hazard ratio for HCC was 0.216(0.108,0.432)when FZHY treatment was>36 months.Age,diabetes,alanine aminotransferase,γ-glutamyl transpeptidase,albumin,hepatitis B e-antigen,and fibrosis 4 score were associated with the occurrence of HCC.FZHY decreased the risk of HCC in patients aged>45 years with a hepatitis B virus DNA level of≥2,000 IU/l.Conclusion:Adjunctive FZHY treatment reduced HCC occurrence in patients with hepatitis B virus cirrhosis who were treated with ETV,possibly due to the antifibrotic properties of FZHY.

关 键 词：ENTECAVIR Fuzheng Huayu Hepatitis B virus CIRRHOSIS Hepatocellular carcinoma Traditional Chinese Medicine 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]