Risk of Liver Injury Associated with Chinese Herbal Products Containing Radix bupleuri in 639,779 Patients with Hepatitis B Virus Infection 英文参考文献.docVIP

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Risk of Liver Injury Associated with Chinese Herbal Products Containing Radix bupleuri in 639,779 Patients with Hepatitis B Virus Infection 英文参考文献.doc

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Risk of Liver Injury Associated with Chinese Herbal Products Containing Radix bupleuri in 639,779 Patients with Hepatitis B Virus Infection 英文参考文献

RiskofLiverInjuryAssociatedwithChineseHerbal ProductsContainingRadixbupleuriin639,779Patients withHepatitisBVirusInfection Chang-HsingLee1,2,Jung-DerWang1,3,4,Pau-ChungChen1* 1InstituteofOccupationalMedicineandIndustrialHygiene,NationalTaiwanUniversityCollegeofPublicHealth,Taipei,Taiwan,2DepartmentofOccupationalMedicine, Ton Yen General Hospital, Hsin-Chu, Taiwan, 3Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan, 4Department of EnvironmentalandOccupationalMedicine,NationalTaiwanUniversityHospital,Taipei,Taiwan Abstract Background: Chinese herbal products (CHPs) containing Radix bupleuri are often prescribed for chronic hepatitis. There havebeennoepidemiologicalstudiesinpopulationswithhepatitisBvirus(HBV)infection.Ourstudywasconductedto determinetheassociationbetweentheuseofCHPscontainingRadixbupleuriandtheriskofhospitalisationrelatedtoliver injuryamongHBV-infectedpatientsinTaiwan. Methods:Fromatotalof639,779patientswithdiagnosesrelatedtoHBVinfection,weincludedhospitalisedadultcases withaprimarydiagnosisofliverinjuryinthedatabaseofTaiwan’snationalhealthinsuranceduringtheperiod1997–2004. Case-controlandcase-crossoverdesignswereusedtoassesstheriskofhospitalisationwithconditionallogisticregression models constructed and adjusted for 270 conventionally hepatotoxic drugs. Cumulative doses of these CHPs and Radix bupleuriwereassessedforanydose-responserelationship. Findings:Intotal,wecollected1,080casesfulfilledtheinclusioncriteria.Inthecase-controldesign,theadjustedoddsratio was1.90(95%confidenceinterval[CI]:1.30to2.77).TherisksfromprescribingtheCHPsXiao-Chai-Hu-TangandLong-Dan- Xie-Gan-Tangweresignificantlyhigh,anddose-responserelationshipswerefound.Theriskofaddingeach19gmdoseof Radixbupleuriwas2.19(95%CI:1.66to2.89).Theresultsusingthecase-crossoverdesignremainedsimilar. Conclusions: Prescribing Xiao-Chai-Hu-Tang, Long-Dan-Xie-Gan-Tang, or CHPs containing more than 19 gram of Radix bupleuriinHBV-infectedpatientsmightinc