Effects of Adjuvant Chinese Patent Medicine Therapy on Prevention of Variceal Rebleeding: A Retrospective Cohort Study
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hinese Journal of Integrative Medicine
Available online at link.springer.com/journal/11655 Journal homepage: www.cjim.cn/zxyjhen/zxyjhen/ch/index.aspx E-mail: [email protected]
Original Article
Effects of Adjuvant Chinese Patent Medicine Therapy on Prevention of Variceal Rebleeding: A Retrospective Cohort Study ZHANG Qun1, LI Yu-xin1, LIU Yao1, HOU Yi-xin1, ZHU Bing-bing2, HUANG Yun-yi3, SHI Ke3, and WANG Xian-bo1 Objective:: To assess whether adjuvant Chinese patent medicines (CPMs) to standard treatment ABSTRACT Objective Methods:: This study retrospectively could reduce recurrent bleeding after variceal bleeding in cirrhotic patients. Methods collected 555 consecutive patients who recovered from variceal bleeding. A population-based cohort study was established depending on if adjuvant CPMs were administered to prevent rebleeding. A total of 139 patients who had taken 28 cumulative defined daily doses (cDDDs) of CPMs were included in the CPMs cohort, and 416 patients who used 180 cDDDs of CPMs, respectively. The median rebleeding interval in the CPMs cohort was significantly larger compared Conclusion:: Adjuvant CPMs to standard therapy can with the non-CPMs cohort (113.5 vs . 93.0 days; P =0.008). Conclusion significantly reduce the incidence of variceal rebleeding and delay the time to rebleeding. KEYWORDS adjuvant therapy, Chinese patent medicine, variceal bleeding, variceal rebleeding
Esophagogastric variceal bleeding (EGVB) is one of the most common and severe complications of portal hypertension, and represents a leading cause of death in patients with liver cirrhosis.(1-4) Once variceal bleeding has occurred, approximately 70% of cirrhotic patients experience recurrent variceal hemorrhage within a year.(5) Rebleeding is a serious life-threatening complication in cirrhotic patients, with a mortality rate of 20% at 6 weeks.(6) Therefore, for patients recovering from an acute bleeding event, prevention of esophageal variceal rebleeding is crucial to reducing bleeding risk, increasing survival rates, and improving prognosis. Currently, the first-line standard therapy after variceal bleeding is the combination of repeated endoscopic treatment (endoscopic variceal ligation for esophageal varices and N-butyl cyanoacrylate injection for gastric varices) and nonselective β-blockers (NSBBs), until variceal eradication. (7) Although there is a great advantage in the standard
therapy, the prognosis of portal hypertension has not recorded remarkable improvement, and the risk of rebleeding remains high. (8) Some patients are contra-indicated to NSBB treatment or intolerant of side effects.(9) Therefore, many patients will use complementary and alternative therapies to improve efficacy, alleviate treatment-related side effect, improve survival rate and delay rebleeding time. ©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature 2020 Supported by the Capital Health Development Research Project (No. 2018-1-2172), and Beijing Municipal
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