Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial

Yu-ming Guo; Feng-yi Li; Man Gong; Lin Zhang; Jia-bo Wang; Xiao-he Xiao; Jun Li; Yan-ling Zhao; Li-fu Wang; Xiao-feng Zhang

doi:10.1007/s11655-016-2582-2

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Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial

OriginalPaper | Updated：2021-08-27

- Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial
- Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial
- 中国结合医学杂志（英文版） 2016年22卷第8期页码：573-580
- Affiliations：
  
  1. China Military Institute of Chinese Materia Medica, Military Hospital,Beijing,China,302
  2. Treatment and Research Center for Infectious Diseases, Military Hospital,Beijing,China,302
  3. Integrative Medical Center for Liver Diseases, Military Hospital,Beijing,China,302
  4. Medical Affairs, Novartis Pharma China,Beijing,China
- Author bio：
- Funds：
  
  Supported by the Ministry of Science and Technology of China, through its National Key Projects for Basic Research (No. 2007CB512607), and National Eleventh Five-year Great Science and Technology Project (No. 2008ZX10005-007)
- DOI：10.1007/s11655-016-2582-2
  中图分类号：
- 纸质出版日期：2016，
  
  网络出版日期：2016-5-24，
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Guo, Ym., Li, Fy., Gong, M. et al. Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial., Chin. J. Integr. Med. 22, 573–580 (2016). https://doi.org/10.1007/s11655-016-2582-2

Yu-ming Guo, Feng-yi Li, Man Gong, et al. Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial[J]. Chinese Journal of Integrative Medicine, 2016,22(8):573-580.
Guo, Ym., Li, Fy., Gong, M. et al. Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial., Chin. J. Integr. Med. 22, 573–580 (2016). https://doi.org/10.1007/s11655-016-2582-2 DOI：

Yu-ming Guo, Feng-yi Li, Man Gong, et al. Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial[J]. Chinese Journal of Integrative Medicine, 2016,22(8):573-580. DOI： 10.1007/s11655-016-2582-2.

摘要

To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (茵陈术附汤

YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus (HBV-ACLF) with cold pattern in Chinese medicine (CM). This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine (WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM (integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease (MELD) score

liver biochemical function

coagulation function and complications. Adverse events during treatment were reported. The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ2 =6.156

P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353

P=0.020). There were statistically signifificant differences in aspartate transaminase

total bilirubin

indirect bilirubin

direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ2=9.033

P=0.003) and spontaneous bacteria peritonitis (χ2=4.194

P=0.041) were improved signifificantly in the integrative treatment group. No serious adverse event was reported. The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle “treating cold pattern with hot herbs” remains valuable to the clinical therapy. (Trial registration No. ChiCTR-TRC-10000766)

Abstract

To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (茵陈术附汤

liver biochemical function

coagulation function and complications. Adverse events during treatment were reported. The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ2 =6.156

P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353

P=0.020). There were statistically signifificant differences in aspartate transaminase

total bilirubin

indirect bilirubin

direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ2=9.033

P=0.003) and spontaneous bacteria peritonitis (χ2=4.194

关键词

hepatitis B virus-related acute-on-chronic liver failuremortalityChinese Medicinecold patternYinchen Zhufu Decoction

Keywords

hepatitis B virus-related acute-on-chronic liver failuremortalityChinese Medicinecold patternYinchen Zhufu Decoction

references

Laleman W, Verbeke L, Meersseman P, Wauters J, van Pelt J, Cassiman D, et al. Acute-on-chronic liver failure:current concepts on definition, pathogenesis, clinical manifestations and potential therapeutic interventions. Expert Rev Gastroenterol Hepatol 2011;5:523–537.

Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Diseases and Artificial Liver Group, Chinese Society of Hepatology. Diagnostic and treatment guidelines for liver failure. Chin J Hepatol (Chin) 2006;14:643–646.

Jia JD, Zhuang H. A winning war against hepatitis B virus infection in China. Chin Med J 2007;120:2157–2158.

Liu Q. Role of Cytokines in the Pathophysiology of acuteon-chronic liver failure. Blood Purif 2009;28:331–341.

Stadlbauer V, Davies NA, Sen S, Jalan R. Artificial liver support systems in the management of complications of cirrhosis. Semin Liver Dis 2008;28:96–109.

Laleman W, Wilmer A, Evenepoel P, Verslype C, Fevery J, Nevens F. Review article: non-biological liver support in liver failure. Aliment Pharmacol Ther 2006;23:351–363.

Jalan R, Williams R. Acute-on-chronic liver failure: pathophysiological basis of therapeutic options. Blood Purif 2002;20:252–261.

Evans WE, Relling MV. Moving towards individualized medicine with pharmacogenomics. Nature 2004;429:464–468.

Qiu J. Traditional medicine: a culture in the balance. Nature 2007;448:126–128.

Lei ZQ, Chen SY, Gao XM, eds. Chinese pharmacy. Shanghai: Shanghai Science and Technology Press; 2008.

Wang Q, Jiang P, Ye FY, Shi R, Ma YM, Zhong J, et al. Identification and pharmacokinetics of multiple constituents in rat plasma after oral administration of Yinchenzhufu Decoction. J Ethnopharmacol 2014;153:714–724.

Yang HY. Two cases for treatment of yin-jaundice by Yinchen Zhufu Decoction. J Chin Med Clin 2008;3:23.

China Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China. Beijing: Chemical Industry Press;2005.

Sun KW, Chen B, Huang YH. Clinical observation on chronic severe hepatitis B treated by principles of coolingblood and detoxicating combined with clearing-heat and resolving-damp or combined with strengthening-Pi and warming-yang. Chin J Integr Tradit West Med (Chin) 2006;26:981–983.

Shiv KS, Ashish K, John AA, Chawla YK, Fan ST, Garg H, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). Hepatol Int 2009;3:269–282.

Zheng XY, ed. Guiding principle of clinical research on new drugs of Chinese medicine (trial implementation). Beijing: Chinese Medical Science and Technology Press; 2002.

Wang YY, Li MF, Dai XM, eds. Chinese internal medicine. Shanghai: Shanghai Scientific and Technical Publishers;1998.

ICH Good Clinical Practices. Available at: http://www. vadscorner.com/internet29.html.

Luo SQ, Zhang LX. AASLD practice guidelines: chronic Hepatitis B. Chin J Hepatol (Chin) 2007;15:477–480.

Ministry of Health, General Logistics Department of PLA. Diagnosis and curing criteria of clinical diseases (2nd ed). Beijing: People’s Military Medical Press; 2002.

Sanyal AJ, Stravitz RT, eds. Hepatology: a textbook of liver disease. 5th ed. Philadelphia: Saunders Elsevier;2006.

Bui Han SH, Martin P. Liver transplantation for hepatitis B. Hepatol Res 2004;29:193–201.

Rutherford A, Davern T, Hay JE, Murray NG, Hassanein T, Lee WM, et al. Influence of high body mass index on outcome in acute liver failure. Clin Gastroenterol Hepatol 2006;4:1544–1549.

Bernal W, Wendon J. Liver transplantation in adults with acute liver failure. J Hepatol 2004;40:192–197.

O’Shea RS, Dasarathy S, McCullough AJ. Alcoholic liver disease. Am J Gastroenterol 2010;105:14–32.

Merle P, Trépo C, Zoulim F. Current management strategies for hepatitis B in the elderly. Drugs Aging 2001;18:725–735.

Dang ZQ, Yang GH, Ma YJ, Zhao CP, Yu JZ, Xi YH, et al. Synergistic effect of multi-ways Chinese medication on routine therapy for hepatitis B virus related acute-on-chronic liver failure. J Tradit Chin Med (Chin) 2012;53:2109–2111.

Liu Q, Liu Z, Wang T, Wang Q, Shi X, Dao W. Characteristics of acute and sub-acute liver failure in China: nomination, classification and interval. J Gastroenterol Hepatol 2007;22:2101–2106.

Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. J Hepatol 2000;31:864–871.

Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL. A model to predict survival in patients with end-stage liver disease. J Hepatol 2001;33:464–470.

Kamath PS, Kim WR. The model for end-stage liver disease (MELD). J Hepatol 2007;45:797–805.

Zaman MB, Hoti E, Qasim A, Maguire D, McCormick PA, Hegarty JE, et al. MELD score as a prognostic model for listing acute liver failure patients for liver transplantation. Transplant Proc 2006;38:2097–2098.

Santori G, Andorno E, Morelli N, Antonucci A, Bottino G, Mondello R, et al. MELD score versus conventional UNOS status in predicting short-term mortality after liver transplantation. Transpl Int 2005;18:65–72.

Dunn W, Jamil LH, Brown LS, Wiesner RH, Kim WR, Menon KV, et al. MELD accurately predicts mortality in patients with alcoholic hepatitis. J Hepatol 2005;41:353–358.

Zhao J, Zhang JY, Yu HW, He YL, Zhao JJ, Li J, et al. Improved survival ratios correlate with myeloid dendritic cell restoration in acute-on-chronic liver failure patients receiving methylprednisolone therapy. Cell Mol Immunol 2012;9:417–422.

Zhang Q, Sun FX. Clinical analysis of 79 patients with subacute liver failure. J Clin Hepatol 2012;28:53–54.

Cao CA, Zou ZS, Li BS, Chen JM, Zhang W, Xie H, et al. Clinical features and prognosis of 151 cases with subacute severe hepatitis. J Clin Intern Med 2006;23:96–97.

Huang K, Hu JH, Wang HF, He WP, Chen J, Duan XZ, et al. Survival and prognostic factors in hepatitis B virusrelated acute-on-chronic liver failure. World J Gastroenterol 2011;17:3448–3452.

Lu AP, Chen KJ. Integrative medicine in clinical practice: from pattern differentiation in traditional Chinese medicine to disease treatment. Chin J Integr Med 2009;15:152.

Jiang M, Lu C, Zhang C, Yang J, Tan Y, Lu A, et al. Syndrome differentiation in modern research of traditional Chinese medicine. J Ethnopharmacol 2012;140:634–642.

Jiang M, Lu C, Chen G, Xiao C, Zha Q, Niu X, et al. Understanding the molecular mechanism of interventions in treating rheumatoid arthritis patients with corresponding traditional Chinese medicine patterns based on bioinformatics approach. Evid Based Complement Alternat Med 2012;2012:1294.

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