Gutuo Jiejiu decoction improves survival of patients with severe alcoholic hepatitis: A retrospective cohort study

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: Prednisone; Retrospective study; Severe alcoholic hepatitis; Survival rate; Traditional Chinese medicine therapy.

Figure 1

Algorithm showing how patients were enrolled in the study. SAH: Severe alcoholic hepatitis.

Figure 2

Kaplan-Meier curves demonstrating the 90-d survival rates. 1: Observation group; 2: Control group. Observation group vs control group [56/68 (82.4%) vs 27/60 (45.0%), respectively; P = 0.0000].

Figure 3

Kaplan-Meier curves demonstrating the 365-d survival rates. 1: Observation group; 2: Control group. Observation group vs control group [48/68 (70.6%) vs 13/60 (21.7%), P = 00000].