Chinese medicinal herbs for chronic hepatitis B - PubMed (original) (raw)

Review

Chinese medicinal herbs for chronic hepatitis B

J P Liu et al. Cochrane Database Syst Rev. 2001.

Abstract

Background: Hepatitis B virus infection is a serious health problem worldwide. Traditional Chinese medicinal herbs have been widely used to treat chronic liver diseases, and many controlled trials have been done to investigate their efficacy.

Objectives: To assess the efficacy and safety of traditional Chinese medicinal herbs for chronic hepatitis B infection.

Search strategy: Searches were applied to the following electronic databases: the CHBG Trials Register, the Cochrane Complementary Medicine Field Trials Register, the Cochrane Library, MEDLINE, EMBASE and BIOSIS. Five Chinese journals and conference proceedings were handsearched. No language restriction was used.

Selection criteria: Randomised or quasi-randomised trials with at least three months follow-up. Trials of Chinese medicinal herbs (single or compound) compared with placebo, no intervention, general non-specific treatment or interferon treatment were included. Trials of Chinese medicinal herbs plus interferon versus interferon alone were also included. Trials could be double-blind, single-blind or not blinded.

Data collection and analysis: Data were extracted independently by two reviewers. The methodological quality of trials was evaluated using the Jadad-scale plus allocation concealment. Intention-to-treat analyses were performed.

Main results: Nine randomised trials, including 936 patients, met the inclusion criteria. Methodological quality was considered adequate in only one trial. There was a significant funnel plot asymmetry (regression coefficient=3.37, standard error 1.40, P=0.047). Ten different medicinal herbs were tested in the nine trials. Compared to non-specific treatment or placebo, Fuzheng Jiedu Tang (compound of herbs) showed significantly positive effects on clearance of serum HBsAg, HBeAg, and HBV DNA; Polyporus umbellatus polysaccharide on serum HBeAg and HBV DNA; Phyllanthus amarus on serum HBeAg. Phyllanthus compound and kurorinone showed no significant effect on clearance of serum HBeAg and HBV DNA and on alanine aminotransferase normalisation compared to interferon treatment. There were no significant effects of the other examined herbs.

Reviewer's conclusions: Some Chinese medicinal herbs may work in chronic hepatitis B. However, the evidence is too weak to recommend any single herb. Rigorously designed, randomised, double-blind, placebo-controlled trials are required.

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Conflict of interest statement

We certify that we have no affiliations with or involvement in any organisation or entity with a direct financial interest in the subject matter of the review (e.g., employment, consultancy, stock ownership, honoraria, expert testimony).

Figures

1.1

1.1. Analysis

Comparison 1 Chinese medicinal herbs versus placebo or non‐specific treatment, Outcome 1 Loss of serum HBsAg.

1.2

1.2. Analysis

Comparison 1 Chinese medicinal herbs versus placebo or non‐specific treatment, Outcome 2 Loss of serum HBeAg.

1.3

1.3. Analysis

Comparison 1 Chinese medicinal herbs versus placebo or non‐specific treatment, Outcome 3 Seroconversion of serum HBeAg to anti‐HBe antibody.

1.4

1.4. Analysis

Comparison 1 Chinese medicinal herbs versus placebo or non‐specific treatment, Outcome 4 Loss of serum HBV DNA.

1.5

1.5. Analysis

Comparison 1 Chinese medicinal herbs versus placebo or non‐specific treatment, Outcome 5 Serum ALT normalisation.

2.1

2.1. Analysis

Comparison 2 Chinese medicinal herbs versus IFN, Outcome 1 Loss of serum HBsAg.

2.2

2.2. Analysis

Comparison 2 Chinese medicinal herbs versus IFN, Outcome 2 Loss of serum HBeAg.

2.3

2.3. Analysis

Comparison 2 Chinese medicinal herbs versus IFN, Outcome 3 Loss of serum HBV DNA.

2.4

2.4. Analysis

Comparison 2 Chinese medicinal herbs versus IFN, Outcome 4 Serum ALT normalisation.

3.1

3.1. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 1 Loss of serum HBsAg.

3.2

3.2. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 2 Loss of serum HBeAg.

3.3

3.3. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 3 Seroconversion of HBeAg to HBeAb.

3.4

3.4. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 4 Loss of serum HBV DNA.

3.5

3.5. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 5 ALT normalisation.

3.6

3.6. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 6 AST normalisation.

3.7

3.7. Analysis

Comparison 3 Chinese medicinal herbs plus IFN versus IFN alone, Outcome 7 Serum bilirubin normalisation.

4.1

4.1. Analysis

Comparison 4 Duration of follow‐up, Outcome 1 Loss of serum HBsAg (follow‐up >/= 3 months).

4.2

4.2. Analysis

Comparison 4 Duration of follow‐up, Outcome 2 Loss of serum HBsAg (follow‐up < 3 months).

4.3

4.3. Analysis

Comparison 4 Duration of follow‐up, Outcome 3 Loss of serum HBeAg (follow‐up >/= 3 months).

4.4

4.4. Analysis

Comparison 4 Duration of follow‐up, Outcome 4 Loss of serum HBeAg (follow‐up < 3 months).

4.5

4.5. Analysis

Comparison 4 Duration of follow‐up, Outcome 5 Seroconversion of serum HBeAg to HBeAb (follow‐up >/= 3 months).

4.6

4.6. Analysis

Comparison 4 Duration of follow‐up, Outcome 6 Seroconversion of serum HBeAg to HBeAb (follow‐up < 3 months).

4.7

4.7. Analysis

Comparison 4 Duration of follow‐up, Outcome 7 Loss of serum HBV DNA (follow‐up >/= 3 months).

4.8

4.8. Analysis

Comparison 4 Duration of follow‐up, Outcome 8 Loss of serum HBV DNA (follow‐up < 3 months).

4.9

4.9. Analysis

Comparison 4 Duration of follow‐up, Outcome 9 Serum ALT normalisation (follow‐up >/= 3 months).

4.10

4.10. Analysis

Comparison 4 Duration of follow‐up, Outcome 10 Serum ALT normalisation (follow‐up < 3 months).

5.1

5.1. Analysis

Comparison 5 'Worst‐case' scenario (treatment failure), Outcome 1 Loss of serum HBsAg.

5.2

5.2. Analysis

Comparison 5 'Worst‐case' scenario (treatment failure), Outcome 2 Loss of serum HBeAg.

5.3

5.3. Analysis

Comparison 5 'Worst‐case' scenario (treatment failure), Outcome 3 Loss of serum HBV DNA.

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Wen 1998 {published data only}
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Wu 1991 {published data only}
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Yu 1991 {published data only}
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Yu 1999a {published data only}
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Zhang 1992 {published data only}
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Zhang 1993b {published data only}
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Zhang 1993c {published data only}
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Zhang 1996 {published data only}
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Zhang 1997 {published data only}
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Zheng 1992 {published data only}
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Zhou 1993 {published data only}
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Zhu 1992 {published data only}
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Zhuo 1985 {published data only}
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