Abstract

Traditional Chinese medicine (TCM) has a long history in the treatment of chronic hepatitis B (CHB) based on the syndrome identification. Previous studies reported CHB patients with damp-heat (DH) syndrome accompanied with a severe liver function damage, but lacked the medication analysis. In this study, we analyzed 999 CHB patients with unidentified individual-level data from database to explore clinical features of two common syndromes of CHB patients based on the real world. Compared with the spleen deficiency (SD) syndrome, the CHB patients with DH syndrome had a significantly higher level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (P < 0.05) but took more immunomodulators and hepatoprotective drugs (P < 0.1). Similarly, in the follow-up of 207 patients after 3 months, the improvement trend of ALT and AST of patients with sustained SD syndrome was significantly better than those whose TCM syndrome changed from SD to DH (P < 0.05). The logistic model indicated DH syndrome was a significant negative factor for reducing ALT level in CHB patients (OR = 4.854, P=0.032). This study suggests that CHB patients with DH syndrome have potentially more serious and sustained liver damage than the SD syndrome, which provides a reference for the personalized management of CHB patients from the perspective of TCM syndromes.

Highlights

  • Hepatitis B is caused by hepatitis B virus (HBV) infection

  • About 50% patients with HCC were complicated with HBV infection [3]; the Global Hepatitis Report 2017 shows that approximately 887 thousand people die of chronic hepatitis B- (CHB-) related complications worldwide in 2015, mainly due to liver cirrhosis and hepatocellular carcinoma

  • Informed consent was obtained from all patients for being included in the study. is is a cross section study based on 2079 unidentified individual-level data from the database collected from 2008 to 2015, which consisted of two parts. e first data set contained 999 CHB patients with Traditional Chinese medicine (TCM) syndrome differentiation records in the database; we described the distribution of syndrome types and compared the general information, clinical indicators, and drug usage between CHB patients with DH syndrome and spleen deficiency (SD) syndrome

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Summary

Introduction

Hepatitis B is caused by hepatitis B virus (HBV) infection. The prevalence of hepatitis B surface antigen (HBsAg)-positive is about 4.9% worldwide [1]. China has a high incidence of hepatitis B. It is estimated that the prevalence of HBV infection in the general population of China is 5%–7.99% [2]. About 50% patients with HCC were complicated with HBV infection [3]; the Global Hepatitis Report 2017 shows that approximately 887 thousand people die of chronic hepatitis B- (CHB-) related complications worldwide in 2015, mainly due to liver cirrhosis and hepatocellular carcinoma. To prevent the prognosis of CHB, early diagnosis and effective treatment are very important

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