Anti-fibrosis Effect of the Traditional Chinese Medicine Compound <i>Biejiaruangan</i> in Patients with Chronic Hepatitis B: A Retrospective Cohort Study

<sec><title>Background</title> Liver fibrosis is the intermediate stage of hepatic B virus (HBV) induced-chronic liver disease and a common pathway leading to liver cirrhosis and hepatocellular carcinoma (HCC). It is reversible and can be modified by treatment. Compound <italic>Biejiaruangan</italic> (CBJRG) tablet acts as the first traditional Chinese medicine to treat liver fibrosis and has been widely used in clinical practice. The present study aimed to illustrate the anti-fibrosis effect of CBJRG in patients with chronic hepatitis B (CHB) in West China Hospital. </sec><sec><title>Methods</title> All Eligible patients achieved virological response at baseline, and these patients were divided into the Without group and the With CBJGR group based on whether the CBJRG was present in the treatment regimen. The differences of live stiffness measurements (LSM) values, aspartate aminotransferase-to-platelet ratio index (APRI) scores and fibrosis index based on four factors (FIB-4) scores were compared between the baseline and the week 24 in the Without and the With CBJRG groups, and in patients treated with different antiviral drugs, including entecavir (ETV), adefovir dipivoxil (ADV), lamivudine (LAM) and telbivudine (LDT). </sec><sec><title>Results</title> Total of 210 patients were enrolled, 90 in the Without CBJRG group and 210 in the With CBJRG group. LSM values (<italic>P &lt;</italic> 0.001) and APRI scores (<italic>P &lt;</italic> 0.01) were significantly decreased in the With CBJRG group after 24-week treatment, while only LSM values (<italic>P &lt;</italic> 0.01) were reduced in the Without group. The improvement of fibrosis stages was only observed in patients receiving 24-week CBJRG in the context of ETV antiviral therapy, not in patients receiving CBJRG plus other antiviral drugs. Moreover, LSM values (<italic>P &lt;</italic> 0.001) at week 24 were decreased as compared to the baseline in the ETV group, whereas no differences of APRI and FIB-4 scores were observed. LSM value (<italic>P &lt;</italic> 0.001), APRI (<italic>P &lt;</italic> 0.01) and FIB-4 score (<italic>P &lt;</italic> 0.05) were all statistically lower in patients treated with ETV plus CBJRG. The percentage of patient with fibrosis F4 were significantly lower in the ETV plus CBJRG group when compared to the ETV group (20% vs 36.67%, <italic>P &lt;</italic> 0.05). </sec><sec><title>Conclusion</title> The CBJRG plus ETV combination treatment showed a stronger anti-fibrosis efficacy than ETV alone in patients with CHB. </sec>