About 350 million people are chronically infected carriers of hepatitis B virus and are at a higher risk of serious illness and death from cirrhosis of the liver and liver cancer. Chinese medicinal herbs have been used widely for more than 2000 years to treat chronic liver disease.
To assess whether Chinese medicinal herbs are effective and safe for treating asymptomatic carriers of hepatitis B virus.
The trials registers of The Cochrane Hepato-Biliary Group, The Cochrane Library, and The Cochrane Complementary Medicine Field were searched in combination with MEDLINE, EMBASE, and handsearches of Chinese journals and conference proceedings (October 2000).
Randomised or quasi-randomised trials (minimum follow-up three months) in asymptomatic carriers of hepatitis B virus. Chinese medicinal herbs (single herb or compound of herbs) compared with placebo, no intervention, general non-specific treatment, or interferon treatment. Trials of Chinese medicinal herbs plus interferon versus interferon alone were also included.
Data collection and analysis
Data were extracted independently by two authors. Analysis was performed by intention-to-treat where possible. Pre-specified subgroup analyses were: ethnic origin, age at time of infection, and single herb or compound of herbs.
Three randomised clinical trials (307 patients) that followed patients for three months or more after the end of treatment were included. The methodological quality was poor. The herbal compound 'Jianpi Wenshen recipe' had significant effects on viral markers compared to interferon: relative risk 2.40 (95% CI 1.01 to 5.72) for clearance of serum HBsAg, 2.03 (95% CI 0.98 to 4.20) for clearance of HBeAg, and 2.54 (95% CI 1.13 to 5.70) for seroconversion of HBeAg to anti-HBe. Phyllanthus amarus and Astragalus membranaceus showed no significant antiviral effect compared with placebo. Analysis of pooling eight randomised clinical trials with less than three months follow-up did not show a significant benefit of Chinese medicinal herbs on viral markers. Data on long-term clinical outcomes and quality of life were lacking.
Based on one low quality trial, the medicinal herb 'Jianpi Wenshen recipe' may have an antiviral activity in asymptomatic carriers of hepatitis B virus. However, rigorous randomised, double-blind, placebo-controlled trials are needed before herbs should be used for this condition.
搜尋The trials registers of The Cochrane HepatoBiliary Group、The Cochrane Library和 The Cochrane Complementary Medicine Field，合併MEDLINE、EMBASE與人工搜尋中文期刊及研討會摘要手冊 (2000年10月).
共收納3項隨機臨床試驗(307位病人)在治療結束後追蹤3個月或以上。研究方法品質較差。比起干擾素治療，草藥複方Jianpi wenshen recipe對病毒標誌物具有顯著作用：清除血清中HBsAg的relative risk(RR)2.40 (95% CI 1.01 5.72)，清除HBeAg RR 2.03 (95% CI 0.98 – 4.20)，HBeAg血清轉化成antiHBe RR2. 54 (95% CI 1.13 – 5.70) 。 與安慰劑相比，Phyllanthus amarus和Astragalus membranaceus沒有顯著的抗病毒療效。對於追蹤3個月以下的8項隨機臨床試驗進行合併分析，沒有顯示中草藥對病毒標誌物沒有顯著的好處。 缺乏長期臨床療效和生活品質的資料。
根據一項品質較差的試驗，草藥 ‘Jianpi Wenshen recipe’可以抵抗無症狀B型肝炎帶原者體中病毒的活動。但若要將中草藥用在這些病人，需要嚴謹的隨機、雙盲、安慰劑對照試驗。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。
中草藥治療無症狀B型肝炎帶原者的療效仍有待觀察。中草藥被用於治療肝病已有一段時間。本回顧共收納了3項隨機臨床試驗。 由於研究方法品質量差，現有試驗數量少，目前中草藥如草藥複方Jianpi wenshen recipe和Astragalus membranaceus治療無症狀B型肝炎帶原者的證據仍顯不足。需要更好研究設計方法品質及更大型比較草藥和安慰劑的隨機試驗。