A Retrospective Study Based On AMAP Score To Evaluate The Effect Of Long-term Treatment With Bielong Ruangan Tablets Combined With Entecavir On Reducing The Incidence Of Hepatitis B Cirrhosis-related Liver Cance

Objective: In this study,a retrospective cohort study was conducted to observe the effect of Bielong Ruangan Tablets combined with entecavir on the incidence of liver cancer associated with hepatitis B and cirrhosis,providing new ideas and clinical data support for the prevention and treatment of liver cancer.Methods: This study screened out patients with hepatitis B and liver cirrhosis who were treated in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2014 to December 2017 by accessing the electronic medical records at the Information Center of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine.They were strictly included according to the inclusion and exclusion criteria,and used age,gender,ALB,TBIL,PLT,medication,and clinical stage as covariates to conduct a propensity score matching(PSM),The patients were divided into antiviral group and combined group,and the canceration rate,aMAP score factor data,and risk level at the time of the end point event were observed in both groups.Results:A total of 293 patients who met the criteria were included,including 213 patients who took entecavir combined with Bielong Ruangan tablets(Bielong Ruangan tablets were taken for>6 months),and 80 patients who took entecavir.After PSM,there were 72 patients in the antiviral group(entecavir)and 72 patients in the combination group(entecavir combined with Bielong Ruangan tablets).There was no statistically significant difference between the two groups at baseline in terms of age,gender,clinical stage,ALB,TBIL,and PLT(P>0.05).At the time of the end point event,there was no statistically significant difference between the two groups in terms of age and clinical stage(P>0.05).There was a statistically significant difference in ALB,TBIL,PLT,and medication duration between the two groups(P<0.05): the TBIL of the antiviral group was higher than that of the combination group(14.460;11.693),ALB was lower than that of the combination group(36.061;38.506),PLT was lower than that of the combination group(86.00;102.78),and medication duration was shorter than that of the combination group(55.17;58.08).The medication duration was shorter than that in the combined group(55.17;58.08).Comparison of canceration rates between the two groups: The 5-year canceration rate in the combined group was significantly lower than that in the antiviral group(6.9%;19.4%)(Log rank P<0.05).For patients in the compensatory period,there was no statistically significant difference between the two groups(Log rank P>0.05);In decompensated patients,the cancer transformation rate in the combination group was significantly lower than that in the antiviral group(1.39%;11.1%)(Log rank P<0.05).There was no statistically significant difference in the5-year cancer transformation rate between the low-risk and medium risk groups in patients with aMAP score(Log rank P>0.05);At high risk,the 5-year cancer transformation rate in the combination group was significantly lower than that in the antiviral group(4.12%;18.06%)(Log rank P<0.05).Conclusion:1.The aMAP score is an effective tool for assessing and screening the risk of liver cancer.2.Compared to using only entecavir for antiviral treatment,long-term use of Bielong Ruangan Tablets combined with entecavir treatment can significantly reduce the incidence of HBC related liver cancer,especially in the decompensated period of HBC and high-risk population for liver cancer.