Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2017; 23(16): 2957-2963
Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.2957
Gutuo Jiejiu decoction improves survival of patients with severe alcoholic hepatitis: A retrospective cohort study
Hong-Yuan Mou, Hong-Ming Nie, Xiao-Yu Hu
Hong-Yuan Mou, School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Hong-Ming Nie, Department of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Xiao-Yu Hu, Department of Infectious Diseases, Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Author contributions: Mou HY and Nie HM contributed equally to this work; Hu XY conceived and designed this study; Mou HY and Nie HM performed the research and analyzed the data; Mou HY, Nie HM and Hu XY wrote the paper; all authors read and approved the manuscript.
Institutional review board statement: This study is a retrospective study, involving case collection. The data from treated patients were analyzed based on the clinical data collected at our hospitals. The aim of the study was only to review retrospective data from the clinical records of the patients. Therefore, we have no need for an institutional review board statement.
Informed consent statement: We did not obtain individual informed consent. We used current hospital medical files. All of the data presented were anonymized and the chance of patient identification was extremely low.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Yu Hu, Professor, Department of Infectious Diseases, Teaching Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Chengdu 610072, Sichuan Province, China. xiaoyuhu@aliyun.com
Telephone: +86-28-87766041 Fax: +86-28-87732407
Received: January 14, 2017
Peer-review started: January 14, 2017
First decision: February 23, 2017
Revised: March 13, 2017
Accepted: March 20, 2017
Article in press: March 20, 2017
Published online: April 28, 2017
Abstract
AIM

To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis (SAH).

METHODS

We performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury before and after treatment. Additionally, the 3- and 12-mo survival rates and the occurrence of complications were analyzed.

RESULTS

One hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients’ baseline characteristics (P > 0.05). However, significant improvements of 90-d survival rate [56/68 (82.4%) vs 27/60 (45.0%), P = 0.0000] and 365-d survival rate [48/68 (70.6%) vs 13/60 (21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group (P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant (P < 0.05). No significant differences in complications and adverse effects were found between the two groups.

CONCLUSION

Gutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.

Keywords: Severe alcoholic hepatitis, Survival rate, Prednisone, Traditional Chinese medicine therapy, Retrospective study

Core tip: Severe alcoholic hepatitis (SAH) has high mortality, regardless of the standard therapy. Finding new effective and safe therapeutic options is frequently necessary. With this aim, we reviewed SAH cases from January 2013 to July 2015 at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine and performed a retrospective analysis. We found that Gutuo Jiejiu decoction + prednisone improved the 3- and 12-mo survival rates and the clinical parameters of liver injury in patients with SAH more significantly than prednisone alone.