Effect of endoscopic ligation combined with traditional Chinese medicine syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding in patients with liver cirrhosis

Chong CHEN; Ying LYU; Xilei CHEN; Chenghai LIU; Ping LIU; Yongping MU

doi:10.3969/j.issn.1001-5256.2022.05.019

Volume 38 Issue 5

May 2022

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Article Navigation > Journal of Clinical Hepatology > 2022 > 38(5): 1075-1080

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Effect of endoscopic ligation combined with traditional Chinese medicine syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2022.05.019

Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Institute of Liver Diseases, Shanghai Institute of Traditional Chinese Medicine; Key Laboratory of Liver and Kidney Diseases, Ministry of Education; Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China

Research funding:

National Natural Science Foundation of China (81874390);

Scientific and Technological Innovation Project of Shanghai Municipal Commission of Science and Technology (15411950500);

Shanghai Key Specialty of Traditional Chinese Clinical Medicine (shslczdzk01201)

More Information

Corresponding author: LIU Ping, liuliver@vip.sina.com(ORCID: 0000-0002-6808-8243); MU Yongping, ypmu8888@126.com(ORCID: 0000-0002-6152-4508)
Received Date: 2021-09-27
Accepted Date: 2021-10-29
Published Date: 2022-05-20

Abstract

Abstract

Objective To investigate the efficacy of endoscopic ligation combined with traditional Chinese medicine (TCM) syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding (EVB) in patients with liver cirrhosis. Methods A total of 108 EVB patients who were admitted to Department of Liver Cirrhosis, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from April 2015 to February 2021 and underwent endoscopic ligation were enrolled, among whom 59 patients with TCM treatment were enrolled as Chinese and Western medicine group, and 49 patients without TCM treatment were enrolled as Western medicine group. The two groups were compared in terms of the incidence rate of rebleeding, mortality rate, and the improvement rate of portal hypertensive gastropathy. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups; a Cox regression analysis was used to evaluate the risk factors for rebleeding. Results Compared with the Western medicine group, the Chinese and Western medicine group had a significantly lower rebleeding rate within 13-24 months after ligation (2% vs 12%, P=0.045), a significantly lower mortality rate of rebleeding (2% vs 12%, P=0.045), and a significantly higher overall response rate of portal hypertensive gastropathy (90% vs 77%, P=0.04). Underlying diseases (mainly including diabetes, hypertension, and heart disease) and Child-Pugh class for liver function were significant risk factors for rebleeding (all P < 0.05). Conclusion Ligation combined with TCM treatment can significantly reduce the incidence rate of delayed rebleeding and the mortality rate of EVB and improve the degree of portal hypertensive gastropathy, which provides a new strategy for ligation combined with TCM treatment to improve the overall response of EVB secondary prevention.
- Liver Cirrhosis,
- Esophageal and Gastric Varices,
- Endoscopy,
- Medicine, Chinese Traditional

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References

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Effect of endoscopic ligation combined with traditional Chinese medicine syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding in patients with liver cirrhosis

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Effect of endoscopic ligation combined with traditional Chinese medicine syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding in patients with liver cirrhosis

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