Intervention Review

Chinese medicinal herbs for chronic hepatitis B

  1. Jian Ping Liu1,*,
  2. Heather McIntosh2,
  3. Hui Lin3

Editorial Group: Cochrane Hepato-Biliary Group

Published Online: 23 OCT 2000

Assessed as up-to-date: 19 OCT 2000

DOI: 10.1002/14651858.CD001940

How to Cite

Liu JP, McIntosh H, Lin H. Chinese medicinal herbs for chronic hepatitis B. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD001940. DOI: 10.1002/14651858.CD001940.

Author Information

  1. 1

    Beijing University of Chinese Medicine, Centre for Evidence-Based Chinese Medicine, Beijing, China

  2. 2

    University of Edinburgh, Community Health Sciences General Practice, Edinburgh, UK

  3. 3

    Third Military Medical University, Department of Epidemiology, Chongqing, China

*Jian Ping Liu, Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China. jianping_l@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 23 OCT 2000

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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 methods

Searches were applied to the following electronic databases: the Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Complementary Medicine Field Trials Register, The Cochrane Library (Issue 2, 2000), MEDLINE, EMBASE, and BIOSIS (October 2000). 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 unblinded.

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.

Authors' 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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Still awaiting evidence on Chinese medicinal herbs for chronic hepatitis B

Chronic hepatitis B is an infectious disease of the liver caused by hepatitis B virus. Around 350 million people worldwide are chronic infected carriers of the virus. Traditional Chinese medicinal herbs have for long been used for treating chronic liver diseases both in China and in Southeast Asia. This systematic review evaluates the effect of Chinese medicinal herbs (single or compound) for treating chronic hepatitis B infection.

The review of trials found that some of the Chinese medicinal herbs may have a positive effect on the clearance of hepatitis B virus and on the diseased liver. However, the methodological quality of the trials evaluating these herbs was generally poor. Analysis of the identified trials also indicated that trials with positive findings are more likely to be published than trials without significant findings. Further, medicinal herbs may be associated with side effects. Therefore, Chinese medicinal herbs should not be used outside new trials. Testing the herbs in larger, well-designed trials is needed in order to establish the necessary evidence for their use.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

以中草藥治療慢性B型肝炎

B型肝炎病毒感染是一種遍佈全世界嚴重的衛生問題。傳統中草藥已被廣泛用於治療慢性肝病,並且有許多對照試驗研究它們的效果。

目標

評估傳統中草藥治療慢性B型肝炎感染的療效和安全性。

搜尋策略

搜尋下列電子資料庫:Cochrane HepatoBiliary Group Controlled Trials Register、The Cochrane Complementary Medicine Field Trials Register、Cochrane Library (2000年第2期)、MEDLINE。EMBASE、BIOSIS (2000年10月)。手動檢索5種中文期刊和研討會手冊。沒有使用語言限制。

選擇標準

至少追蹤3個月的隨機或伴隨機試驗。收納中草藥 (包括單一藥物或複方製劑)與安慰劑、無處置、一般非特異性治療或干擾素治療比較的試驗。.中草藥與干擾素合併運用與干擾素單獨運用比較的試驗也予以納入。試驗可以是雙盲、單盲或未進行遮盲。

資料收集與分析

兩位回顧作者獨立摘錄數據。 使用Jadad量表和分配方案隱藏的方法評估試驗的研究方法品質。並且實施治療意向分析。

主要結論

包含共936位病人的9項隨機試驗符合納入標準。只有一項試驗有適當研究方法品質。漏斗圖(funnel plot)顯示明顯不對稱性(迴歸係數 = 3.37,標準差1.40, P = 0.047)。9項試驗檢測了10種不同的草藥。比較非特異性治療法或安慰劑, Fuzheng Jiedu Tang (複合草藥)對清除血清中的HBsAg、 HBeAg、HBV DNA 具有顯著正面效果;Polyporus umbellatus polysaccharide則在血清中的HBeAg 和HBV DNA; Phyllanthus amarusy在HBeAg。與干擾素比較,Phyllanthus Compound和kurorinone對清除血清中的 HBeAg和HBV DNA,以及 alanine aminotransferase正常化不具有顯著效果。其他受檢的草藥沒有顯示顯著效果。

作者結論

某些中草藥對慢性B型肝炎可能有效。但是,由於證據太弱,不足以建議使用任何種單一草藥。我們需要設計嚴謹、隨機雙盲的對照試驗。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

中草藥治療慢性B型肝炎的證據仍無。慢性B型肝炎是B型肝炎病毒使肝臟受感染的疾病。在全球,大約3億5千萬的人口是該病毒的慢性帶原者。中國和東南亞長期使用傳統中草藥來治療慢性肝病。 本系統性文獻回顧評估了中草藥(單一或複方)治療慢性B型肝炎感染的效果。本回顧發現,某些中草藥對清除B型肝炎病毒和受感染肝臟病毒有正面療效。但是整體而言這些草藥的試驗研究方法品質差。也發現有正面發現的試驗比沒有顯著發現的試驗有更易發表。另外草藥也可能有相關副作用。因此,中草藥不應在新試驗以外的領域使用。需要更大、研究設計更好的試驗來確立這些草藥的使用的證據。