Associations between prescribed Chinese herbal medicine and risk of hepatocellular carcinoma in patients with chronic hepatitis B: a nationwide population-based cohort study

Abstract

ObjectivePatients with chronic hepatitis B (CHB) are reported to exhibit higher risk of subsequent hepatocellular carcinoma (HCC). However, it remains unclear if Chinese herbal medicine (CHM), an important category of traditional Chinese medicine (TCM), may lower HCC risk in this population. So this study aimed to investigate the effects of CHM on HCC risk among patients with CHB.MethodsThis cohort study used the Taiwanese National Health Insurance Research Database to identify 21 020 newly diagnosed patients with CHB from 1998 to 2007. Among them, 8640 received CHM products after CHB onset (CHM users), and the remaining 12 380 patients were designated as a control group (non-CHM users). All enrolees were followed until the end of 2012 to measure the incidence rate and HR of HCC.ResultsDuring 15 years of follow-up, 371 CHM users and 958 non-CHM users developed HCC, representing an incidence rate of 5.28% and 10.18% per 1000 person-years, respectively. CHM users had significantly lower HCC risk compared with non-CHM users (adjusted HR=0.63, 95% CI 0.56 to 0.72). The predominant effect was observed in those receiving CHM products for more than 180 days (adjusted HR=0.52). Some CHM products, such as Hedyotis diffusa, Scutellaria barbata, Rehmannia glutinosa, Isatis tinctoria, Yi Guan Jian, Xiao Chai Hu Tang, Wu Ling San and Gan Lu Yin, were significantly associated with lower risk of HCC.ConclusionsThe use of CHM was associated with a significantly reduced HCC risk in patients with CHB, which supports the integration of TCM with CHM into clinical practice to influence a favourable prognosis.

<p>Association of Chinese Herbal Medicines Use with Development of Chronic Obstructive Pulmonary Disease Among Patients with Rheumatoid Arthritis: A Population-Based Cohort Study</p>

“…Those who used CHMs for more than 30 days after RA onset were considered CHMs users; enrollees treated for 30 days or less were considered non-CHMs users. 16 Using this procedure, 3360 cases were designated as CHMs users. A comparison cohort was randomly selected from the remaining insured RA cases without CHMs use.…”

Efficacy and safety of YinQiSanHuang-antiviral decoction on chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

“…A cohort study showed that the use of CHM is associated with a significantly reversed cirrhosis and reduced HCC risk in patients with CHB. [ 15] Lots of researches identified the active ingredients in single herb or in herbal formula has therapeutic effect on CHB, the mechanisms related in anti-HBV, anti-fibrosis, liver protection, anti-tumour, anti-bacterial, antioxidant, anti-acute liver injury and anti-hepatocellular carcinoma.…”

An update on Chinese herbal medicines as adjuvant treatment of anticancer therapeutics

“…A cohort study that also used the Taiwanese National Health Insurance Research Database was conducted to investigate the effects of Chinese herbal medicine on HCC risk among patients with chronic hepatitis B. They suggested that the use of some Chinese herbal medicines including Xiao-chai-hutang was associated with a significantly reduced HCC risk in patients with chronic hepatitis B, which supports the integration of TCM into clinical practice to influence a favorable prognosis (82). In addition, Xiao-chai-hutang gargle as a gargling agent for patients receiving chemotherapy showed a significantly decreased incidence of stomatitis, and a painkilling effect compared to gargling with providone-iodine and amphotericin B.…”