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Herbal medicines for fatty liver diseases

  1. Zhao Lan Liu1,
  2. Liang Zhen Xie2,
  3. Jiang Zhu3,
  4. George Q Li4,
  5. Suzanne J Grant5,
  6. Jian Ping Liu1,*

Editorial Group: Cochrane Hepato-Biliary Group

Published Online: 24 AUG 2013

DOI: 10.1002/14651858.CD009059.pub2


How to Cite

Liu ZL, Xie LZ, Zhu J, Li GQ, Grant SJ, Liu JP. Herbal medicines for fatty liver diseases. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD009059. DOI: 10.1002/14651858.CD009059.pub2.

Author Information

  1. 1

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

  2. 2

    First Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine, Haerbin, Heilongjiang Province, Heilongjiang Province, China

  3. 3

    Beijing University of Chinese Medicine, College of Humanities, Beijing, China

  4. 4

    University of Sydney, Faculty of Pharmacy, Sydney, NSW, Australia

  5. 5

    University of Western Sydney, Center for Complementary Medicine Research, Sydney, New South Wales, Australia

*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: New
  2. Published Online: 24 AUG 2013

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Characteristics of included studies [ordered by study ID]

MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: October 2009 to December 2010.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Zhang Jiakou Infectious Disease Hospital, Hebei Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 90. 45 received Huazhuo Xiaozhi decotion, 45 received Baisainuo.

Sex ratio: 49 males (54.4%), 41 females (45.6%).

Mean age: 43.5 years (range 26-67 years) in the treatment group; 46.2 years (range 27-68 years) in the control group.

Duration of fatty liver diseases: 3.2 years (range 0.7-5.7 years) in the treatment group; 3.1 years (range 1.1-5.2 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association, diagnostic standard of non-alcoholic fatty liver (draft), Chinese Journal of Hepatology 2001 (CMA 2001a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huazhuo Xiaozhi decoction, 1 decoction, 400 mL, twice/day.

Control: Baisainuo, 50 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 2 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, GGT, TG, TC, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Zini Zhigan prescription, 30 received liptor.

Sex ratio: 37 males (61.7%), 23 females (38.3%).

Mean age: 43.43 years in the treatment group; 41.30 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Haozhu Chen, Practice of Internal Medicine, People's Medical Publishing House 2005 (Chen 2005).

Inclusion criteria: aged 18-65 years; the diagnosis were NAFLD and Pixushisheng type.

Exclusion criteria: current liver disease or previous episode of liver disease; current excessive drinking or history of heavy drinking; severe diseases of respiratory, digestive, circulatory, endocrine, and renal system or history of these diseases; gestation or lactating women; people taking drugs with drug-related drug allergy; psychosis or dementia.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zini Zhigan decoction, 1 dose, twice/day.

Control: liptor, 10 mg, po, once daily.

Post-treatment follow-up: none.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, GGT, TG, TC, LDL-C, HDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: July 2006 to December 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Wenzhou Traditional Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 120. 60 received Jiangzhi Baogan, 60 received vitamin C and B placebo.

Sex ratio: 86 males (71.7%), 34 females (28.3%).

Mean age: 38.6 years (range 18-45 years) in the treatment group; 37.2 years (range 20-44 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association, Diagnostic standard of non-alcoholic fatty liver diseases, Chinese Journal of Hepatology 2003 (CMA 2003c).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Jiangzhi Baogan decotion, 2 dose decoction, twice/day.

Control: vitamin C 0.1 g and vitamin B complex 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, CT, ALT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xinghua Hospital of Traditional Chinese Medicine, Jiangsu Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 86. 47 received Huatan Huoxuefang, 39 received polyene phosphatidylcholine.

Sex ratio: 47 males (69%), 21 females (31%).

Mean age: 28.1 years (range 18-46 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huatan Huoxuefang decoction, 300 mL, twice/day.

Control: polyene phosphatidylcholine capsules, 228-456 mg, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo information about allocation concealment.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNo information about blinding.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: April 2003 to April 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hubei Hospital of Traditional Chinese Medicine.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 100. 50 received Zhiyan Xiao decoction, 50 received UDCA.

Sex ratio: 45 males (45%), 55 females (55%).

Mean age: 42 years in the treatment group; 41.8 years in the control group.

Duration of fatty liver diseases: 2.5 years in the treatment group; 2.4 years in the control group.

Diagnostic criteria: varying degrees of weakness, lack of appetite, hepatic oppression or null pain; by B-ultrasonography liver showed diffuse enlargement, neat and smooth contour, expansion and blunting in the edge, intrahepatic small blood vessels unclear, liver and kidney in control significantly enhanced and weakened in deep, zigzag or turning wave in hepatic blood flow diagram; by CT liver density reduced; TC > 6.47 mmol/L, TG > 2.30 mmol/L; ALT, AST, GGT moderate to mild increase.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zhiyan Xiao decoction, 1 dose decoction, bid.

Control: UDCA, 10 mg/kg/day, po, tid.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, GGT, TG, TC, LDL-C, HDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Department of Health Management at Changgung Medical Center, Linkou.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Gynostemma pentaphyllum, 30 received placebo.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: not specified.

Inclusion criteria: participants at least 20 years old and diagnosed as having fatty liver on abdominal ultrasound scanning; increased ALT > 36 U/L or AST > 34 U/L.

Exclusion criteria: a history of cardiovascular diseases and cerebrovascular diseases; diseases that could affect liver function; current or prior use of medications that might have influenced liver function and plasma lipids; impaired renal function; hyperglycaemia that required an oral hypoglycaemia agent or insulin treatment; pregnancy or lactation; undergoing immunosuppressive therapy.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Gynostemma pentaphyllum, po, 3 times/day.

Control: placebo, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 6 months.


OutcomesOutcome(s): BMI, HDL-C, LDL-C, ALT, AST, ALP, uric acid, urea, creatinine, fasting GLU, insulin, HOMA-IR, fatty liver score, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskDrawing lots.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
High risk4 withdrew before the trial medicine treatment began. 56 with 28 in each group finished the study and were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasLow riskSample size calculation was reported.

Blinding of participants and personnel (performance bias)
All outcomes
Low riskParticipants were blinded by placebo capsules.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2006 to February 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Zhangbei Country Chinese Medicine Hospital, Hebei Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Shuli Qingzhi powder, 30 received simvastatin tablets.

Sex ratio: 40 males (66.7%), 20 females (23.3%).

Mean age: 36.5 years (range 27-60 years) in the treatment group; 38.7 years (range 26-62 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Ministry of Health of the People's Republic of China. Guidelines for clinical research of Traditional Chinese Drug Research. China Press of Traditional Chinese Medicine 2005 (China 2005).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: Administration of Traditional Chinese Medicine of Hebei.


InterventionsIntervention: Shuli Qingzhi powder, 10 g, po, twice/day.

Control: simvastatin tablets, 10 mg, po, once daily.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasound, ALT, AST, TG, TC, HDL-C, LDL-C, GGT.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasUnclear riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2003 to May 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Henan Province Hospital of the Chinese Medicine.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 100. 50 received Shiwenzhigankang, 50 received Dongbao Gantai.

Sex ratio: 76 males (76%), 24 females (24%).

Mean age: 39 years (range 18-60 years).

Duration of fatty liver diseases: 5.46 years.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shiweizhigankang capsule, 4 granules, po, 3 times/day.

Control: Dongbao Gantai tablets, 4 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasound, ALT, AST, TG, TC, HDL-C, LDL-C, GGT, ALP, blood GLU, blood, urine, stool routines, ECG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Guangxi Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 100. 50 received Huanglong Ganzhixiao, 50 received fenofibrate.

Sex ratio: 53 males (53%), 47 females (47%).

Mean age: 39.3 years (range 28-59 years) in the treatment group; 37.2 years (range 31-53 years) in the control group.

Duration of fatty liver diseases: 2.4 years (range 0.4-3.2 years) in the treatment group; 2.2 years (range 0.3-2.9 years) in the control group.

Diagnostic criteria: not specified.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huanglong Ganzhixiao decoction, 100 mL, po, twice/day.

Control: fenofibrate, 0.1 g, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, TG, TC, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
High riskNo blinding was applied.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
High riskNo blinding.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2004 to September 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Huangshi Infectious Disease Hospital, Hubei Province.

Origin of the participants: not specified.

Sample size calculation: not done.

Number of participants: 76. 39 received Xiaoyao, 37 received legalon.

Sex ratio: 47 males (61.8%), 29 females (38.1%).

Mean age: 35.6 years (range 16-67 years) in the treatment group; 36.3 years (range 16-68 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaoyao tablets, 10 granules, po, 3 times/day plus legalon, 140 mg, po, 3 times/day.

Control: legalon, 140 mg, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, TG, TC, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: August 2006 to August 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Huashan Hospital, Fudan University.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 42. 22 received Yuqin, 20 received placebo.

Sex ratio: 22 males (52.4%), 20 females (47.6%).

Mean age: 28.1 years (range 18-46 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003a; CMA 2003b.

Inclusion criteria: not described.

Exclusion criteria: people with alcoholic fatty liver disease, viral hepatitis, drug-induced hepatitis, autoimmune disease, hepatolenticular degeneration, malignant tumour. 

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Yuqin capsule, 3 granules, po, 3 times/day.

Control: placebo, 3 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, GGT.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: English.

Type of publication: journal article.

Date of trial: June 2004 to July 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Ruyang Hospital of Traditional Chinese Medicine.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 130. 101 received herbal, 29 received thiola tablet.

Sex ratio: 98 males (75.4%), 32 females (24.6%).

Mean age (± standard deviation): intervention group: 47.38 ± 9.5 years (range 20-61 years); control group: 43.34 ± 10.54 years (range 22-59 years).

Duration of fatty liver diseases: 2 months to 6 years.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: people who matched the diagnostic standard of NAFLD, aged 18-65 years; knew and granted consent to the scenario, volunteered to be tested with informed consent; used good clinical practice.

Exclusion criteria: people with fatty liver caused by chronic malnutrition or other factors; with viral hepatitis or with liver function decompensation; had received other treatment for uncomplicated fatty liver; aged < 18 years or > 65 years or pregnant and lactating women; people with serious primary disease or suspected to have a history of alcoholism or misuse of drugs.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Tiaozhi Yanggan decoction, 1 dose decoction, twice/day.

Control: thiola tablets, 200 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BMI, ALT, AST, TG, TC, L/S CT, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2004 to May 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hubei Province Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 80. 40 received Zhongyibianzheng, 20 received Zhongyibianzheng plus silybininon tablets, 20 received silybininon tablets.

Mean age: 37 years (range 18-56 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003a; CMA 2003b.

Inclusion criteria: not described.

Exclusion criteria: virus hepatitis, hypertension, and diabetes.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zhongyibianzheng, po, every day.

Control: silybininon tablets, po, 3 times/day.

Another intervention group: Zhongyibianzheng, po, every day plus silybininon tablets, 200 mg, po, 3 times/day.

Post-treatment follow-up: none.

Cointervention: received the same lifestyle changes.

Treatment duration: 12 weeks


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2007 to December 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hongxing Hospital of Hami, Xinjiang Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 58. 31 received wild apricot, 27 received vitamin B plus vitamin C.

Sex ratio: 52 males (89%), 6 females (11%).

Mean age: 37.5 years (range 15-60 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003a.

Inclusion criteria: not described.

Exclusion criteria: viral hepatitis, drug-induced hepatitis, autoimmune hepatitis, and metabolic liver diseases.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: wild apricot, 30 mg, po, twice/day.

Control: vitamin B plus vitamin C, 6 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2005 to June 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hospital of college of traditional Chinese medicine, Shannxi Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 66. 36 received Hegan Yin, 30 received tiopronin.

Sex ratio: 52 males (79%), 14 females (21%).

Mean age: 49.36 years in the treatment group; 51.06 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: people who matched the diagnostic standard for NAFLD and tanyuhujie pattern of traditional Chinese medicine; aged 18-65 years; people who took drugs for NAFLD in the past 2 months.

Exclusion criteria: cirrhosis; pregnant women; serious damage in other organs; diagnosis of personality or mental disorder; people with allergies.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Hegan Yin, 1 dose decoction, twice/day.

Control: tiopronin, 200 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of liver protection drugs and lifestyle changes.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: April 2009 to March 2010.

Judgement of the quality of the atria: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hospital of Chinese Medicine, Heilongjiang Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 62. 32 received Xiaogan Jiangzhifang, 30 received Ganle.

Sex ratio: 41 males (66.1%), 21 females (33.9%).

Mean age: 45 years (range 20-60 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Guidelines for diagnosis and treatment of non-alcoholic liver diseases, 2006; Guiding principle of clinical research on new drugs of TCM, 2003 (CMA 2003b).

Inclusion criteria: 62 participants confirmed diagnosis.

Exclusion criteria: alcoholic liver diseases; chronic viral hepatitis; fatty liver resulted by other factors.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaogan Jiangzhifang, po, every day.

Control: Ganle tablets, 40 mg, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: April 2001 to March 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Wuhan Hospital of Traditional Chinese Medicine, Hubei Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 110. 56 received Tangganjian, 54 received Erjiashuanggua.

Sex ratio: 59 males (54%), 51 females (46%).

Mean age: 51 years (range 37-65 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2006b.

Inclusion criteria: age range 38-65 years; people were diagnosed with diabetes, fatty liver, and ganyupixu and shireyunjie.

Exclusion criteria: diabetes; diabetes with diabetic ketoacidosis or other acute complications; serious primary diseases with heart, brain, kidney, etc; alcoholic hepatitis, viral hepatitis, drug-induced hepatitis, etc; mental disease.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Tangganjian, 1 dose decoction, twice/day.

Control: Erjiashuanggua tablets, 0.25-0.5 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of liver protection drugs and lifestyle changes.

Treatment duration: 12 weeks


OutcomesOutcome(s): symptoms, signs, FBG, P2HBG, HbA1C, ALT, AST, TG, TC, HDL-C, LDL-C, BMI.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome prespecified outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: February 2002 to February 2004.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First Affiliated Hospital of Guangxi Chinese Medicine University.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 141. 78 received Shugan Lipi San, 63 received GSH.

Sex ratio: all participants were male.

Mean age: 39 years (range 28-62 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. 2000. Diagnostic source was not given and we could not find the article on these diagnostic criteria.

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shugan Lipi San. The usage and dosage did not state.

Control: GSH, 1.2 g, vigtt, once daily.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of liver protection drugs and lifestyle changes.

Treatment duration: 2 months.


OutcomesOutcome(s): symptoms, signs, ALT, GGT, TG, L/S CT ratio.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome prespecified outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2008 to December 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First Affiliated Hospital of Guangxi Chinese Medicine University.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 120. 60 received Quyu Huazhuo, 60 received polyene phosphatidylcholine.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: people diagnosed with CMA 2006; ALT and AST rose and AST was 2 times higher than the normal value or greater.

Exclusion criteria: age < 18 years or > 65 years; pregnant women; primary diseases and diagnosis of personality or mental disorder; infectious diseases.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Quyu Huazhuo decoction, 1 dose decoction, twice/day.

Control: polyene phosphatidylcholine capsules, 3 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2006 to December 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Nanyang Central Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 76. 38 received Kezhi, 38 received polyene phosphatidylcholine.

Sex ratio: 51 males (67.1%), 25 females (32.9%).

Mean age: 42.6 years in the treatment group; 40.8 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2006b.

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Kezhi capsules, 5/day and polyene phosphatidylcholine capsules, 456 mg, po, 3 times/day.

Control: polyene phosphatidylcholine capsules, 456 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: multicentre randomised double-blinded parallel trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: September 2003 to October 2004.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 4.

Setting: Longhua Hospital Shanghai University of TCM, Shanghai First People's Hospital of the Jiao Tong University, Shuguang Hospital Shanghai University of TCM, Digestive Disease Institute, Shanghai City.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 144. 102 received Danning, 33 received UDCA.

Sex ratio: 102 males (75.6%), 33 females (24.4%).

Mean age: 48.37 years (range 22-59 years) in the treatment group; 44.43 years (range 24-56 years) in the control group.

Duration of fatty liver diseases: 0.86 years (range 0.2-6 years) in the treatment group; 0.93 years (range 0.2-7 years) in the control group.

Diagnostic criteria: CMA 2001a.

Inclusion criteria: aged 18-65 years, informed consent.

Exclusion criteria: fatty liver due to chronic heart failure, malnutrition and other reasons; fatty liver with viral hepatitis and liver function discompensation; already taking traditional Chinese medicine and Western medicine for simple fatty liver after this attack; pregnancy and lactation; primary diseases, history of alcoholic and drug abuse.

Dropouts: 4 dropouts in the treatment group and 3 dropouts in the control group; the reasons were not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Danning tablet, 5 tablets, po, 3 times/day.

Control: UDCA, 250 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 24 weeks


OutcomesOutcome(s): symptoms, BWI, B-ultrasound, CT, ALT, AST, γGGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskStratified blocked randomisations.

Allocation concealment (selection bias)Low riskCenter randomised.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskClaimed double-blinded, but did not reported who were blinded.

Incomplete outcome data (attrition bias)
All outcomes
High riskFive people were lost to follow-up, 2 could not finish the observation and 2 dropped out due to diarrhoea.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskClaimed double-blinded, but did not reported who were blinded.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskClaimed double-blinded, but did not reported who were blinded.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: 1993 to October 2002.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First People's Hospital of Raodu region, Fenlin City, Shanxi Province.

Origin of the participants: not specified.

Sample size calculation: not done.

Number of participants: 200. 102 received Juge Yigan, 98 received conventional therapy.

Sex ratio: 158 males (79%), 42 females (21%).

Mean age: range 19-58 years.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: long-term history of heavy drinking; no obvious symptoms or low-grade abdominal distention, nausea and hepatic null pain; hepatomegaly; serum transaminases elevated and were more than 5 times the normal value; obvious AST elevation, and AST/ALT ratio > 2, but serum transaminases 2 times the normal value after 2 weeks of temperance; low-grade or moderate hepatomegaly by B-ultrasonography or CT; exclude non-alcoholic fatty liver, viral hepatitis, and drug-induced liver injury; strict temperance in the trial.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Juge Yigan decoction, 1 dose decoction/day.

Control: vitamin B1, B2, B6, 30 mg and folic acid, 10 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, AST, ALT, GGT, L/S CT ratio.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2004 to December 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First People's Hospital of Raodu region, Fenlin City, Shanxi Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 124. 62 received Shengqing Jiangzhuo, 62 received lifestyle intervention.

Sex ratio: 82 males (66.1%), 42 females (33.9%).

Mean age: 38.4 years (range 23-60 years) in the treatment group; 37.6 years (range 21-61 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003a; CMA 2006b.

Inclusion criteria: not described.

Exclusion criteria: people who did not drink alcohol or had total alcohol intake > 140 g/week (male) and 70 g/week (female); chronic HBV and HCV or HIV; drug-induced hepatitis; agnogenic hepatic masses; applied glucocorticoid in the past or present; cirrhosis or hepatic insufficiency; agnogenic fatty liver; pregnancy; diabetes; TG > 0.5 mmol/L.

Dropouts: 21 participants dropped out of the study, including 8 from the treatment group and 13 from the control group. The reasons for leaving were described.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shengqing Jiangzhuo granules, 1 dose 200 mL, po, twice/day.

Control: lifestyle intervention.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 months.


OutcomesOutcome(s): symptoms, signs, AST, ALT, GGT, TC, TG, LDL-C, FBG, BMI.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low risk21 participants dropped from the study, including 8 from the treatment group and 13 from the control group. The reason for missing was described.

Selective reporting (reporting bias)High riskPrespecified outcome FPG, CT, B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, double-blinded, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2006 to March 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Guangdong Province Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 58. 30 received Zhishi Xiaopi, 28 received polyene phosphatidylcholine.

Sex ratio: 43 males (74.1%), 15 females (25.9%).

Mean age: 39.2 years in the treatment group; 40.6 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2006b.

Inclusion criteria: not described.

Exclusion criteria: lactating or pregnant women.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zhishi Xiaopi decoction, 1 dose decoction, twice/day.

Control: polygene phosphatidylcholine capsule, 228 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BMI, WC, AST, ALT, GGT, TC, TG, HDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, double-blinded, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: 2006-2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Fifth Affiliated Hospital, Sun Yet-Sen University.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 100. 50 received lipid-lowering, 50 received polygene phosphatetidylcholine.

Sex ratio: 65 males (65%), 35 females (35%).

Mean age: 46.61 years.

Duration of fatty liver diseases: 3.21 years.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver (Draft). Chinese Hepatology 2001 (CMA 2001b).

Inclusion criteria: people who matched the diagnostic standard of NAFLD; aged 18-65 years; understood and granted consent to the scenario; using GCP.

Exclusion criteria: people with severe fatty liver; organic lesion, serious primary disease, diagnosis of personality or mental disorder; lactating or pregnant women; people with allergies.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: lipid-lowering granules, 1 dose taken in 2 potions every day.

Control: polygene phosphatidylcholine capsule, 1 granule, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, BWI, B-ultrasonography, ALT, CT.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Low riskSealed envelopes were used.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Low riskStatisticians were blinded.

Blinding of outcome assessment (detection bias)
All outcomes
Low riskOutcome assessors were blinded.


MethodsTrial design: randomised, double-blinded, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Yantai Yu Huangding Hospital of the Affiliated Hospital, Qingdao Medicine University.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 86. 45 received Huoxue Qinggan, 41 received polyene phosphatidylcholine.

Sex ratio: all participants were male.

Mean age: range 33-56 years.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Chinese Society of Hepatology. Diagnostic standard of alcoholic fatty liver, 2002. Diagnostic source did not state. We could not find the article on the diagnostic criteria.

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huoxue Qinggan decoction, 1 dose decoction once daily plus polyene phosphatidylcholine capsules plus Danshen injections 10 mL, 5% GLU 20 mL, iv, once daily.

Control: polygene phosphatidylcholine capsule.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes and conventional treatment.

Treatment duration: 6 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TBIL, GGT, ALB, PT, IV-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Linyi Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 80. 40 received Baogan Xiaozhi plus lifestyle changes, 40 received lifestyle changes.

Sex ratio: 51 males (63.8%), 29 females (36.2%).

Mean age: 46 years (range 27-65 years) in the treatment group; 45 years (range 26-66 years) in the control group.

Duration of fatty liver diseases: 4.4 years (range 1-10 years) in the treatment group; 4.6 years (range 1-10 years) in the control group.

Diagnostic criteria: CMA 2003a; CMA 2003b.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Baogan Xiaozhi powder, 12 g, po, twice/day plus lifestyle changes.

Control: lifestyle changes.

Post-treatment follow-up: none.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TG, TC, HDL-C, LDL-C, IAI, IR, FIns, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: 2002-2004.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Laiwu Chinese Medicine Hospital, Shandong Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 82. 42 received Baogan Xiaozhi plus lifestyle intervention, 40 received vitamin E nicotinic capsules plus lifestyle intervention.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Epidemic disease and Verminosis, Society of Hepatology, Chinese Medical Association. National Program for Prevention and Treatment of Viral Hepatitis. Chinese Journal of Hepatology 2000 (CMA 2000).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Baogan Xiaozhi pellet, 9 g, po, 3 times/day plus lifestyle intervention.

Control: vitamin E nicotinic capsules, 0.2 g, po, 3 times/day plus lifestyle intervention.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 45 days.


OutcomesOutcome(s): symptoms, signs, ALT, AST, γ-GT, TG, TC, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: November 2005 to October 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Affiliated Hospital of Ningxia Medicine University.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 66. 36 received Shuanghu Qinggan plus tiopronin, 30 received tiopronin.

Sex ratio: 27 males (68.2%), 21 females (31.8%).

Mean age: 42 years (range 27-68 years) in the treatment group; 41 years (range 24-68 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shuanghu Qinggan granules, 1 bag, po, twice/day, plus tiopronin, 0.2 g, po, 3 times/day.

Control: tiopronin, 0.2 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, ALT, γ-GT, TG, TC, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 2.

Setting: No. 1 Hospital affiliated to General Hospital of Guangzhou University of Chinese Medicine; No. 1 Hospital affiliated to General Hospital of GuangXi Traditional Chinese Medicine University.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 89. 46 received Shenling Baizhu plus Erchen, 43 received zocor plus diammonium.

Sex ratio: 60 males (67.4%), 29 females (32.2%).

Mean age: 42.56 years (range 31-60 years) in the treatment group; 43.32 years (range 32-59 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003c).

Inclusion criteria: aged 30-60 years.

Exclusion criteria: pregnant, lactating women, or alcoholic; viral hepatitis and other type of hepatitis; primary diseases and diagnosis of personality or mental disorder; poor compliancewith medicine; not able to judge the effectiveness; incomprehensive materials.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shenling Baizhu powder plus Erchen decoction, 200 mL decoction, twice/day.

Control: zocor, 20 mg, po, twice/day, plus diammonium, 100 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, HDL-C, LDL-C, ALT, AST, γ-GGT, TG, TC, SOD, MDA.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2007 to January 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Second Chinese Medicine Hospital, Nanchong City.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 40. 20 received Qinggan, 20 received tiopronin.

Sex ratio: 27 males (67.5%), 13 females (32.5%).

Mean age: 45.3 years.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: occupying lesions in liver, cirrhosis of the liver, acute fatty liver of pregnancy, Reye syndrome, alcoholic liver disease.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qinggan decoction, 1 dose, twice/day.

Control: tiopronin, 200 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, LDL-C, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Unclear riskNo information on whether there subjects withdrew or were lost to follow-up.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2007 to December 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Chinese Medicine Hospital of Fuzuo country, Chongzuo, Guangxi Province.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 66. 33 received Xiaotanjiagnzhi, 33 received polyene phosphatidylcholine (Yishanfu).

Sex ratio: 40 males (60.6%), 26 females (39.4%).

Mean age: 45.7 years.

Duration of fatty liver diseases: 9.28 years.

Diagnostic criteria: CMA 2003a.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaotanjiagnzhi, once/day; polyene phosphatidylcholine (Yishanfu), 456 mg, 5% glucose, 250 mL, iv once daily.

Control: polyene phosphatidylcholine (Yishanfu), 456 mg, 5% glucose, 250 mL, iv, once daily.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, L/S CT ratio, ALT, AST, GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: October 2004 to October 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Yuhuan Xian Hospital of TCM.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 146. 73 received herbal medicine plus conventional therapy, 73 received conventional therapy.

Sex ratio: all participants were males.

Mean age: 46.8 years (range 26-56 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: 60 mL herbal mixture administered via coloclysis and kept in the intestines for 1 h plus conventional therapy.

Control: conventional therapy.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of liver protection drugs or lifestyle changes.

Treatment duration: 4 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, γ-GGT, TG, TC.


NotesIntervention was a herbal mixture via coloclysis (colon dialysis) composed of Atractylodes lancea, Pogostemon cablin, Eupatorium fortunei, Pinellia ternate, Cyperus rotundus, Citrus aurtantium, Cassia obtusifolia, Salvia miltiorrhiza, Crataegus pinnatifida, Rheum palmatum. The coloclysis treatment was used to insert the medicines to the intestine, where they were kept for 1 h.


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: February 2008 to February 2010.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the hospital of South China Normal University, Guangzhou City.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 75. 40 received Jiangpi Huazhou, 35 received polyene phosphatidylcholine.

Sex ratio: 41 males (54.7%), 34 females (45.3%).

Mean age: 42.7 years (range 20-60 years) in the treatment group; 42.5 years (range 19-60 years) in the control group.

Duration of fatty liver diseases: 5.1 years (range 1-12 years) in the treatment group; 5.2 years (range 1-11 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: people met the diagnostic standard of NAFLD, aged 18-65 years; no hepatoprotectants, antilipidaemic agents or diet tablets were taken 2 weeks before trial.

Exclusion criteria: people with serious cardiovascular, cerebral, and kidney diseases; with acute or chronic viral hepatitis; value of ALT, AST, r-GT 5 times over the regular value; serious damage of liver function.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Jianpi Huashi decoction, 1 dose, decocted 150 mL in water and take in 2 potions every day.

Control: polyene phosphatidylcholine capsule, 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BWI, L/S CT, cholesterol, LDL-C, ALT, AST, γ-GGT, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: October 2007 to October 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the first affiliated Hospital of Heilongjiang University of Chinese Medicine.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 80. 40 received Baogan Xiaozhikeli, 40 received Dongbao Gantai.

Sex ratio: 48 males (60%), 32 females (40%).

Mean age: 46.2 years.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2006a.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: YJSCX2009-177HLJ.


InterventionsIntervention: Baogan Xiaozhikeli, 1 bag, po, 3 times/day.

Control: Dongbao Gantai tablets, 3 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 6 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskComputer generated random number.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2008 to December 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xiamen Chinese Medicine Hospital.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 75. 40 received Xiaozhi Jiangpi, 35 received polyene phosphatidylcholine.

Sex ratio: 41 males (54.7%), 34 females (45.3%).

Mean age: 42.36 years in the treatment group; 43.34 years in the control group.

Duration of fatty liver diseases: 16.24 years in the treatment group; 17.12 years in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaozhi Jianpi decoction, 100 mL, twice/day.

Control: polyene phosphatidylcholine, 1 granule, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 2 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TC, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2006 to October 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Buji People's Hospital of Shenzhen City.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 112. 57 received Zini Jianpi Huatan, 55 received polyene phosphatid.

Sex ratio: 72 males (64.3%), 40 females (35.7%).

Mean age: 34.1 years (range 23-60 years) in the treatment group; 33.6 years (range 21-60 years) in the control group.

Duration of fatty liver diseases: not described.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: not specified.

Exclusion criteria: specific diseases may cause fatty liver such as viral hepatitis, drug-induced liver disease, total parenteral nutrition, hepatolenticular degeneration; lactating or pregnant women; severe primary diseases with cardiovascular, liver, kidney, haematology, lung, or effects on survival.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zini Jianpi Huatan formula, 1 dose decoction, twice/day.

Control: polyene phosphatid, 456 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes and conventional treatment.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, BMI, B-ultrasonography, ALT, GGT, TC, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: February 2005 to February 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the First Affiliated Hospital, Sun Yat-sen University.

Origin of the participants: not specified.

Sample size calculation: not done.

Number of participants: 65. 33 received Yunpi Tongluo, 32 received UDCA.

Sex ratio: 37 males (56.9%), 28 females (43.1%).

Mean age: 38.8 years (range 18-60 years) in the treatment group; 37.5 years (range 18-60 years) in the control group.

Duration of fatty liver diseases: 3.5 years (range 0.9-11.5 years) in the treatment group; 3.1 years (range 0.8-10.5 years) in the control group.

Diagnostic criteria: American Gastroenterological Association. American Gastroenterological Association medical position statement: nonalcoholic fatty liver disease. Gastroenterology 2002 (AGA 2002).

Inclusion criteria: participants conforming NAFLD criteria, aged 18-60 years.

Exclusion criteria: pregnant or lactating women; people with HAV, HBV, HCV, HDV, HEV, HIV, or liver cancer; decompensated liver cirrhosis; nephrotic syndrome; diabetes; hypothyroidism; acute hepatobiliary disease; people who took lipid-lowering agents, β-blockers, phenothiazines, adrenal steroid or contraceptives during the previous month; the acute primary diseases of liver, kidney, and hematopoietic system,

people refused to sign the informed consent; people with acute myocardial infarction, cerebrovascular events, hepatic and renal dysfunction, malignant tumour and other serious diseases during the previous 6 months; diagnosis of personality or mental disorder; compensated cirrhosis.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: National Eleventh Five-Year Science and Technology Major Project; Guangdong Science and Plan Foundation; Guangdong National Science Foundation.


InterventionsIntervention: Yunpi Tongluo formula, 1 dose decoction, 3 times/day.

Control: UDCA, 2 granules, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms and signs, B-ultrasonography, ALT, AST, GGT, MBI, TC, TG, LDL-C, HDL-C, TNF-α, IL-8, SOD, MDA.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
High risk2 dropped from the study, including 1 from the treatment group and 1 from the control group left. But the reason was not specified.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2007 to December 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xinjiang Uygur Autonomous Region Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 70. 35 received Qiyin, 35 received polyene phosphatidylcholine.

Sex ratio: 53 males (75.7%), 17 females (24.3%).

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver and alcoholic liver diseases. Chinese Journal of Hepatology 2006 (CMA 2006c).

Inclusion criteria: inpatients and outpatients; their diagnostic criteria was Diagnostic standard of non-alcoholic fatty liver and alcoholic liver diseases and 2 high qualification doctors made their symptoms and signs integral.

Exclusion criteria: pregnant or lactating women, and people refused to sign the informed consent; people with acute myocardial infarction, cerebrovascular events, hepatic and renal dysfunction, malignant tumour, and other serious diseases during the previous 6 months; diagnosis of personality or mental disorder; compensated cirrhosis.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qiyin granules, 1 dose, 2 potions every day.

Control: polyene phosphatidylcholine capsule, 1 granule, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2006 to February 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the Chines Medicine hospital of Jinghai Country, Tianjing City.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 105. 65 received Xiaoyu Huatan Yin, 40 received methionine and choline bitartrate.

Sex ratio: 77 males (73.3%), 28 females (26.7%).

Mean age: 41.5 years (range 28-65 years) in the treatment group; 42.1 years (range 30-64 years) in the control group.

Duration of fatty liver diseases: 3.7 years (range 0.5-7 years) in the treatment group; 4 years (range 1-7 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaoyu Huatan Yin, 1 dose, decoction 300 mL, twice/day.

Control: methionine plus choline bitartrate tablet, 3 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskDrawing lots.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome FPG, FNS, HOMA-IR in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported. And there was imbalanced distribution of participants in 2 groups.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: July 2006 to December 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Shanghai Huashan Integrated Traditional Chinese and Western Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 67. 39 received Yiqi, 28 received placebo.

Sex ratio: 44 males (65.7%), 23 females (34.3%).

Mean age: 52.6 years in the treatment group; 54.8 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: not described.

Exclusion criteria: history of alcohol or alcohol intake > 140 g/week for males, > 70 g/week for females; specific diseases may cause fatty liver such as viral hepatitis, drug-induced liver disease, total parenteral nutrition, hepatolenticular degeneration.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Yiqi formula, 2 bags, po, twice/day.

Control: placebo, 2 bags, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, BMI, WC, CT, HDL-C, LDL-C, ALT, AST, TG, TC, HOMA2-IR, TNF-α, hs-CRP.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2004 to February 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xi'an City the Eighth Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Zhiganqing, 30 received tiopronin.

Sex ratio: 39 males (65%), 21 females (35%).

Mean age: 38 years (range 20-60 years) in the treatment group; 39 years (range 19-60 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zhiganqing granules, 1 bag, po, 3 times/day.

Control: tiopronin, 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 24 weeks.


OutcomesOutcome(s): symptoms, signs, HDL-C, LDL-C, ALT, AST, TG, TC, ALP, GGT, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: June 2006 to June 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First Affiliated Hospital of Heilongjiang Chinese Medicine University.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 80. 40 received Qinggan Xiaozhi plus GSH, 40 received GSH.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: not described.

Exclusion criteria: people with fatty liver caused by chronic malnutrition or other factors; with viral hepatitis or with liver function decompensation; aged < 18 years or > 70 years; pregnant or lactating women; serious primary disease or diagnosis of personality or mental disorder; people with allergies.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qinggan Xiaozhi decoction, 150 mL, po, twice/day, plus GSH, 1.2 g with 250 mL 5% GLU, iv, once daily.

Control: GSH, 1.2 g, 250 mL 5% GLU, iv, once daily.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BWI, L/S CT ratio, ALT, AST, GGT, HDL-C, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: November 2007 to May 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Tianjin Infectious Disease Hospital; Tianjin Liver Disease Study Institute.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 120. 60 received Jiangganjiangzhi, 60 received silibinin.

Sex ratio: 87 males (72.5%), 33 females (27.5%).

Mean age: 42.7 years (range 20-60 years) in the treatment group; 40.7 years (range 19-60 years) in the control group.

Duration of fatty liver diseases: 4.8 years (range 1-12 years) in the treatment group; 4.7 years (range 1-11 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: aged > 15 years, < 70 years.

Exclusion criteria: allergic constitution; severe cardiovascular, cerebral, or kidney disease.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Jianganjiangzhi tablets, 2 tablets, po, 3 times/day.

Control: silibinin capsule, 4 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BWI, B-ultrasonography, LDL-C, ALT, AST, γ-GGT, TG, FBG, cholesterol.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2006 to October 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Jiangyin Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 100. 53 received modified Wendan, 47 received polyene phosphatidylcholine.

Sex ratio: 54 males (54%), 46 females (46%).

Mean age: 36.9 years (range 18-65 years) in the treatment group; 37.1 years (20-66 years) in the control group.

Duration of fatty liver diseases: 7.12 years (range 0.2-10 years) in the treatment group; 7.1 years (range 0.5-10 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: modified Wendan decoction, 1 dose decoction, twice/day.

Control: polyene phosphatidylcholine, 2 capsules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, B-ultrasonography, AST, ALT.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Kunming Third People's Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 73. 42 received diammonium glycyrrihizinate with Panax Notoginseng, 31 received tiopronin.

Sex ratio: 54 males (74%), 19 females (26%).

Mean age: 34.5 years (range 21-58 years) in the treatment group; 36 years (range 19-60 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: diammonium glycyrrihizinate capsules, 150 mg, po, 3 times/day and Panax Notoginseng powder, 5 g, po, twice/day.

Control: tiopronin, 0.2 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, B-ultrasonography, AST, ALT, TC, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2003 to December 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Dazhou Central Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 66. 36 received Chuige Jiugan plus tiopronin, 30 received tiopronin.

Sex ratio: all males.

Mean age: 40.25 years (range 25-56 years).

Duration of fatty liver diseases: 6.5 years (range 5-8 years).

Diagnostic criteria: Chinese Society of Hepatology, Diagnosis of alcoholic fatty liver, 2002. Diagnostic source was not given and we could not find the article on these diagnostic criteria.

Inclusion criteria: not described.

Exclusion criteria: liver failure diseases such as viral hepatitis, drug-induced hepatitis, metabolic liver diseases, merged hepatic encephalopathy, or hepatorenal syndrome.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Chuige Jiugan decoction, 1 dose plus tiopronin, 0.2 g, po, 3 times/day.

Control: tiopronin, 0.2 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional treatment and lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, B-ultrasonography, AST, ALT, GGT.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: June 2002 to August 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Mentou Gou Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 98. 64 received Sisheng Jiangzhi, 34 received simvastatin.

Sex ratio: 54 males (55.1%), 44 females (44.9%).

Mean age: 48.63 years (range 34-67 years) in the treatment group; 53.06 years (range 38-69 years) in the control group.

Duration of fatty liver diseases: 2.83 years (range 0.5-5 years) in the treatment group; 2.35 years (range 0.3-4.5 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003c).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Sisheng Jiangzhi formula, 1 dose, 150 mL, po, twice/day.

Control: simvastatin, 20 mg, po, twice/day.

Post-treatment follow-up: none.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, B-ultrasonography, HDL-C, LDL-C, ALT, AST, γ-GGT, TG, TC, kidney function tests.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Unclear riskWe could not judge whether subjects withdrew or were lost to follow-up.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: April 2005 to June 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 2.

Setting: Shanghai First People's Hospital; Shanghai TCM-Integrated Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 120. 63 received modified Jiangzhiligan, 57 received lifestyle intervention.

Sex ratio: 64 males (53.3%), 56 females (46.7%).

Mean age: 52.88 years in the treatment group; 53.14 years in the control group.

Duration of fatty liver diseases: 3.43 years in the treatment group; 3.65 years in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: people who matched the diagnostic standard of NAFLD; aged 18-75 years; understood and granted consent to the scenario; using GCP.

Exclusion criteria: pregnant or lactating women; allergic to this medicine combined with serious primary disease, diagnosis of personality or mental disorder, or malignant tumour; none compliance of medication.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: modified Jiangzhiligan decoction, 1 dose, decocted in water and 2 potions every day.

Control: lifestyle intervention.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BWI, B-ultrasonography, ALT, AST, r-GT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNot described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2007 to March 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xinjiang Uygur Autonomous Region People's Hospital.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 108. 54 received Chaihu Shugan, 54 received fenofibrate.

Sex ratio: 56 males (51.9%), 52 females (48.1%).

Mean age: 40 years (range 26-62 years) in the treatment group; 40 years (range 29-65 years) in the control group.

Duration of fatty liver diseases: 3.2 years (range 0.5-5.4 years) in the treatment group; 3.1 years (range 0.4-5.6 years) in the control group.

Diagnostic criteria: Haozhu Chen. Practice of Internal Medicine. People's Medical Publishing House 1997 (Chen 1997).

Inclusion criteria: not described.

Exclusion criteria: age < 18 years or > 65 years; pregnancy and lactating women; severe liver diseases, viral hepatitis, schistosomiasis hepatitis, alcoholic hepatitis or other genetic and metabolic liver diseases; people with cancer or mental disorders; people that did not co-operate with the doctor or took similar drugs in previous 3 months.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Chaihu Shugan powder, 1 dose 300 mL decoction, twice/day.

Control: fenofibrate sustained release capsules, 250 mg, po, once daily.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, B-ultrasonography, HDL-C, LDL-C, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: July 2006 to July 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: not specified.

Setting: not specified.

Origin of the participants: not specified.

Sample size calculation: not done.

Number of participants: 112. 56 received Tiaoganlizhong plus Qingbai, 56 received Shuifeijibinjiaan plus fufanggancaosuangan plus vitamin C plus vitamin B.

Sex ratio: all male.

Mean age: 35 years (range 35-70 years).

Duration of fatty liver diseases: 5.1 years (range 1-9.1 years).

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of alcoholic fatty liver diseases. Diagnostic source was given incorrectly and we could not find the correct article for these diagnostic criteria.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: Shandong Province.


InterventionsIntervention: Tiaoganlizhong decoction 1 dose, po, 3 times/day; Qingbai powder 2 tablets, po, twice/day or 3 times/day.

Control: Shuifeijibinpujiaan tablets, 100 mg plus fufanggancaosuangan tablets, 50 mg plus vitamin C, 200 mg plus vitamin B, 2 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, ALT, AST, γ-GT, TBIL.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: September 2004 to March 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Mentou Gou Chinese Medicine Hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 80. 29 received Bushen Yipi Fa, 25 received polyene phosphatidylcholine.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: not specified.

Inclusion criteria: not described.

Exclusion criteria: severe heart, liver, or kidney disease; pregnant and lactating women; immune and endocrine diseases such as other liver diseases or severe diabetes.

Dropouts: not specified.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Bushen Yipi Fa, 1 dose, twice/day.

Control: polyene phosphatidylcholine, 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, B-ultrasonography, HDL-C, LDL-C, ALT, AST, γ-GGT, TG, TC, GLU, ALP, BMI.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Unclear riskWe could not judge whether subjects withdrew or were loss to follow-up.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: October 2002 to October 2004.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Donghu Hospital of Shenzhen City.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 74. 40 received Shanzha Beimu, 34 received Duoxi Kangzhi.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: not specified.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: no funding.


InterventionsIntervention: Shanzha Beimu decoction, 1 dose, twice/day.

Control: Duoxi Kangzhi capsules, 0.75 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, GGT, TG, TC, LDL-C, HDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2004 to March 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hospital of Liaoning University of Chinese Medicine. Liaoning Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 56. 30 received herbal formula, 26 received polyene phosphatidylcholine.

Mean age: 40.1 years (range 20-53 years) in the treatment group; 39.2 years (range 22-52 years) in the control group

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003a.

Inclusion criteria: not described.

Exclusion criteria: viral hepatitis, drug-induced liver disease, autoimmune hepatitis, metabolic diseases, chronic heart failure.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: herbal formula, 50 mL decoction, twice/day.

Control: polyene phosphatidylcholine capsules, 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST.


NotesSee  Table 2 for components of herbal formula.


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2006 to December 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Chaozhou Traditional Chinese Medical Hospital, Guangdong Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 64. 33 received Zinichaihutang, 31 received Duoxilinzhidanjian.

Sex ratio: 34 males (53%), 30 females (47%).

Mean age: 42.5 years (range 19-62 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association (CMA 2006b).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: no funding.


InterventionsIntervention: Zinichaihutang, po, every day.

Control: Duoxilinzhidanjian tablets, 456 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2000 to June 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Traditional Chinese Medical Hospital, Hubei Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Qingre Huatan Huoxuefa, 30 received Kaixilai.

Sex ratio: 39 males (65%), 21 females (35%).

Mean age: 46 years (range 27-65 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qingre Huatan Huoxuefa, 1 bag, po, once daily.

Control: Kaixilai tablets, 2 tablets po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 6 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2006 to December 2007.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Wuxi People's Hospital of Nanjing Medicine University.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 56. 28 received Huganning plus metformin hydrochloride, 28 received metformin hydrochloride.

Sex ratio: 32 males (57.1%), 24 females (42.9%).

Mean age: 38 years (range 28-50 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2003d.

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huganning tablets, 5 granules, po, 3 times/day plus metformin hydrochloride, 250 mg, po, 3 times/day.

Control: metformin hydrochloride 250 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes and conventional therapy.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TC, TG, HDL-C, LDL-C, FBG, IRI, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: July 2007 to January 2010.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First Affiliated Hospital of Heilongjiang University.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Jiejiuhugan, 30 received polyene phosphatidylcholine.

Sex ratio: not specified.

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of alcoholic liver diseases. Chinese Journal of Hepatology 2003 (CMA 2003b).

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Jiejiuhugan decoction, 1 dose, twice/day, plus polyene phosphatidylcholine 456 mg, po, 3 times/day.

Control: polyene phosphatidylcholine 456 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 4 weeks.


OutcomesOutcome(s): symptoms, signs, liver function, ALT, GPT, AST, GOT, γ-GGT, r-GT, TBIL.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: November 2002 to October 2003.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Shucheng Country Chinese Medicine Hospital, Anhui Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 71. 38 received Zini Xiaozhi Jianggan plus diammonium glycyrrihizinate, 33 received diammonium glycyrrihizinate.

Sex ratio: 51 males (71.8%), 20 females (28.2%).

Mean age: 32.5 years (range 23-62 years) in the treatment group; 33.6 years (range 22-64 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: not specified.

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zini Xiaozhi Jianggan decoction plus diammonium glycyrrihizinate.

Control: diammonium glycyrrihizinate.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 1 month.


OutcomesOutcome(s): symptoms, signs, ALT, AST, GGT, TC, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: August 2002 to March 2004.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Guangxi Province Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 90. 45 received Guben Xiaozhuo, 45 received fenofibrate.

Sex ratio: 46 males (51.1%), 44 females (48.9%).

Mean age: 42.2 years (range 32-59 years) in the treatment group; 39.6 years (range 31-58 years) in the control group.

Duration of fatty liver diseases: 2.8 years (range 1.2-4.3 years) in the treatment group; 3.2 years (range 1.5-4.8 years) in the control group.

Diagnostic criteria: Kuohuang Liang. Hepatology. People's Medical Publishing House 1995 (Liang 1995).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Guben Xiaozhuo decoction, 1 dose 300 mL decoction, twice/day.

Control: fenofibrate tablets, 0.1 g, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, ALT, AST, B-ultrasonography, TC, TG, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
High riskNo blinding was applied.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
High riskNo blinding was applied.

Blinding of outcome assessment (detection bias)
All outcomes
High riskNo blinding was applied.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2005 to April 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Yuhuan Xian Hospital of TCM.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 62. 32 received Qingzhifugan Yin, 30 received polyene phosphatidylcholine.

Sex ratio: 35 males (56.5%), 27 females (43.5%).

Mean age: 36.6 years (range 28-68 years) in the treatment group; 38.3 years (range 30-72 years) in the control group.

Duration of fatty liver diseases: 7.4 years (range 0.25-20 years) in the treatment group; 7.8 years (range 0.5-21 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver diseases. Modern Practical Medicine 2002 (CMA 2002).

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qingzhifugan Yin, 1 dose decocted, twice/day.

Control: polyene phosphatidylcholine capsule, 600 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): B-ultrasound, ALT, AST, TG, TC


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskComputer generated random number was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: December 2005 to March 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Shiyan City Chinese Medicine Hospital, Hubei Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 110. 56 received Shennong Ganzhi, 54 received lifestyle intervention.

Sex ratio: 48 males (43.6%), 62 females (56.3%).

Mean age: 43.6 years in the treatment group; 41.3 years in the control group.

Duration of fatty liver diseases: 7.2 years in the treatment group; 8.6 years in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association ;Diagnosis of non-alcoholic fatty liver and alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003b; CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Shennon Ganzhi tablet, 0.6 g, po, 3 times/day.

Control: lifestyle intervention.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, GGT, TC, TG, HDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskAll predefined outcomes were not specified.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: 2004-2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Hubei Province Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Xiaozhi, 30 received Essentiale.

Sex ratio: 44 males (73.3%), 16 females (26.7%).

Mean age: 45.88 years in the treatment group; 44.6 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaozhi decoction, 1 dose, 300 mL decoction, twice/day.

Control: Essentiale, 2 granule, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TC, TG.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: First Affiliated Hospital, Sun Yat-Sen University.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 45. 30 received Qingrelishi, 15 received complex vitamins B, C, and E plus bifendatatum plus glucuronolactone.

Sex ratio: 38 males (84.4%), 7 females (15.6%).

Mean age: 25.6 years (range 20-63 years) in the treatment group; 24.6 years (range 18-61 years) in the control group.

Duration of fatty liver diseases: 2.8 years (range 1-6 years) in the treatment group; 2.3 years (range 1-5.5 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver (draft). Chinese Journal of Hepatology 2001 (CMA 2001c).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: administration bureau of traditional Chinese medicine, Guangdong Province and Sun Yat-Sen University.


InterventionsIntervention: Qingrelishi formula, 1 dose, 3 times/day.

Control: complex vitamins B, C, and E plus bifendatatum plus glucuronolactone. The frequency and dosage were not specified.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 4 weeks.


OutcomesOutcome(s): symptoms, signs, ALT, AST, TBIL, GGT, IL-8, MDA, SOD.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: June 2000 to June 2001.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Jieshou City People's Hospital.

Origin of the participants: inpatients.

Sample size calculation: not done.

Number of participants: 64. 36 received Hugan plus UDCA, 28 received UDCA.

Sex ratio: 42 males (65.6%), 22 females (34.5%).

Mean age: 42 years (range 9-67 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: not specified.

Inclusion criteria: fatty liver was diagnosed by B-ultrasonography/CT; liver function was abnormal; not drink alcohol or alcohol consumption < 40 g/week; no HBV or HCV.

Exclusion criteria: not described.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Hugan granules, 4 granules, po, 3 times/day and UDCA, 300 mg, po, twice/day.

Control: UDCA, 300 mg, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, BMI, ACR, B-ultrasonography, ALT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: July 2000 to December 2003.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Liaoyang Hospital for infectious disease.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 125. 67 received Quganzhitang, 58 received diisopropylamini dichlorovacetas.

Sex ratio: 81 males (65%), 44 females (35%).

Mean age: 36 years (range 19-67 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Guidelines for diagnosis and treatment of alcoholic liver diseases, 2002; Guiding principle of clinical research on new drugs of TCM, 2002 (CMA 2002).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Quganzhitang, 1, po, once daily.

Control: diisopropylamin dichlorovacetas, 40 mg, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskPrespecified outcome B-ultrasound in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: May 2004 to May 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: the Hospital of Iron and Steel Group, Henan Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 70. 35 received Xuezhikang, 35 received conventional therapy (not specified in the original article).

Sex ratio: 44 males (63%), 26 females (37%).

Mean age: 44.5 years (range 28-61 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association 2003 (CMA 2003b).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: no funding.


InterventionsIntervention: Xuezhikang, 0.6 g, po, twice/day.

Control: conventional therapy (not specified in the original article).

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, TG, TC, LDL, HDL, FPG, 2hPG, fasting insulin, insulin, HOMA-IR.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: February 2005 to January 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: The Hospital of Shanxi Medicine University, Shanxi Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 88. 48 received Ganzhikang, 40 received rosiglitazon.

Sex ratio: 80 males (69%), 8 females (31%).

Mean age: 44.5 years (range 28-61 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Guidelines for diagnosis and treatment of non-alcoholic liver diseases, 2006; Guiding principle of clinical research on new drugs of TCM, 2002 (CMA 2002).

Inclusion criteria: not described.

Exclusion criteria: not described.

Dropouts: none.

ITT analysis: not done.

Sources of funding: Department of Health Science and technology research projects.


InterventionsIntervention: Ganzhikang, 3 tablets, po, 3 times/day.

Control: rosiglitazon, 4 mg, po, once daily.

Post-treatment follow-up: none.

Treatment duration: 60 days.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, GGT, TG, TC, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2001 to December 2005.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Rizhao Traditional Chinese Medical Hospital, Shandong Province.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 120. 60 received Sanyuhuazhuotang, 60 received Gandejian.

Sex ratio: 71 males (60%), 49 females (40%).

Mean age: 36.2 years (range 19-62 years).

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of non-alcoholic fatty liver(draft). Chinese Journal of Hepatology 2001 (CMA 2001a).

Inclusion criteria: not described.

Exclusion criteria: viral hepatitis, drug-induced hepatitis, alcoholic liver hepatitis, autoimmune liver disease, and metabolic hepatitis; during trial, people who did take drug on time, interrupted treatment, or used other therapies; decompensated liver disease; unstable diabetes.

Dropouts: none.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Sanyuhuazhuotang, 1 bag, po, once daily.

Control: Gandejian tablets, 2 tablets, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same conventional treatment of liver protection drugs or lifestyle changes.

Treatment duration: 12 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, GGT, TG, TC, body weight, HDL-C, LDL-C.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: English.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: China.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 69. 35 received Quyuhuatantongluo, 34 received UDCA.

Sex ratio: 39 males (56.5%), 30 females (43.5%).

Mean age: 36.9 years (range 18-60 years) in the treatment group; 38.5 years (range 18-60 years) in the control group.

Duration of fatty liver diseases: 3.6 years (range 0.8-12.5 years) in the treatment group; 3.2 years (range 0.6-11.5 years) in the control group.

Diagnostic criteria: stated that people were enrolled as NASH if they possessed 1-5 items or 1-3 and 5 items of inclusion criteria.

1. people with no history of regular alcohol consumption > 140 g/week (for men) or 70 g/week (for women).
2. people with no known aetiologies of liver diseases including viral hepatitis, autoimmune hepatitis, Wilson’s disease, haemochromatosis, and drug-related hepatitis.
3. in addition to the clinical features of original disease, people could have non-specific symptoms and signs such as fatigue, functional dyspepsia, dull pain in the right-sided hypochondrium, hepatomegaly, and splenomegaly, etc.

4. people with persistently elevated serum ALT levels for 4 weeks or with metabolic syndrome.
5. echogenicity examination showed diffuse fatty liver disease.
6. histological evidence of steatosis confirmed by a percutaneous liver biopsy.

Inclusion criteria: not specified.

Exclusion criteria: > 60 or < 18 years of age; pregnant or lactating women; complicated with hepatic carcinoma or decompensatory cirrhosis; severe complications of cardiovascular systems, renal, or haematopoietic system; mental diseases.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Quyuhuatantongluo decoction, 1 dose, twice/day.

Control: UDCA 15 mg/kg/day.

Post-treatment follow-up: none.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, γ-GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low risk2 people dropped out of the study, 1 from the treatment group for a family reason and 1 from the control group due to nausea.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2007 to March 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Shanghai Pudong New Area Infectious Disease Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 182. 92 received Kangzhi, 90 received tiopronin.

Sex ratio: 55 males (56.7%), 42 females (43.3%).

Mean age: 38.6 years (range 18-65 years) in the treatment group; 39.3 years (range 17-66 years) in the control group.

Duration of fatty liver diseases: 4.65 years (range 0.3-12.5 years) in the treatment group; 4.76 years (range 0.3-11.5 years) in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver diseases. Chinese Hepatology 2006 (CMA 2006a).

Inclusion criteria: not specified.

Exclusion criteria: viral hepatitis, drug-induced hepatitis, Wilson's disease, total parenteral nutrition, and autoimmune liver disease.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Kangzhi formula, 100 mL, po, twice/day.

Control: tiopronin, 0.2 g, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, signs, ALT, AST, ALP, γ-GGT, TG, TC, TBil, B-ultrasonography.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: June 2006 to September 2008.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Baodi Chinese Medicine Hospital of Tianjing City.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 97. 51 received Huoxuejiangzhi, 46 received Yishanfu.

Sex ratio: 55 males (56.7%), 42 females (43.3%).

Mean age: 41.6 years (range 28-69 years) in the treatment group; 42.7 years (range 23-68 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: not specified.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Huoxuejiangzhi decoction, 1 dose, decoction twice/day.

Control: Yishanfu, 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 3 months.


OutcomesOutcome(s): symptoms, signs, ALT, γ-GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)High riskSome predefined outcomes in the methods section of the article were not reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: January 2009 to August 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Xinjiang Uygur Autonomous Region Chinese Medicine Hospital.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 112. 56 received Qiyin, 56 received polyene phosphatidylcholine.

Sex ratio: 46 males (41.1%), 66 females (58.9%).

Mean age: not specified.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: CMA 2006c.

Inclusion criteria: people who matched the diagnostic standard of NAFLD; understood and granted consent to the scenario.

Exclusion criteria: people with viral hepatitis or with liver function decompensation; long history of alcohol abuse; serious infections, acute complications of diabetes.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Qiyin granules, 1 dose, once daily.

Control: polyene phosphatidylcholine capsule, 1 granule, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 8 weeks.


OutcomesOutcome(s): symptoms, signs, B-ultrasonography, ALT, AST, ALP, γ-GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: June 2005 to March 2006.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Kaifeng first People's Hospital, Henan Province.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 106. 54 received Kezhi, 53 received lifestyle intervention.

Sex ratio: 62 males (58.5%), 44 females (41.5%).

Mean age: 36 years (range 21-65 years) in the treatment group; 34 years (range 24-64 years) in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association. Diagnostic standard of nonalcoholic fatty liver diseases. Chinese Journal of Hepatology 2006 (CMA 2006d).

Exclusion criteria: not specified.

Inclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Kezhi capsule, 5 granules, po, 3 times/day.

Control: lifestyle intervention including controlling weight, increasing exercise, adapting healthy lifestyle.

Post-treatment follow-up: none.

Treatment duration: 6 months.


OutcomesOutcome(s): symptoms, signs, CT, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskNo information on random sequence generation.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: March 2006 to March 2009.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: People's or Traditional Chinese Medicine Hospital of Ruyang County.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 120. 60 received Lishihuoxuetongluo, 60 received tiopronin.

Sex ratio: 81 males (67.5%), 39 females (32.5%).

Mean age: 45.8 years in the treatment group; 44.2 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Guidelines for diagnosis and treatment of non-alcoholic fatty liver. Chinese Journal of Hepatology 2006 (CMA 2006b).

Inclusion criteria: not specified.

Exclusion criteria: specific diseases that may cause fatty liver, such as viral hepatitis, drug-induced liver disease, total parenteral nutrition, hepatolenticular degeneration; lactating or pregnant women; alcoholics; aged < 18 years and > 65 years; serious primary disease or diagnosis of personality or mental disorder.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Lishihuoxuetongluo decoction, 100 mL, po, twice/day.

Control: tiopronin, 100 mg, po, twice/day.

Post-treatment follow-up: none.

Both groups received the same lifestyle changes.

Treatment duration: 48 weeks.


OutcomesOutcome(s): symptoms, abdominal distention, liver function, B-ultrasonography, ALT, AST, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Henan Province Hospital of TCM.

Origin of the participants: inpatients and outpatients.

Sample size calculation: not done.

Number of participants: 100. 50 received Zhixiao, 50 received ethyl polyenoate.

Sex ratio: 75 males (75%), 25 females (25%).

Mean age: 38.22 years in the treatment group; 38.64 years in the control group.

Duration of fatty liver diseases: 5.24 years in the treatment group; 5.68 years in the control group.

Diagnostic criteria: Group of Fatty Liver and Alcoholic Liver Diseases, Society of Heoatology, Chinese Medical Association. Diagnosis of non-alcoholic fatty liver. Chinese Journal of Hepatology 2003 (CMA 2003a).

Inclusion criteria: risk factors; no history of alcohol abuse or the amount of alcohol < 40 g/week; in addition to clinical manifestation of primary diseases, also shows fatigue, dull pain in liver with hepatosplenomegaly; increasing serum ALT value; evidence of diagnostic imaging.

Exclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Zhixiao capsule, 4 granules, po, 3 times/day.

Control: ethyl polyenoate soft capsules, 4 granules, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 12 weeks.


OutcomesOutcome(s): HDL-C, ALT, AST, ALP, γ-GGT, TG, TC.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.


MethodsTrial design: randomised, parallel group trial.

Language: Chinese.

Type of publication: journal article.

Date of trial: not specified.

Judgement of the quality of the trial: high risk of bias.


ParticipantsNumber of study centres: 1.

Setting: Jiaozuo People's hospital.

Origin of the participants: outpatients.

Sample size calculation: not done.

Number of participants: 60. 30 received Xiaotanhugan plus Gandejian plus vitamin E plus vitamin C, 30 received Gandejian plus vitamin E plus vitamin C.

Sex ratio: 45 males (75%), 15 females (25%).

Mean age: 45.32 years in the treatment group; 42.56 years in the control group.

Duration of fatty liver diseases: not specified.

Diagnostic criteria: diagnostic standard of non-alcoholic fatty liver, 2002. Diagnostic source was not specified. We could not find the article on the diagnostic criteria.

Exclusion criteria: not specified.

Inclusion criteria: not specified.

Dropouts: all participants randomised were analysed.

ITT analysis: not done.

Sources of funding: not specified.


InterventionsIntervention: Xiaotanhugan decoction, 200 mL, po, twice/day plus Gandejian 2 tablets, po, twice/day plus vitamin E, 1 granule, po, 3 times/day plus vitamin C 2 granules, po, 3 times/day.

Control: Gandejian 2 tablets, po, twice/day plus vitamin E 1 granule, po, 3 times/day plus vitamin C 2 granules, po, 3 times/day.

Post-treatment follow-up: none.

Treatment duration: 12 weeks.


OutcomesOutcome(s): B-ultrasonography, HDL-C, ALT, AST, ALP, γ-GGT, TG, TC, GLU.


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom number table was used.

Allocation concealment (selection bias)Unclear riskNo allocation concealment method was described.

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot described.

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo withdrawals or dropouts were reported. All participants randomised were analysed.

Selective reporting (reporting bias)Low riskAll predefined outcomes in the methods section of the article were reported in the results section.

Other biasHigh riskSample size calculation was not reported.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNot described.

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNot described.

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Deng 2003The participants did not meet the inclusion criteria.

Deng 2005Randomised clinical trial comparing silymarin versus polyene.
Phosphatidylcholine capsules in 64 people with non-alcohol fatty liver disease. The control intervention did not meet the inclusion criteria of this review.

Gao 2002Clinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment, and blinding. We could not determine if it was a randomised clinical trial. The outcome measures of symptoms and signs, as well as laboratory tests, were inadequately reported and raw data could not be abstracted.

Gao 2004Clinical observational study. The study design did not meet the inclusion criteria.

Han 2011Randomised clinical trial comparing Dangshen Baizhu decoction versus Yanggan tablet in 146 people with non-alcohol fatty liver disease. The control intervention did not meet the inclusion criteria of this review.

Huang 2000Clinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment, and blinding. We could not determine if it was a randomised clinical trial. The outcome measures of symptoms and signs, as well as laboratory tests, were inadequately reported and raw data could not be abstracted.

Ji 2004The participants did not meet the inclusion criteria.

Kang 2006Clinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment, and blinding. We could not determine if it was a randomised clinical trial. The outcome measures of symptoms and signs as well as laboratory tests were inadequately reported and raw data could not be abstracted.

Li 2004Clinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment and blinding. We could not determine if it was a randomised clinical trial. The outcome measures of symptoms and signs as well as laboratory tests were inadequately reported and raw data could not be abstracted.

Liu 2009aRandomised clinical trial comparing Dangning tablet plus placebo versus Dong Bao Gan Tai plus placebo in 60 people with non-alcohol fatty liver disease. Both the intervention and control group used placebo. The control intervention did not meet the inclusion criteria of this review.

Mohammadi 2010Randomised clinical trial comparing herbal mixture (aqueous liquorice root extract) versus placebo in 44 people with non-alcohol fatty liver disease. It was published as an abstract and the outcome measures of symptoms and signs, as well as laboratory tests, were inadequately reported and raw data could not be abstracted.

Tao 2008Randomised clinical trial comparing herbal mixture (Shuganhuazhuohuoxue formula) versus vitamin E in 62 people with non-alcohol fatty liver disease. The outcome measures of symptoms and signs, as well as laboratory tests, were inadequately reported and raw data could not be abstracted.

Wu 2008aClinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment, and blinding. We could not determine if it was a randomised clinical trial. The control did not meet the inclusion criteria of this review. The control intervention was complex and did not give specific information of the drugs given to participants.

Zhang 2005bClinical control study mentioned randomisation in the methods section and did not give any information on sequence generation, allocation concealment, and blinding. The clinical trial comparing herbal medicines versus herbal medicines plus liver disease treatment instruments in 80 people with non-alcohol fatty liver disease. Both the intervention and control group used herbal medicines. The control intervention did not meet the inclusion criteria of this review.

Zhao 2003The participants did not meet the inclusion criteria.

 
Comparison 1. Medicinal herbs versus placebo

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 ALT (U/L)1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Yuqin capsules versus placebo
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 AST (U/L)1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    2.1 Yuqin capsules versus placebo
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 3 Liver/spleen CT ratio1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    3.1 Yuqin capsules versus placebo
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Comparison 2. Herbal medicines plus lifestyle intervention versus placebo plus lifestyle intervention

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 AST (U/L)2Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Yiqi Sanju formula + lifestyle versus Yiqi Sanju placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.2 Gynostemma pentaphyllum + lifestyle versus placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 ALT (U/L)3Mean Difference (IV, Fixed, 95% CI)Totals not selected

    2.1 Yiqi Sanju formula + lifestyle versus Yiqi Sanju placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.2 Gynostemma pentaphyllum + lifestyle versus placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.3 Jiangzhi Baogan decoction + lifestyle versus placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 3 ALP (U/L)1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    3.1 Gynostemma pentaphyllum + lifestyle versus placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 4 Liver/spleen CT ratio1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    4.1 Yiqi Sanju formula + lifestyle versus Yiqi Sanju placebo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Comparison 3. Herbal medicines plus lifestyle intervention versus lifestyle intervention

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 ALT (IU/L)5Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Jiangzhi Ligan decoction + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.2 Shengqing Jiangzhuo granules + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.3 Xiaozhi powder + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.4 Shennong Ganzhi tablets + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.5 Kezhi capsule + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 AST (IU/L)4Mean Difference (IV, Fixed, 95% CI)Totals not selected

    2.1 Jiangzhi Ligan decoction + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.2 Xiaozhi powder + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.3 Shennong Ganzhi tablets + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.4 Kezhi capsule + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 3 Ultrasound: liver score1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    3.1 Jiangzhi Ligan decoction + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 4 Liver CT without improvement1Odds Ratio (M-H, Fixed, 95% CI)Totals not selected

    4.1 Shengqing Jiangzhuo granule + lifestyle versus lifestyle
1Odds Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 5 Adverse events1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    5.1 Shengqing Jiangzhuo granule + lifestyle versus lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 6 GGT (U/L)1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    6.1 Shennong Ganzhi tablets + lifestyle versus lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Comparison 4. Herbal medicines versus conventional therapy

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 ALT (IU/L)15Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.2 Tiaogan Jiangzhi granules versus Essentiale capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.3 Sisheng Jiangzhi formula versus simvastatin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.4 Zhixiao capsules versus ethyl polyenoate soft capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.5 Quyuhua Tan Tongluo decoction versus UDCA
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.6 Zini Zhigan prescription versus liptor
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

   1.7 Shugan Jianpi Huashi Tang versus Yuyou Jiangzhi tablets plus vitamin C
0Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.8 Huanglong Ganzhixiao decoction versus fenofibrate tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.9 Wild apricot versus vitamin B and C + glucurolactone tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.10 Herbal formula versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.11 Qingre Huatan Huoxue formula versus tiopronin tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.12 Ganzhikang capsule versus rosiglitazone hydrochloride tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.13 Sanyu Huazhuo decoction versus Essentiale
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.14 Baogan Xiaozhi pellet versus Dongbao gantai
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.15 Bushen Yipi Fa versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.16 Kangzhi formula versus tiopronin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 AST (IU/L)12Mean Difference (IV, Fixed, 95% CI)Totals not selected

    2.1 Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.2 Zhixiao capsules versus ethyl polyenoate soft capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.3 Quyuhua Tan Tongluo decoction versus UDCA
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.4 Sisheng Jiangzhi formula versus simvastatin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.5 Zini Zhigan prescription versus liptor
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

   2.6 Shugan Jianpi Huashi Tang versus Yuyou Jiangzhi tablets plus vitamin C
0Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.7 Wild apricot versus vitamin B and C + glucurolactone tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.8 Herbal formula versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.9 Ganzhikang capsule versus rosiglitazone hydrochloride tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.10 Sanyu Huazhuo decoction versus Essentiale
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.11 Baogan Xiaozhi pellet versus Dongbao gantai
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.12 Bushen Yipi Fa versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.13 Kangzhi formula versus tiopronin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 3 GGT (U/L)11Mean Difference (IV, Fixed, 95% CI)Totals not selected

    3.1 Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.2 Zhixiao capsules versus ethyl polyenoate soft capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.3 Quyuhua Tan Tongluo decoction versus UDCA
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.4 Sisheng Jiangzhi formula versus simvastatin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.5 Zini Zhigan prescription versus liptor
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.6 Qingre Huatan Huoxue formula versus tiopronin tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.7 Ganzhikang capsule versus rosiglitazone hydrochloride tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.8 Sanyu Huazhuo decoction versus Essentiale
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.9 Baogan Xiaozhi pellet versus Dongbao gantai
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.10 Bushen Yipi Fa versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.11 Kangzhi formula versus tiopronin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 4 ALP (U/L)4Mean Difference (IV, Fixed, 95% CI)Totals not selected

    4.1 Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.2 Zhixiao capsules versus ethyl polyenoate soft capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.3 Bushen Yipi Fa versus polyene phosphatidylcholine capsules
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.4 Kangzhi formula versus tiopronin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 5 Abnormal ultrasound5Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    5.1 Quyuhua Tan Tongluo decoction versus UDCA
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.2 Wild apricot versus vitamin B and C + glucurolactone tablets
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.3 Sanyu Huazhuo decoction versus Essentiale
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.4 Baogan Xiaozhi pellet versus Dongbaogantai
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.5 Kangzhi formula versus tiopronin
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 6 Abnormal AST (> 50 U/L)1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    6.1 Qingzhifugan decoction versus Essentiale
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 7 Abnormal ALT (> 50 U/L)1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    7.1 Qingzhifugan decoction versus Essentiale
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 8 Adverse events158Risk Difference (M-H, Fixed, 95% CI)0.10 [-0.02, 0.22]

    8.1 Wild apricot versus vitamin B and C + glucurolactone tablets
158Risk Difference (M-H, Fixed, 95% CI)0.10 [-0.02, 0.22]

 
Comparison 5. Herbal medicines plus conventional therapy versus conventional therapy

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 ALT (IU/L)1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitamin
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

   1.2 Gegen decoction + UDCA + potassium magnesium aspartate + vitamin C, B6 and K1 + potenline versus ursodeoxycholic acid + potassium magnesium aspartate + vitamin C, B6 and K1 + potenline
0Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 AST (IU/L)1Mean Difference (IV, Fixed, 95% CI)Subtotals only

    2.1 Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitamin
160Mean Difference (IV, Fixed, 95% CI)-12.09 [-18.88, -5.30]

 3 GGT (IU/L)1Mean Difference (IV, Fixed, 95% CI)Subtotals only

    3.1 Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitamin
160Mean Difference (IV, Fixed, 95% CI)-45.45 [-47.98, -42.92]

 4 Hepatic ultrasound without improvement1Odds Ratio (M-H, Fixed, 95% CI)Totals not selected

    4.1 Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitamin
1Odds Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Comparison 6. Herbal medicines plus lifestyle intervention versus conventional therapy plus lifestyle intervention

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 ALT (IU/L)35Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Huatan Huoxue formula + lifestyle versus Essentiale capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.2 Jianpi Huazhuo formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.3 Qinggan decoction + lifestyle versus tiopronin tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.4 Xiaoyu Huatan decoction + lifestyle versus compound methionine and choline bitartrate tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.5 Lishi Huoxue Tongluo decoction + lifestyle versus tiopronin tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.6 Qiyin granules + lifestyle versus Essentiale + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.7 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.8 Qiyin tea + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.9 Shenling Baizhu powder with Erchen decoction + lifestyle versus Zocor + diammonium glycyrrihizinate + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.10 Danning tablets + lifestyle versus UDCA capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.11 Tiaozhi Yanggan decoction + lifestyle versus thiola tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.12 Zhiyan Xiao decoction + lifestyle versus UDCA + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.13 Shuli Qingzhi powder + lifestyle versus simvastatin tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.14 Xiaogan Jiangzhi formula + lifestyle versus Diisopropylamini Dichlorocacetas + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.15 Tangganjian + lifestyle versus metformin hydrochloride tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.16 Quyu Huazhuo decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.17 Herbal + lifestyle versus silybininon + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.18 Juge Yigan decoction + lifestyle versus vitamin B and folic acid + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.19 Zhishi Xiaopi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.20 Baogan Xiaozhi pellet + lifestyle versus vitamin E nicotinicate capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.21 Xiaozhi Jiangpi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.22 Zini Jianpi Huatan formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.23 Zhiganqing granules + lifestyle versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.24 Modified Wendan decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.25 Diammonium glycyrrihizinate capsules with Panax Notoginseng powder + lifestyle versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.26 Shanzha Beimu decoction + lifestyle versus Duoxi Kangzhi capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.27 Zini Chailing decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.28 Guben Xiaozhuo decoction + lifestyle versus fenofibrate tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.29 Xiaozhi decoction + lifestyle versus Essentiale + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.30 Clearing heat and removing dampness + lifestyle versus conventional therapy + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.31 Quganzhi decoction + lifestyle versus diisopropylamini dichlorovacetas + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.32 Herbal therapy + lifestyle versus Essentiale + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.33 Huazhuo Xiaozhi decoction + lifestyle versus Baisainuo + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.34 Yunpi Tongluo formula + lifestyle versus UDCA + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    1.35 Tiaogan Lizhong decoction with Qingbai powder + lifestyle versus conventional therapy + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 AST (IU/L)33Mean Difference (IV, Fixed, 95% CI)Subtotals only

    2.1 Huatan Huoxue formula + lifestyle versus Essentiale capsules + lifestyle
186Mean Difference (IV, Fixed, 95% CI)-6.30 [-10.90, -1.70]

    2.2 Jianpi Huazhuo formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
175Mean Difference (IV, Fixed, 95% CI)-0.30 [-3.98, 3.38]

    2.3 Qinggan decoction + lifestyle versus tiopronin tablets + lifestyle
140Mean Difference (IV, Fixed, 95% CI)-34.8 [-45.11, -24.49]

    2.4 Xiaoyu Huatan decoction + lifestyle versus compound methionine and choline bitartrate tablets + lifestyle
1105Mean Difference (IV, Fixed, 95% CI)-12.2 [-14.70, -9.70]

    2.5 Lishi Huoxue Tongluo decoction + lifestyle versus tiopronin tablets + lifestyle
1120Mean Difference (IV, Fixed, 95% CI)-19.00 [-20.36, -17.64]

    2.6 Qiyin granules + lifestyle versus Essentiale + lifestyle
170Mean Difference (IV, Fixed, 95% CI)3.40 [-1.13, 7.93]

    2.7 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1120Mean Difference (IV, Fixed, 95% CI)-0.60 [-3.44, 2.24]

    2.8 Qiyin tea + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1112Mean Difference (IV, Fixed, 95% CI)-0.51 [-4.37, 3.35]

    2.9 Shenling Baizhu powder with Erchen decoction + lifestyle versus Zocor + diammonium glycyrrihizinate + lifestyle
189Mean Difference (IV, Fixed, 95% CI)-5.60 [-9.97, -1.23]

    2.10 Danning tablets + lifestyle versus UDCA capsules + lifestyle
1135Mean Difference (IV, Fixed, 95% CI)-2.78 [-8.84, 3.28]

    2.11 Tiaozhi Yanggan decoction + lifestyle versus thiola tablets + lifestyle
1130Mean Difference (IV, Fixed, 95% CI)-13.55 [-23.47, -3.63]

    2.12 Zhiyan Xiao decoction + lifestyle versus UDCA + lifestyle
1100Mean Difference (IV, Fixed, 95% CI)-16.20 [-20.71, -11.69]

    2.13 Shuli Qingzhi powder + lifestyle versus simvastatin tablets + lifestyle
160Mean Difference (IV, Fixed, 95% CI)-11.09 [-16.76, -5.42]

    2.14 Xiaogan Jiangzhi formula + lifestyle versus diisopropylamini dichlorocacetas + lifestyle
162Mean Difference (IV, Fixed, 95% CI)-1.5 [-4.06, 1.06]

    2.15 Tangganjian + lifestyle versus metformin hydrochloride tablets + lifestyle
1110Mean Difference (IV, Fixed, 95% CI)-36.57 [-46.15, -26.99]

    2.16 Quyu Huazhuo decoction + lifestyle versus polyene phosphatidylcholine
1120Mean Difference (IV, Fixed, 95% CI)-3.29 [-6.29, -0.29]

    2.17 Herbal + lifestyle versus silybininon + lifestyle
140Mean Difference (IV, Fixed, 95% CI)-10.04 [-39.77, 19.69]

    2.18 Juge Yigan decoction + lifestyle versus vitamin B + folic acid + lifestyle
1200Mean Difference (IV, Fixed, 95% CI)-9.20 [-10.78, -7.62]

    2.19 Zhishi Xiaopi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
158Mean Difference (IV, Fixed, 95% CI)-23.56 [-31.08, -16.04]

    2.20 Baogan Xiaozhi pellet + lifestyle versus vitamin E nicotinicate capsules + lifestyle
180Mean Difference (IV, Fixed, 95% CI)-5.0 [-8.19, -1.81]

    2.21 Xiaozhi Jiangpi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
175Mean Difference (IV, Fixed, 95% CI)-3.0 [-6.12, 0.12]

    2.22 Zhiganqing granules + lifestyle versus tiopronin + lifestyle
160Mean Difference (IV, Fixed, 95% CI)-21.25 [-24.38, -18.12]

    2.23 Modified Wendan decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
196Mean Difference (IV, Fixed, 95% CI)-15.0 [-24.50, -5.50]

    2.24 Diammonium glycyrrihizinate capsules with Panax Notoginseng powder + lifestyle versus tiopronin + lifestyle
173Mean Difference (IV, Fixed, 95% CI)-21.1 [-30.21, -11.99]

    2.25 Shanzha Beimu decoction + lifestyle versus Duoxi Kangzhi capsules + lifestyle
174Mean Difference (IV, Fixed, 95% CI)-16.20 [-21.56, -10.84]

    2.26 Zini Chailing decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
164Mean Difference (IV, Fixed, 95% CI)-11.8 [-14.64, -8.96]

    2.27 Guben Xiaozhuo decoction + lifestyle versus fenofibrate tablets + lifestyle
190Mean Difference (IV, Fixed, 95% CI)-16.9 [-23.82, -9.98]

    2.28 Xiaozhi decoction + lifestyle versus Essentiale + lifestyle
160Mean Difference (IV, Fixed, 95% CI)-7.79 [-15.83, 0.25]

    2.29 Clearing heat and removing dampness + lifestyle versus conventional therapy + lifestyle
145Mean Difference (IV, Fixed, 95% CI)-4.10 [-7.14, -1.06]

    2.30 Quganzhi decoction + lifestyle versus diisopropylamini dichlorovacetas + lifestyle
1125Mean Difference (IV, Fixed, 95% CI)-13.23 [-14.36, -12.10]

    2.31 Huazhuo Xiaozhi decoction + lifestyle versus Baisainuo + lifestyle
190Mean Difference (IV, Fixed, 95% CI)-44.30 [-51.30, -37.30]

    2.32 Yunpi Tongluo formula + lifestyle versus UDCA + lifestyle
163Mean Difference (IV, Fixed, 95% CI)-9.08 [-13.53, -4.63]

    2.33 Tiaogan Lizhong decoction with Qingbai powder + lifestyle versus conventional therapy + lifestyle
1112Mean Difference (IV, Fixed, 95% CI)-34.64 [-38.91, -30.37]

 3 GGT (IU/L)20Mean Difference (IV, Fixed, 95% CI)Subtotals only

    3.1 Jianpi Huazhuo formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
175Mean Difference (IV, Fixed, 95% CI)-14.5 [-23.41, -5.59]

    3.2 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1120Mean Difference (IV, Fixed, 95% CI)-12.60 [-19.84, -5.36]

    3.3 Qiyin tea + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1112Mean Difference (IV, Fixed, 95% CI)1.77 [-2.54, 6.08]

    3.4 Shenling Baizhu powder with Erchen decoction + lifestyle versus Zocor + diammonium glycyrrihizinate + lifestyle
189Mean Difference (IV, Fixed, 95% CI)-4.80 [-11.47, 1.87]

    3.5 Danning tablets lifestyle versus UDCA capsules + lifestyle
1135Mean Difference (IV, Fixed, 95% CI)-9.63 [-23.76, 4.50]

    3.6 Tiaozhi Yanggan decoction + lifestyle versus thiola tablets + lifestyle
1130Mean Difference (IV, Fixed, 95% CI)-12.74 [-25.90, 0.42]

    3.7 Zhiyan Xiao decoction + lifestyle versus UDCA + lifestyle
1100Mean Difference (IV, Fixed, 95% CI)-16.30 [-24.75, -7.85]

    3.8 Shuli Qingzhi powder + lifestyle versus simvastatin tablets + lifestyle
160Mean Difference (IV, Fixed, 95% CI)-11.88 [-21.36, -2.40]

    3.9 Xiaogan Jiangzhi formula + lifestyle versus diisopropylamini dichlorocacetas + lifestyle
162Mean Difference (IV, Fixed, 95% CI)-11.60 [-16.54, -6.66]

    3.10 Juge Yigan decoction + lifestyle versus vitamin B + folic acid + lifestyle
1200Mean Difference (IV, Fixed, 95% CI)-12.30 [-14.26, -10.34]

    3.11 Zhishi Xiaopi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
158Mean Difference (IV, Fixed, 95% CI)-28.99 [-37.66, -20.32]

    3.12 Baogan Xiaozhi pellet + lifestyle versus vitamin E nicotinicate capsules + lifestyle
180Mean Difference (IV, Fixed, 95% CI)-19.6 [-22.14, -17.06]

    3.13 Zini Jianpi Huatan formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1112Mean Difference (IV, Fixed, 95% CI)-13.30 [-18.62, -7.98]

    3.14 Zhiganqing granules + lifestyle versus tiopronin + lifestyle
160Mean Difference (IV, Fixed, 95% CI)-35.0 [-39.67, -30.33]

    3.15 Shanzha Beimu decoction + lifestyle versus Duoxi Kangzhi capsules + lifestyle
174Mean Difference (IV, Fixed, 95% CI)-16.30 [-26.26, -6.34]

    3.16 Clearing heat and removing dampness + lifestyle versus conventional therapy + lifestyle
145Mean Difference (IV, Fixed, 95% CI)-15.23 [-18.84, -11.62]

    3.17 Herbal therapy + lifestyle versus Essentiale + lifestyle
197Mean Difference (IV, Fixed, 95% CI)-22.13 [-25.07, -19.19]

    3.18 Huazhuo Xiaozhi decoction + lifestyle versus Baisainuo + lifestyle
190Mean Difference (IV, Fixed, 95% CI)-13.94 [-15.41, -12.47]

    3.19 Yunpi Tongluo formula + lifestyle versus UDCA + lifestyle
163Mean Difference (IV, Fixed, 95% CI)-7.35 [-12.39, -2.31]

    3.20 Tiaogan Lizhong decoction with Qingbai powder + lifestyle versus conventional therapy + lifestyle
1112Mean Difference (IV, Fixed, 95% CI)-34.39 [-36.58, -32.20]

 4 L/S CT ratio1Mean Difference (IV, Fixed, 95% CI)Subtotals only

    4.1 Jianpi Huazhuo formula + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
175Mean Difference (IV, Fixed, 95% CI)0.49 [0.37, 0.61]

 5 Ultrasound without improvement10Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    5.1 Xiaoyu Huatan decoction + lifestyle versus compound methionine and choline bitartrate tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.2 Lishi Huoxue Tongluo decoction + lifestyle versus tiopronin tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.3 Qiyin granules + lifestyle versus Essentiale + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.4 Qiyin tea + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.5 Danning tablets + lifestyle versus UDCA capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.6 Tiaozhi Yanggan decoction + lifestyle versus thiola tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.7 Shuli Qingzhi powder + lifestyle versus simvastatin tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.8 Zini Chailing decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.9 Yunpi Tongluo formula + lifestyle versus UDCA + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    5.10 Xiaozhi Jiangpi decoction + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 6 Ultrasound: proximal diffuse high echogenic dots1Odds Ratio (M-H, Fixed, 95% CI)Totals not selected

    6.1 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1Odds Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 7 Ultrasound: distal end echo attenuation1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    7.1 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 8 Ultrasound: unclear hepatic vessel structure2Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    8.1 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    8.2 Shuli Qingzhi powder + lifestyle versus simvastatin tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 9 Ultrasound: reduction of blood flow1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    9.1 Jiangan Jiangzhi tablets + lifestyle versus silibinin capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 10 Liver CT without improvement2Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    10.1 Danning tablets + lifestyle versus UDCA capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    10.2 Tiaozhi Yanggan decoction + lifestyle versus thiola tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 11 Adverse events1Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    11.1 Yunpi Tongluo formula + lifestyle versus UDCA + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 12 Ultrasound: liver score1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    12.1 Chaihu Shugan powder + lifestyle versus fenofibrate sustained release capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Comparison 7. Herbal medicines plus lifestyle intervention plus conventional therapy versus lifestyle intervention plus conventional therapy

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Liver/spleen CT ratio1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    1.1 Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle versus reduced glutathione tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 2 ALT (U/L)15Mean Difference (IV, Fixed, 95% CI)Totals not selected

    2.1 Colon herbs dialysis therapy + lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets versus lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.2 Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle versus reduced glutathione tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.3 Jiejiuhugan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.4 Xiaoyao tablets + legalon + lifestyle versus legalon + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.5 Hegan Yin + tiopronin + lifestyle versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.6 Shugan Lipi San + GSH + lifestyle versus GSH + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.7 Kezhi capsules + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.8 Herbal + silybininon + lifestyle versus silybininon + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.9 Huoxue Qinggan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.10 Shuanghu Qinggan granules + tiopronin tablets + lifestyle versus tiopronin tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.11 Xiaotan Jiangzhi formula + polyene phosphatidylcholine + lifestyle versus polyene phosphatidylcholine + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.12 Chuige Jiugan decoction + lifestyle + tiopronin versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.13 Huganning tablets + metformin hydrochloride tablets + lifestyle versus metformin hydrochloride tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.14 Zini Xiaozhi Jianggan decoction + lifestyle + diammonium glycyrrihizinate versus lifestyle + diammonium glycyrrihizinate
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    2.15 Hugan tablets + UDCA + lifestyle versus UDCA + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 3 AST (U/L)9Mean Difference (IV, Fixed, 95% CI)Totals not selected

    3.1 Colon herbs dialysis therapy + lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets versus lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.2 Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle versus reduced glutathione tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.3 Jiejiuhugan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.4 Kezhi capsules + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.5 Huoxue Qinggan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.6 Xiaotan Jiangzhi formula + polyene phosphatidylcholine + lifestyle versus polyene phosphatidylcholine + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.7 Chuige Jiugan decoction + lifestyle + tiopronin versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.8 Huganning tablets + metformin hydrochloride tablets + lifestyle versus metformin hydrochloride tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    3.9 Zini Xiaozhi Jianggan decoction + lifestyle + diammonium glycyrrihizinate versus lifestyle + diammonium glycyrrihizinate
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 4 GGT (U/L)11Mean Difference (IV, Fixed, 95% CI)Totals not selected

    4.1 Colon herbs dialysis therapy + lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets versus lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.2 Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle versus reduced glutathione tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.3 Jiejiuhugan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.4 Xiaoyao tablets + legalon + lifestyle versus legalon + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.5 Hegan decoction + tiopronin + lifestyle versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.6 Shugan Lipi San + GSH + lifestyle versus GSH + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.7 Huoxue Qinggan decoction + polyene phosphatidylcholine capsules + lifestyle versus polyene phosphatidylcholine capsules + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.8 Shuanghu Qinggan granules + tiopronin tablets + lifestyle versus tiopronin tablets + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.9 Xiaotan Jiangzhi formula + polyene phosphatidylcholine + lifestyle versus polyene phosphatidylcholine + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.10 Chuige Jiugan decoction + lifestyle + tiopronin versus tiopronin + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

    4.11 Zini Xiaozhi Jianggan decoction + lifestyle + diammonium glycyrrihizinate versus lifestyle + diammonium glycyrrihizinate
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 5 Ultrasound: liver echo intensity1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    5.1 Colon herbs dialysis therapy + lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets versus lifestyle + polyene phosphatidylcholine + simvastatin + silybin meglumine tablets
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 6 Abnormal ultrasound2Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    6.1 Kezhi capsules + polyene phosphatidylcholine capsules + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    6.2 Chuige Jiugan decoction + lifestyle + tiopronin versus tiopronin + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 7 Liver CT value1Mean Difference (IV, Fixed, 95% CI)Totals not selected

    7.1 Xiaotan Jiangzhi formula + polyene phosphatidylcholine + lifestyle versus polyene phosphatidylcholine + lifestyle
1Mean Difference (IV, Fixed, 95% CI)0.0 [0.0, 0.0]

 8 Adverse events2Risk Ratio (M-H, Fixed, 95% CI)Totals not selected

    8.1 Huganning tablets + metformin hydrochloride tablets + lifestyle versus metformin hydrochloride tablets + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

    8.2 Hugan tablets + UDCA + lifestyle versus UDCA + lifestyle
1Risk Ratio (M-H, Fixed, 95% CI)0.0 [0.0, 0.0]

 
Table 2. Herbal medicines and adverse effects in the included studies

Study IDChinese NameBotanical Name of IngredientAdverse events (n / %)

Cao 2011Huazhuo Xiaozhi decoctionBupleurum chinensis,Paeonia albiflora Pallas,var,trichocarpa,Atractylodes ovata,Poria cocos,Curcuma aromatica,Saliva miltiorrhiza,Alisma plantago var. viglomum,Crataegus cuneata,Rheum palmatum,Glycyrrhiza glabra var. glandulifera.Not reported.

Chen 2010Huatan Huoxuefang decoctionBupleurum chinense (with vinegar), Salvia miltiorrhiza, Poria cocos, Alisma orientalis, Pinellia ternate, Hordeum vulgare (fried), Crataegus pinnatifida, Nelumbo nucifera, dialectical to add and subtract: Astragalus membranaceous, Atractylodes macrocephala, Melia toosendan, Citrus aurtantium (fried), Codonopsis pilosula, Atractylodes macrocephala, Polygonum multiflorum, Lycium barbarum, Polygonum cuspidatum, Sedum sarmentosum.Not reported.

Chen 2007aZini Zhigan decoctionAtractylodes ovata,Cassia obtusifolia.2 cases of dry mouth in the control group.

Chen 2007bJiangzhi Baogan decoctionAstragalus membranaceous,Saliva miltiorrhiza,Atractylodes japonica,Atractylodes ovata,Abrus cantoniensis,Crataegus cuneata,Citrus reticulata,Curcuma aromatica,Bupleurum chinensis,Typha latifolia.Not reported.

Cheng 2006Zhiyan Xiao decoctionAstragalus membranaceous,Curcuma zedoaria,Nelumbo nucifera,Polygonum multiflorum,Alisma plantago,Saliva miltiorrhiza,Schizandra chinensis.Not reported.

Chou 2006Jiaogulan ChaGynostemma pentaphyllum.Not observed.

Dai 2009Shuli Qingzhi powerPolygonum cuspidatum,Artemisia capillaris,Onioselinum unvittatum,Paeonia albiflora,Curcuma aromatica,Cyperus rotundus,Trichosanthis kirilowii ,Allium macrostemon,Dioscorea batatas,Aquilaria agallocha,Perichaeta communissma,Auricularia auricula,Astragalus membranaceous,Angelica sinensis,Atractylodes pinnatifida,Poria cocos,Schizandra chinensis,Indigo naturalis.Not reported.

Dang 2007Shiweizhigankang  capsuleLysimachia christinae,Citrus reticulate,Curcuma longa,Rheum palmatum.1 case of diarrhoea.

Deng 2003aHuanglong Ganzhixiao decoctionAstragalus membranaceous, Polygonatum chinense,Epimedium sagittatum,Crataegus pinnatifida,Alisma plantago. Not reported.

Deng 2010Xiaoyao tabletIngredients not reported.Not reported.

Fei 2009Yuqin granulesCurcuma wenyujin,Panax notoginseng,Bupleurum chinense,Glycyrrhiza uralensis,Carthamus tinctorius,Polyporus umbellatus. Not reported.

Gu 2007aTiaozhi Yanggan decoctionBupleurum chinense, Curcuma longa, Paeonia lactiflora, Crataegus pinnatifida, Alisma orientalis, Cassia obtusifolia, Polygonum cuspidata, Rheum palmatum, Prunus armeniaca, Salvia miltiorrhiza, Raphanus sativus, Citrus reticulata.21 cases of diarrhoea, 22 of gastric discomfort or light pain, 15 of abdominal discomfort or dull pain and 11 cases of nausea.

Guan 2010Wild apricot decoctionPrunus armeniaca.3 cases of gastric discomfort in the intervention group.

Guo 2007Hegan Yin decoctionAmygdalus davidiana,Pinella ternata,Poria cocos,Citrus reticulata,Achyranthes bidentata,Saliva miltiorrhiza, Bupleurum chinensis,Glycyrrhiza glabra.Not reported.

Guo 2010Xiaogan Jiangzhifang formulaCrataegus cuneata,Saliva miltiorrhiza,Panax notoginseng,Atractylodes ovata,Poria cocos,Alisma plantago,Cassia obtusifolia,Rheum palmatum.Not reported.

Hu 2010Tangganjian decoctionPaeonia albiflora,var. trichocarpa,Angelica sinensis,

Bupleurum chinensis,Poria cocos,Artemisia capillaris,Schizandra chinensis.
Not reported.

Huang 2005Shugan Lipi SanBupleurum chinensis,Paeonia albiflora,

Atractylodes ovata,Panax notoginseng,

Alisma plantago var. viglomum,Cassia obtusifolia,

Pueraria lobata,Gynostemma pentaphyllum.
Not observed.

Huang 2011Quyu Huazhuo decoctionAlisma plantago var. viglomum,Sargassum siliquastrum,

Saliva miltiorrhiza,Crataegus cuneata,Silybum marianum,Gallus-gallus domesticus,Cassia obtusifolia,

Bupleurum chinensis,Curcuma aromatica,Phyllostachys nigra var. henonis, Coix lacrym-jobi var. frumenttacea,  Ostrea cucullata,Trionyx sinensis,Rehmannia glutinosa,

Polygonum multiflorum,Polygonatum chinense.
Not reported.

Huo 2008Kezhi capsuleIngredients not reported.Several people increased stool frequency and had mid abdominal pain.

Ji 2005Danning tabletRheum palmatum,Polygonum cuspidatum,Citrus reticulate,Curcuma wenyujin,Crataegus pinnatifida, Imperata cylindrica var.Rash (1), nausea (3), defecate number increase for many participants, but tolerant and normal after some days.

Jia 2003Juge Yigan decoctionHovenia acerba,Pueraria lobata,Taraxacum albidum,Forsythia supensa,Artemisia capillaris,Patrinia scabiosaefolia,Polygonum cuspidatum,Bupleurum chinensis,Curcuma longa,Alisma plantago var. viglomum,Angelica sinensis,Saliva miltiorrhiza,Glycyrrhiza glabra.Not reported.

Jia 2009Shengqing Jiangzhuo granulesCampanumaea pilosula,Pueraria lobata,Crataegus pinnatifida,Bupleurum chinensis,Alisma plantago var. viglomum,Atractylodes japonica,Saliva miltiorrhiza,Nelumbo nucifera.45 cases (72.5%) in the intervention group and 47 cases (75.8%) in the control group; but there were no serious adverse events; frequency of fatigue in the control group was higher and frequency of dry throat and flatulence in the intervention group was higher.

Jiang 2009Zhishi Xiaopi decoctionCitrus aurantium,Campanumaea pilosula,Zingiber offcinale,Glycyrrhiza glabra,Hordeum sativum,Medicata Fermentita Fujianensis Massa,Poria cocos,Atractylodes macrocephala,Pinella ternata, Magnolia  officinalis  

Coptis chinensis.
Not observed.

Kong 2010Lipid-lowering granulesBupleurum chinense, Paeonia lactiflora, Citrus aurantium, Crataegus pinnatifida (charred), Panax notoginseng, Poria cocos, Cyperus rotundus, Arisaema heterophyllum (bile prepared), Pinellia ternate (prepared).Not reported.

Li 2005Huoxue Qinggan decoctionSaliva miltiorrhiza,Paeonia albiflora, Imperata arundinacea,Artemisia capillaris,Poria cocos,Pueraria lobata,Glycyrrhiza glabra.Not observed.

Li 2007Shuanghu Qinggan granulePolygonum cuspidatum,Saliva miltiorrhiza,Lonicera japonica,Coptis chinensis,Pinella ternata.Not reported.

Li 2008Shenling Baizhu powder with Erchen decoctionCodonopsis pilosula, Atractylodes macrocephala (fried), Poria cocos, Alisma orientalis, Citrus reticulata, Pinellia ternate (prepared with ginger), Artemisia capillaris, Polygonum multiflorum, Crataegus pinnatifida, Salvia miltiorrhiza, Nelumbo nucifera, Glycyrrhiza uralensis.Not reported.

Li 2009Qinggan decoctionBupleurum chinense, Salvia miltiorrhiza, Oldenlandia diffusa, Astragalus membranaceous, Polygonum cuspidatum, Lycium barbarum, Crataegus pinnatifida, Glycyrrhiza uralensis, Rheum palmatum, Alisma orientalis, Artemisia capillaris, Atractylodes macrocephala.Not reported.

Li 2010Xiaotan Jiangzhi formulaPinella ternata,Citrus maxima,Poria cocos,Bupleurum chinensis,Astragalus membranaceous,Glycyrrhiza glabra,Zingiber offcinale,Armeniaca mume,Crataegus pinnatifida,Rheum palmatum, Alisma plantago,Paeonia moutan,Atractylodes macrocephala.Not reported.

Li 2006aBaogan Xiaozhi powerCoptis chinensis,Alisma plantago, Cassia tora,Bupleurum chinensis,Pinella ternata,Acorus gramineus,Crataegus pinnatifida,Areca catechu.Not reported.

Li 2006bBaogan Xiaozhi pelletBupleurum chinensis,Citrus aurantium,Paeonia albiflora,Cassia tora,Crataegus pinnatifida,Alisma plantago, Paeonia albiflora,Conioselinum unvittatum,Fritillaria roylei,Saliva miltiorrhiza,Nelumbo nucifera,Benincasa hispida,Polygonatum chinese,Glycyrrhiza glabra. Not reported.

Liang 2008Herbs mixtures for colon dialysisAtractylodes lancea, Pogostemon cablin, Eupatorium fortunei, Pinellia ternate, Cyperus rotundus, Citrus aurtantium, Cassia obtusifolia, Salvia miltiorrhiza, Crataegus pinnatifida, Rheum palmatum.Not reported.

Liang 2010Jianpi Huashi decoctionCodonopsis pilosula,Poria cocos, Atractylodes macrocephala, Coix lacryma-jobi var. ma-yuen, Salvia miltiorrhiza, Crataegus pinnatifidaCurcuma wenyujin, Cassia obtusifolia.Not reported.

Liang 2011Baogan XiaozhikeliAtractylodes ovata,Curcuma longa,Bupleurum chinensis,Astragalus membranaceous,Alisma plantago,Saliva miltiorrhiza.Not reported.

Lin 2011Yunpi Tongluo formulaAtractylodes japonica,Crataegus cuneata,Rheum palmatum,Pinella ternata,Raphanus sativus, Alisma plantago,Plantago major,Cassia obtusifolia.4 cases of fatigue, dizziness, diarrhoea, and abdominal pain.

Lin 2010aXiaozhi Jianpi decoctionPanax notoginseng,Paeonia albiflora,Rheum palmatum,Polygonum cuspidatum,Artemisia capillaris,Poria cocos,Bupleurum chinensis.Not reported.

Lin 2010bSelf prescripted Jianpi Huatan formulaAstragalus Henryi,Alisma plantago var. viglomum,Torr,Crataegus cuneata,Saliva miltiorrhiza Bge,Atractylodes ovata, Thunb,Pinella ternata,Breitenbach,Citrus reticulata Blanco,Polygonum cuspidatum,Schizandra chinensis (Turcz) Baill,Poria cocos Wolf,Cassia obtusifolia,Gynostemma pentaphyllum (Thumb) Makino.13 people with increased stool frequency and mid-abdominal pain in the intervention group.

Liu 2008Qiyin Chongji decoctionAstragalus membranaceous,Artemisia capillaris,Crataegus pinnatifida,Psorales corylifolial,Alisma orientalis,Cassia obtusifolia.Not reported.

Liu 2009Xiaoyu Huatan decoctionAlisma orientalis, Pinellia ternate, Sargassum pallidum, Salvia miltiorrhiza, Curcuma wenyujin, Bupleurum chinense, Cassia obtusifoliaRheum palmatum, Astragalus membranaceous, Atractylodes macrocephala. Dialectical to add and subtract: Amomun kravanh, Amomum villosum, Citrus reticulata, Raphanus sativus, Gentiana manshurica, Gardenia jasminoidesCurcuma wenyujin, Trogopterus xanthipes (dung), Codonopsis pilosula, Epimedium brevicornum, Cuscuta chinensis.Not reported.

Lou 2008Yiqi Sanju granuleAstragalus membranaceous,Coptis chinensis3 cased of mild diarrhoea, gastric discomfort, and reduced appetite.

Ma 2009Zhigan Qing granuleAstragalus membranaceous,Euonymus ulmoides,Cornus officinalis,Angelica sinensis,Bupleurum chinensis,Citrus reticulata,Blanco,Typha latifolia,Crataegus pinnatifida.Not reported.

Ma 2010Qinggan Xiaozhi decoctionBupleurum chinenseCurcuma wenyujin, Polygonum cuspidatum, Artemisia capillaris, Rheum palmatum, Crataegus pinnatifida, Alisma orientalis, Poria cocos, Cassia obtusifolia, Pinellia ternate, Citrus reticulata, Astragalus membranaceous, Salvia miltiorrhiza.Not reported.

Mi 2010Jiangan Jiangzhi tabletPoria cocos, Salvia miltiorrhiza, Cassia obtusifolia, Crataegus pinnatifida, Polygonum multiflorum, Curcuma wenyujin, Citrus aurtantium.1 case of diarrhoea.

Pu 2009Modified Wendan decoctionPinella ternata,Citrus aurantium,Alisma plantago,Poria cocos,Citrus reticulata,Crataegus pinnatifida,Areca catechu,Phyllostachys nigra,Medicata Fermentita Fujianensis Massa,Saliva miltiorrhiza,Glycyrrhiza glabra,Zingiber offcinale,Zizyphus vulgaris,Astragalus membranaceous,Atractylodes ovata, Melia toosendan,Corydalis bulbosa,Magnolia officinalis,Cyperus rotundus.Not reported.

Song 2006Panax Notoginseng powderPanax Notoginseng. Not reported.

Wang 2006Chuige Jiugan decoctionLycopodium cernum,Pueraria lobata,Saliva miltiorrhiza,Curcuma aromatica,Cassia tora, Alisma plantago,Atractylodes ovata, Crataegus pinnatifida,Bupleurum chinensis,Paeonia albiflora,Polygonum cuspidatum,Atractylodes ovata,Rheum palmatum,Cyperus rotundus,Scutellaria baicalensis,Gentiana scabra.  Not reported.

Wang 2010Chaihu Shugan decoctionBupleurum chinensis,Citrus aurantium,Citrus reticulata Blanco, Cyperus rotundus,Melia toosendan,Crataegus pinnatifida,Saliva miltiorrhiza,Paeonia albiflora,Rheum palmatum,Alisma plantago,Polygonum multiflorum,Artemisia capillaris,Paeonia moutan,Gardenia florida,Curcuma longa,Curcuma aromatica,Trionyx sinensis,Cornus officinalis,Ligustrum lucidum,Rehmannia glutinosa.Not reported.

Wang 2011aTiaogan Lizhong decoctionDryobalanops aromatica,Citrus maxima,Angelica sinensis,Paeonia albiflora,Paeonia  moutan,Lycopus lucidus,Polygonum cuspidatum, Cassia tora,Crataegus pinnatifida,Campanumaea pilosula, Atractylodes ovata, Amygdalus davidiana,Poria cocos,Hovenia acerba,Indigo naturalis,Curcuma aromatica,Pueraria lobata,Phaseolus radiatus,Rheum palmatum.Not observed.

Wang 2008aSisheng Jiangzhi decoctionAstragalus membranaceous, Crataegus pinnatifida, Cassia obtusifolia,Nelumbo nucifera,Coix lacryma-jobi var. ma-yuen, Massa Fermenata, Salvia miltiorrhiza. Dialectical to add and subtract: Bupleurum chinense,Citrus aurtantium, Curcuma wenyujin, Scutellaria baicalensis, Plantago asiatica, Clematis armandi, Prunus persica, Carthamus tinctorius, Angelica sinensis.Not observed.

Wang 2008bJiangzhi Ligan decoctionSargassum Pallidum, Salvia miltiorrhiza, Cassia obtusifolia, Alisma orientalis, Nelumbo nucifera, Curcuma wenyujin, Curcuma longa, Hirude nipponica, Bupleurum chinense. Dialectical to add and subtract: Corydalis yanhusuo, Rheum palmatum, Aloe vera var. chinesis, Sedum sarmentosum, Gentiana manshurica, Panax ginseng, Astragalus membranaceous, Pseudostellaia heterophylla, Epimedium brevicornum.Not reported.

Wang 2011bBushen Yipi formulaLycium chinensel,Rehmannia glutinosa,Polygonum multiflorum,Astragalus membranaceous,Atractylodes macrocephala,Coix lacrym-jobi,Saliva miltiorrhiza,Citrus reticulata,Citrus reticulata. Not reported.

Wu 2006Shan Beimu decoctionCrataegus pinnatifida,Fritillaria roylei,Alisma plantago,Trichosanthis kirilowii,Artemisia capillaris,Polygonum cuspidatum.Not reported.

Wu 2008Herbs mixturesCrataegus pinnatifida,Rheum palmatum,Saliva miltiorrhiza, Alisma plantago,Bupleurum chinensis,Cassia obtusifolia,Pinella ternata,Poria cocos,Citrus reticulata,Astragalus membranaceous,Atractylodes ovata, Melia toosendan,Corydalis bulbosa,Magnolia officinalis,Cyperus rotundus.Not reported.

Wu 2010Self prescripted Chailing decoctionBupleurum chinensis,Scutellaria baicalensis,Atractylodes ovata, Polyporus umbellatus,Poria cocos,Alisma plantago,Abrus cantoniensis Hance,Curcuma aromatica,Coix lacrym-jobi,Crataegus pinnatifida,Paeonia albiflora,Glycyrrhiza glabra,Chrysanthemum sinense,Uncaria hirsuta,Cassia tora,Sophora japonica,Eclipta prostrata,Atractylodes macrocephala,Areca catechu,Astragalus membranaceous,Dioscorea opposita.Not reported.

Xin 2005Qingre Huatan Huoxue formulaArtemisia capillaris,Trichosanthis kirilowii ,Gynostemma pentaphyllum,Saliva miltiorrhiza,Alisma plantago,Poria cocos,Polygonum multiflorum,Bupleurum chinensis,Curcuma aromatica,Prunella vulgaris,Crataegus pinnatifida.3 cases of mild diarrhoea in the start of treatment.

Xu 2008Huganning tabletsLycopodium cernum,Polygonum cuspidatum,Saliva miltiorrhiza,Ganoderma lucidum.5 cases of mid nausea and decreased appetite in the intervention group and 2 cases of dizziness and decreased appetite in the control group.

Xu 2010Jiejiu Hugan decoctionPueraria lobata,Forsythia suspensa, Acorus tatarinowii,Glycyrrhiza uralensis, Artemisia capillaris, Polygonum cuspidatum, Bupleurum chinense.Not observed.

Yang 2004Xiaozhi Jianggan decoctionCrataegus pinnatifida,Polygonum multiflorum,Saliva miltiorrhiza,Chrysanthemum sinense,Nelumbo nucifera,Cassia obtusifolia,Paeonia albiflora,Bupleurum chinensis,Citrus aurantium,Alisma plantago,Lycopus lucidus,Citrus reticulata,Melia toosendan,Curcuma aromatica,Paeonia moutan,Gardenia florida,Angelica sinensis,Lycium chinensel,Rehmannia glutinosa,Pinella ternata,Citrus reticulata,Conioselinum unvittatum, Sparganium stoloniferum,Curcuma zedoaria,Panax ginseng,Astragalus membranaceous.Not reported.

Yang 2005Guben Xiaozhuo decoctionPolygonum multiflorum,Epimedium macranthum,Astragalus membranaceous,Polygonum cuspidatum,Alisma plantago v,Ginkgo biloba,Panax notoginseng, Crataegus pinnatifida,Citrus aurantium,Poria cocos,Coix lacrym-jobi,Bupleurum chinensis,Curcuma aromatica,Saliva miltiorrhiza,Paeonia albiflora,Atractylodes macrocephala. Not reported.

Yang 2006Qingzhifugan decoctionAstragalus membranaceous,Salvia miltiorrhiza,Poria cocos, Atractylodes macrocephala, Sophora flavescens, Crataegus pinnatifida, Cassia obtusifolia, Polygonum multiflorum. Dialectical to add and subtract: Atractylodes macrocephala, Corydalis yanhusuo, Dolichos lablab, Amomum villosum.Not reported.

Yang 2009Shennong Ganzhining tabletPolygonum multiflorum,Polygonum cuspidatum,Gynostemma pentaphyllum, Nelumbo nucifera,Cassia obtusifolia,Saliva miltiorrhiza.Not reported.

Zeng 2007Xiaozhi decoctionAlisma plantago,Saliva miltiorrhiza,Cassia obtusifolia,Crataegus pinnatifida,Bupleurum chinensis,Curcuma zedoaria,Poria cocos,Angelica sinensis,Citrus reticulata,Pinella ternata. 1 person increased stool frequency in the intervention group.

Zhang 2002Clearing heat and removing dampness formulaBupleurum chinensis,Artemisia capillaris,Curcuma aromatica,Rheum palmatum,Pueraria lobata,Lysimachia christinae,Polygonum cuspidatum.Not reported.

Zhang 2003Hugan tabletArtemisia capillaris,Bupleurum chinensis,Isatis tinctoria,Schizandra chinensis.Not reported.

Zhang 2005aQugan Zhi decoctionCrataegus pinnatifida, Polygonum multiflorum,Saliva miltiorrhiza,Cassia obtusifolia,Paeonia albiflora,Poria cocos,Alisma plantago,Curcuma aromatica,Bupleurum chinensis,Ginkgo biloba, Citrus reticulata,Citrus aurantium,Atractylodes macrocephala, Magnolia officinalis,Scutellaria baicalensis,Angelica sinensis.Not reported.

Zhang 2006aXuezhi Kang capsulePatent medication, ingredients not reported.4 cases of nausea and gastric discomfort in the intervention group.

Zhang 2006bGanzhi Kang capsulePatent medication, ingredients not reported.Not reported.

Zhang 2007Sanyu Huazhuo decoctionBupleurum chinensis,Curcuma aromatica,Artemisia capillaris,Raphanus sativus,Coptis chinensis,Alisma plantago,Cassia tora,Prunella vulgaris,Saliva miltiorrhiza,Crataegus pinnatifida,Lycopus lucidus,Atractylodes ovata, Amomum cardamum,Polygonum multiflorum,Morus multicaulis,Citrus reticulata,Campanumaea pilosula,Polygonatum chinense,Angelica sinensis,Paeonia albiflora.Not reported.

Zhang 2008Quyu Huatan Tongluo decoctionBupleurum chinense, Scutellaria bicalensis, Pinellia ternate, Codonopsis pilosula, Glycyrrhiza uralensis, Ziziphus jujuba, Polygonum cuspidatum, Morinda officinalis, Hedyotis diffusa.Not observed.

Zhang 2011Kangzhi decoctionAstragalus membranaceous, Crataegus pinnatifida,Chrysanthemum sinense,Atractylodes ovata, Cassia obtusifolia,Alisma plantago,Nelumbo nucifera,Atractylodes japonica,Lycopodium cernum.Not observed.

Zhao 2009Self prescripted Huoxue Jiangzhi decoctionLycium chinense,Crataegus pinnatifida,Saliva miltiorrhiza,Atractylodes ovata,Astragalus membranaceous,Pinella ternata,Angelica sinensis,Artemisia capillaris,Nelumbo nucifera,Arisaema erubescens,Amygdalus davidiana,Carthamus tinctorius,Paeonia albiflora,Curcuma aromatica,Ligustrum lucidum,Eclipta prostrata,Polygonum multiflorum. Not reported.

Zhao 2010Qiyin ChaAstragalus membranaceous,Artemisia capillaris,Crataegus pinnatifida,Psorales corylifolial,Alisma orientalis,Cassia obtusifolia,Ilex lutifolia,Panax notoginseng,  Rheum palmatum.Not reported.

Zhou 2008Kezhi capsulePatent medication, ingredients not reported.Not reported.

Zhou 2009Lishi Huoxue Tongluo decoctionArtemisia scoparia,Alisma orientalis,Crataegus pinnatifida,Rheum palmatum,Carapax trionycis,Saliva miltiorrhiza,Luffa cylindrica.Several cases of mild stomach ache, number of stools increased.

Zhu 2006Zhixiao  capsulePoria cocos, Atractylodes macrocephala,Sinapi alba,Citrus reticulata, Crataegus pinnatifida, Alisma orientalis.Not reported.

Zhu 2010Xiaotan Hugan decoctionAstragalus membranaceous, Cassia obtusifolia, Salvia miltiorrhiza, Alisma orientalis, Lysimachia christinae, Curcuma wenyuji, Paeonia lactiflora, Bupleurum chinense.Not observed.

 -: not reported on this item.
 
Table 3. The RevMan results and exact fisher test results of studies that meta-analysis could not be done (categorical variables)

Study ID  Comparison  OutcomeRevMan resultsFisher's test


RR (95% CI)OR (95% CI)P valueOR (95% CI)

Jia 2009Shengqing Jiangzhuo granules + lifestyle intervention versus lifestyle interventionAdverse events1.04 (0.85 to 1.29)1.18 (0.53 to 2.65)0.8381.18 (0.53 to 2.65)

Guan 2010Wild apricot versus vitamin B and C + glucurolactone tabletsAdverse events6.13 (0.33 to 113.50)0.10 (-0.02 to 0.22)0.240-

Lin 2011Yunpi Tongluo formula + lifestyle intervention versus UDCA + lifestyle interventionAdverse events9.28 (0.52 to 165.50)0.13 (0.00 to 0.26)0.053-

Xu 2008Huganning tablets + metformin hydrochloride tablets + lifestyle intervention versus metformin hydrochloride tablets + lifestyle interventionAdverse events0.40 (0.08 to 1.89)0.35 (0.06 to 2.00)0.4220.35 (0.02 to 2.00)

Zhang 2003Hugan tablets + UDCA + lifestyle intervention versus UDCA + lifestyle interventionAdverse events8.90 (0.48 to 166.10)10.02 (0.50 to 202.47)0.079-

Guan 2010Wild apricot versus vitamins B and C + glucurolactone tabletsAbnormal B-ultrasound0.44 (0.24 to 0.80)0.20 (0.07 to 0.62)0.0080.20 (0.07 to 0.62)

Huo 2008Kezhi capsules + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionAbnormal B-ultrasound0.43 (0.18 to 1.00)0.32 (0.11 to 0.96)0.0670.32 (0.11 to 0.96)

Liang 2011Baogan Xiaozhi pellet versus Dongbao gantai tabletsAbnormal B-ultrasound0.73 (0.53 to 1.02)0.41 (0.16 to 1.05)0.1000.41 (0.16 to 1.05)

Wang 2006Chuige Jiugan decoction + tiopronin + lifestyle intervention versus tiopronin + lifestyle interventionAbnormal B-ultrasound0.65 (0.39 to 1.07)0.42 (0.16 to 1.14)0.1370.42 (0.16 to 1.14)

Zhang 2007Sanyu Huazhuo decoction versus EssentialeAbnormal B-ultrasound0.36 (0.19 to 0.67)0.23 (0.10 to 0.53)0.0010.23 (0.10 to 0.53)

Zhang 2008Quyuhua Tan Tongluo decoction versus UDCAAbnormal B-ultrasound0.82 (0.68 to 0.98)0.12 (0.01 to 1.04)0.0540.12 (0.01 to 1.04)

Zhang 2011Kangzhi formula versus tioproninAbnormal B-ultrasound0.79 (0.67 to 0.93)0.33 (0.16 to 0.71)0.0040.33 (0.16 to 0.71)

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionB-ultrasound: proximal diffuse high echogenic dots1.16 (0.85 to 1.58)1.41 (0.68 to 2.91)0.4601.41 (0.68 to 2.91)

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionB-ultrasound: distal end echo attenuation1.25 (0.64 to 2.44)1.33 (0.56 to 3.15)0.6621.33 (0.56 to 3.15)

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionB-ultrasound: reduction of blood flow1.36 (0.94 to 1.97)1.83 (0.89 to 3.78)0.1441.83 (0.89 to 3.78)

Dai 2009Shuai Qingzhi powder + lifestyle intervention versus simvastatin tablets + lifestyle interventionB-ultrasound: unclear hepatic vessel structure0.44 (0.15 to 1.29)0.36 (0.10 to 1.33)0.2090.36 (0.10 to 1.33)

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionB-ultrasound: unclear hepatic vessel structure1.50 (1.00 to 2.25)2.11 (1.02 to 4.39)0.0662.11 (1.02 to 4.39)

Dai 2009Shuai Qingzhi powder + lifestyle intervention versus simvastatin tablets + lifestyle interventionHepatic B-ultrasound without improvement0.38 (0.11 to 1.28)0.31 (0.07 to 1.29)0.1810.31 (0.07 to 1.29)

Gu 2007aTiaozhi Yanggan decoction + lifestyle intervention versus Thiola tablets + lifestyle interventionB-ultrasound without improvement0.72 (0.24 to 2.12)0.69 (0.20 to 2.38)0.5130.69 (0.20 to 2.38)

Ji 2005Danning tablets + lifestyle intervention versus UDCA capsules + lifestyle interventionB-ultrasound without improvement0.71 (0.27 to 1.90)0.68 (0.22 to 2.11)0.5390.68 (0.22 to 2.11)

Lin 2011Yunpi Tongluo formula + lifestyle intervention versus UDCA + lifestyle interventionB-ultrasound without improvement0.81 (0.66 to 0.98)0.12 (0.01 to 1.03)0.0530.12 (0.01 to 1.03)

Lin 2010aXiaozhi Jiangpi decoction + lifestyle intervention versus PPC capsules + lifestyle interventionHepatic B-ultrasound without improvement0.88 (0.61 to 1.25)0.71 (0.28 to 1.80)0.487-

Liu 2008Qiyin granules + lifestyle intervention versus Essentiale + lifestyle interventionB-ultrasound without improvement1.00 (0.15 to 6.71)1.00 (0.13 to 7.53)1.0001.00 (0.13 to 7.53)

Liu 2009Xiaoyu Huatan decoction + lifestyle intervention versus compound methionine and choline bitartrate tablets + lifestyle interventionB-ultrasound without improvement0.44 (0.26 to 0.75)0.27 (0.12 to 0.63)0.0030.27 (0.12 to 0.63)

Wu 2010Zini Jianpi Huatan formula + lifestyle intervention versus PPC capsules + lifestyle interventionB-ultrasound without improvement0.78 (0.54 to 1.11)0.47 (0.16 to 1.36)0.1950.47 (0.16 to 1.36)

Zhao 2010Qiyin tea + lifestyle intervention versus polyene phosphatidylcholine capsules + lifestyle interventionB-ultrasound without improvement0.80 (0.23 to 2.82)0.78 (0.20 to 3.09)1.0000.78 (0.20 to 3.09)

Zhou 2009Lishi Huoxue Tongluo decoction + lifestyle intervention versus tiopronin tablets + lifestyle interventionB-ultrasound without improvement0.16 (0.07 to 0.35)0.06 (0.02 to 0.17)

 
< 0.0010.06 (0.02 to 0.17)

Zhu 2010Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitaminHepatic B-ultrasound without improvement0.60 (0.36 to 1.00)0.33 (0.12 to 0.96)0.0690.33 (0.12 to 0.96)

Gu 2007aTiaozhi Yanggan decoction + lifestyle intervention versus thiola tablets + lifestyle interventionLiver CT without improvement0.29 (0.05 to 1.92)0.27 (0.03 to 2.07)0.2200.27 (0.03 to 2.07)

Ji 2005Danning tablets + lifestyle intervention versus UDCA capsules + lifestyle interventionLiver CT without improvement0.35 (0.05 to 2.28)0.32 (0.04 to 2.46)0.2710.32 (0.04 to 2.46)

Jia 2009Shengqing Jiangzhuo granules + lifestyle intervention versus lifestyle interventionLiver CT without improvement0.80 (0.65 to 0.99)0.36 (0.14 to 0.97)0.0610.36 (0.14 to 0.97)

Yang 2006Qingzhifugan decoction versus EssentialeAbnormal AST (> 50 μ/L)0.28 (0.09 to 0.92)0.21 (0.05 to 0.85)0.0290.21 (0.05 to 0.85)

Yang 2006Qingzhifugan decoction versus EssentialeAbnormal ALT (> 50 μ/L)0.36 (0.15 to 0.87)0.24 (0.07 to 0.78)0.0270.24 (0.07 to 0.78)

 ALT: alanine aminotransferase; AST: aspartate aminotransferase; CI: confidence interval; CT: computed tomography; OR: odds ratio; PPC: polyene phosphatidylcholine; RR: risk ratio; UDCA: ursodeoxycholic acid.
 
Table 4. The RevMan results and t-test results of studies that meta-analysis could not be done (numerical variables)

Study IDComparisonOutcomeRevMan resultst test


t-valueP valuet-valueP value

Wang 2008bJiangzhi Ligan decoction + lifestyle intervention versus lifestyle interventionB-ultrasound: liver score-2.280.025-2.280.025

Wang 2010Chaihu Shugan powder + lifestyle intervention versus fenofibrate sustained release capsules + lifestyle interventionB-ultrasound: liver score-3.61< 0.001-3.61< 0.001

Liang 2008Colon herbs dialysis therapy + lifestyle intervention versus PPC + simvastatin + silybin meglumine tablets + lifestyle interventionB-ultrasound: liver echo intensity-1.670.098-1.670.098

Fei 2009Yuqin capsules versus placeboLiver/spleen CT ratio5.65< 0.0015.65< 0.001

Liang 2010Jianpi Huazhuo formula + lifestyle intervention versus PPC capsules + lifestyle interventionLiver/spleen CT ratio8.08< 0.0018.08< 0.001

Ma 2010Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle intervention versus reduced glutathione tablets + lifestyle interventionLiver/spleen CT ratio1.480.1441.480.144

Lou 2008Yiqi Sanju formula + lifestyle intervention versus Yiqi Sanju placebo + lifestyle interventionLiver/spleen CT ratio12.11< 0.00112.11< 0.001

Li 2010Xiaotan Jiangzhi formula + polyene phosphatidylcholine capsules + lifestyle intervention versus polyene phosphatidylcholine capsules + lifestyle interventionLiver CT density value3.81< 0.0013.81< 0.001

Cao 2011Huazhuo Xiaozhi decoction + lifestyle intervention versus Baisainuo + lifestyle interventionAST-12.41< 0.001-12.41< 0.001

Chen 2010Huatan Huoxue formula + lifestyle intervention versus Essentiale capsules + lifestyle interventionAST-2.670.009-2.670.009

Chen 2007aZini Zhigan prescription versus liptorAST-0.020.981-0.020.981

Cheng 2006Zhiyan Xiao decoction + lifestyle intervention versus UDCA + lifestyle interventionAST-7.04< 0.001-7.04< 0.001

Chou 2006Gynostemma pentaphyllum + lifestyle intervention versus placebo + lifestyle interventionAST-1.430.159-1.430.159

Dai 2009Shuai Qingzhi powder + lifestyle intervention versus simvastatin tablets + lifestyle interventionAST-3.83< 0.001-3.83< 0.001

Dang 2007Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tabletsAST-1.610.111-1.610.111

Fei 2009Yuqin capsules versus placeboAST-10.12< 0.001-10.12< 0.001

Gu 2007aTiaozhi Yanggan decoction + lifestyle intervention versus thiola tablets + lifestyle interventionAST-3.220.002-3.220.002

Gu 2007bHerbal + lifestyle intervention versus silybininon + lifestyle interventionAST-0.660.512-0.660.512

Guan 2010Wild apricot versus vitamin B and C + glucurolactone tabletsAST0.240.8090.240.809

Guo 2010Xiaogan Jiangzhi formula + lifestyle intervention versus diisopropylamini dichlorocacetas + lifestyle interventionAST-1.140.258-1.140.258

Hu 2010Tangganjian + lifestyle intervention versus metformin hydrochloride tablets + lifestyle interventionAST-7.50< 0.001-7.50< 0.001

Huang 2011Quyu Huazhuo decoction + lifestyle intervention versus PPC capsules + lifestyle interventionAST-2.150.034-2.150.034

Huo 2008Kezhi capsules + PPC capsules + lifestyle intervention versus polyene phosphatidylcholine capsules + lifestyle interventionAST1.600.1141.600.114

Ji 2005Danning tablets + lifestyle intervention versus UDCA capsules + lifestyle interventionAST-1.060.293-1.060.293

Jia 2003Juge Yigan decoction + lifestyle intervention versus vitamin B and folic acid + lifestyle interventionAST-11.42< 0.001-11.42< 0.001

Jiang 2009Zhishi Xiaopi decoction + lifestyle intervention versus PPC capsules lifestyle interventionAST-6.20< 0.001-6.20< 0.001

Li 2005Huoxue Qinggan decoction + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionAST-2.330.022-2.330.022

Li 2008Shengling Baizhu powder with Erchen decoction + lifestyle intervention versus zocor + diammoniium glycyrrihizinate + lifestyle interventionAST-2.530.013-2.530.013

Li 2009Qinggan decoction + lifestyle intervention versus tiopronin tablets + lifestyle interventionAST-6.62< 0.001-6.62< 0.001

Li 2010Xiaotan Jiangzhi formula + PPC capsules + lifestyle intervention versus polyene phosphatidylcholine capsules + lifestyle interventionAST-2.010.049-2.010.049

Li 2006aXiaozhi powder + lifestyle intervention versus lifestyle interventionAST-0.320.749-0.320.749

Li 2006bBaogan Xiaozhi pellet + lifestyle intervention versus vitamin E nicotinicate capsules + lifestyle interventionAST-3.080.003-3.080.003

Liang 2008Colon herbs dialysis therapy + lifestyle intervention versus PPC + simvastatin + silybin meglumine tablets + lifestyle interventionAST-8.65< 0.001-8.65< 0.001

Liang 2010Jianpihuazhuo formula + lifestyle intervention versus PPC capsules + lifestyle interventionAST-0.160.870-0.160.870

Liang 2011Baogan Xiaozhi pellet versus Dongbao gantaiAST-4.16< 0.001-4.16< 0.001

Lin 2011Yunpi Tongluo formula + lifestyle intervention versus UDCA + lifestyle interventionAST-4.00< 0.001-4.00< 0.001

Lin 2010aXiaozhi Jiangpi decoction + lifestyle intervention versus polyene phosphatidylcholine capsules + lifestyle interventionAST-1.990.051-1.990.051

Liu 2008Qiyin granules + lifestyle intervention versus Essentiale + lifestyle interventionAST1.470.1461.470.146

Liu 2009Xiaoyu Huatan decoction + lifestyle intervention versus compound methionine and choline bitartrate tablets + lifestyle interventionAST-12.05< 0.001-12.05< 0.001

Lou 2008Yiqi Sanju formula + lifestyle intervention versus Yiqi Sanju placebo + lifestyle interventionAST-2.810.007-2.810.007

Ma 2009Zhiganqing granules + lifestyle intervention versus tiopronin + lifestyle interventionAST-13.33< 0.001-13.33< 0.001

Ma 2010Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle intervention versus reduced glutathione tablets + lifestyle interventionAST0.050.9620.050.962

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionAST-0.410.680-0.410.680

Pu 2009Modified Wendan decoction + lifestyle intervention versus PPC capsules + lifestyle interventionAST-3.190.002-3.190.002

Song 2006Diammonium glycyrrihizinate capsules with Panax Notoginseng powder + lifestyle intervention versus tiopronin + lifestyle interventionAST-5.12< 0.001-5.12< 0.001

Wang 2006Chuige Jiugan decoction + tiopronin + lifestyle intervention versus tiopronin + lifestyle interventionAST-2.220.030-2.220.030

Wang 2011aBushen Yipi Fa versus PPC capsulesAST1.720.0911.720.091

Wang 2011aTiaogan Lizhong decoction with Qingbai powder + lifestyle intervention versus conventional therapy + lifestyle interventionAST-15.92< 0.001-15.92< 0.001

Wang 2008aSisheng Jiangzhi formula versus simvastatinAST-5.20< 0.001-5.20< 0.001

Wang 2008bJiangzhi Ligan decoction + lifestyle intervention versus lifestyle interventionAST-1.310.194-1.310.194

Wu 2006Shanzha Beimu decoction + lifestyle intervention versus Duoxi Kangzhi capsules + lifestyle interventionAST-6.16< 0.001-6.16< 0.001

Wu 2008Herbal formula versus PPC capsulesAST-0.080.939-0.080.939

Wu 2010Zini Jianpi Huatan formula + lifestyle intervention versus PPC capsules + lifestyle interventionAST-8.15< 0.001-8.15< 0.001

Xu 2008Huganning tablets + metformin hydrochloride tablets + lifestyle intervention versus metformin hydrochloride tablets + lifestyle interventionAST-2.840.006-2.840.006

Xu 2010Jiejiuhugan decoction + polyene phosphatidylcholine capsules + lifestyle intervention versus PPC capsules + lifestyle interventionAST-3.090.003-3.090.003

Yang 2004Zini Xiaozhi Jianggan decoction + lifestyle intervention + diammonium glycyrrihizinate versus lifestyle intervention + diammonium glycyrrihizinateAST-14.01< 0.001-14.01< 0.001

Yang 2005Guben Xiaozhuo decoction + lifestyle intervention versus fenofibrate tablets + lifestyle interventionAST-4.79< 0.001-4.79< 0.001

Yang 2009Shengnong Ganzhi tablets + lifestyle intervention versus lifestyle interventionAST-8.20< 0.001-8.20< 0.001

Zeng 2007Xiaozhi decoction + lifestyle intervention versus Essentiale + lifestyle interventionAST-1.900.063-1.900.063

Zhang 2002Clearing heat and removing dampness + lifestyle intervention versus conventional therapy + lifestyle interventionAST-2.490.017-2.490.017

Zhang 2005aQuganzhi decoction + lifestyle intervention versus Diisopylamini Dichlorovacetas + lifestyle interventionAST-23.68< 0.001-23.68< 0.001

Zhang 2006bGanzhikang capsules versus rosiglitazone hydrochloride tabletsAST-2.570.012-2.570.012

Zhang 2007Sanyu Huazhuo decoction versus EssentialeAST-1.800.075-1.800.075

Zhang 2008Quyuhua Tan Tongluo decoction versus UDCAAST-4.75< 0.001-4.75< 0.001

Zhang 2011Kangzhi formula versus tioproninAST-3.68< 0.001-3.68< 0.001

Zhao 2010Qiyin Tea + lifestyle intervention versus PPC capsules + lifestyle interventionAST-0.260.796-0.260.796

Zhou 2008Kezhi capsule + lifestyle intervention versus lifestyle interventionAST-32.96< 0.001-32.96< 0.001

Zhou 2009Lishi Huoxue Tongluo decoction + lifestyle intervention versus tiopronin tablets + lifestyle interventionAST-27.30< 0.001-27.30< 0.001

Zhu 2006Zhixiao capsules versus ethyl polyenoate soft capsulesAST-1.610.111-1.610.111

Zhu 2010Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitaminAST-3.490.001-3.490.001

Cao 2011Huazhuo Xiaozhi decoction + lifestyle intervention versus Baisainuo + lifestyle interventionALT-9.13< 0.001-9.13< 0.001

Chen 2010Huatanhuoxue formula + lifestyle intervention versus Essentiale capsules + lifestyle interventionALT-5.42< 0.001-5.42< 0.001

Chen 2007aZini Zhigan prescription versus liptorALT-0.800.427-0.800.427

Chen 2007bJiangzhi Baogan decoction + lifestyle intervention versus placebo + lifestyle interventionALT-26.92< 0.001-26.92< 0.001

Cheng 2006Zhiyan Xiao decoction + lifestyle versus UDCA + lifestyleALT-9.08< 0.001-9.08< 0.001

Chou 2006Gynostemma pentaphyllum + lifestyle intervention versus placebo + lifestyle interventionALT-0.450.657-0.450.657

Dai 2009Shuai Qingzhi powder + lifestyle intervention versus simvastatin tablets + lifestyle interventionALT-3.94< 0.001-3.94< 0.001

Dang 2007Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tabletsALT-4.59< 0.001-4.59< 0.001

Deng 2003aHuanglong Ganzhixiao decoction versus fenofibrate tabletsALT-19.65< 0.001-19.65< 0.001

Deng 2010Xiaoyao tablets + legalon + lifestyle intervention versus Legalon + lifestyle interventionALT-0.880.381-0.880.381

Fei 2009Yuqin capsules versus placeboALT-9.95< 0.001-9.95< 0.001

Gu 2007aTiaozhi Yanggan decoction + lifestyle intervention versus thiola tablets + lifestyle interventionALT-3.240.002-3.240.002

Gu 2007bHerbal versus silybininonALT-0.220.830-0.220.830

Gu 2007bHerbal + silybininon versus silybininonALT-1.950.056-1.950.056

Gu 2007bHerbal + lifestyle intervention versus silybininon + lifestyle interventionALT-0.220.830-0.220.830

Gu 2007bHerbal + silybininon + lifestyle intervention versus silybininon + lifestyle interventionALT-1.950.056-1.950.056

Guan 2010Wild apricot versus vitamin B and C + glucurolactone tabletsALT1.910.0611.910.061

Guo 2007Hegan Yin + tiopronin + lifestyle intervention versus tiopronin + lifestyle interventionALT-3.82< 0.001-3.82< 0.001

Guo 2010Xiaogan Jiangzhi formula + lifestyle intervention versus diisopropylamini dichlorocacetas + lifestyle interventionALT0.490.6270.490.627

Hu 2010Tangganjian + lifestyle intervention versus metformin hydrochloride tablets + lifestyle interventionALT-17.53< 0.001-17.53< 0.001

Huang 2005Shugan Lipi San + GSH + lifestyle intervention versus GSH + lifestyle interventionALT-1.280.204-1.280.204

Huang 2011Quyu Huazhuo decoction + lifestyle versus PPC capsules + lifestyle interventionALT-5.31< 0.001-5.31< 0.001

Huo 2008Kezhi capsules + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionALT-1.390.169-1.390.169

Ji 2005Danning tablets + lifestyle intervention versus UDCA capsules + lifestyle interventionALT-1.830.070-1.830.070

Jia 2003Juge Yigan decoction + lifestyle intervention versus vitamin B and folic acid + lifestyle interventionALT-14.73< 0.001-14.73< 0.001

Jia 2009Shengqing Jiangzhuo granules + lifestyle intervention versus lifestyle interventionALT-0.330.744-0.330.744

Jiang 2009Zhishi Xiaopi decoction + lifestyle intervention versus polyene phosphatidylcholine capsules lifestyle interventionALT-5.36< 0.001-5.36< 0.001

Kong 2010Tianganjiangzhi granules versus Essentiale capsulesALT-29.52< 0.001-29.52< 0.001

Li 2005Huoxue Qinggan decoction + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionALT-2.310.024-2.310.024

Li 2007Shuanghu Qinggan granules + tiopronin tablets + lifestyle intervention versus tiopronin tablets + lifestyle interventionALT-1.190.238-1.190.238

Li 2008Shenglingbaizhu powder with Erchen decoction + lifestyle intervention versus Zocor + diammoniium glycyrrihizinate + lifestyle interventionALT-2.170.033-2.170.033

Li 2009Qinggan decoction + lifestyle intervention versus tiopronin tablets + lifestyle interventionALT-4.49< 0.001-4.49< 0.001

Li 2010Xiaotan Jiangzhi formula + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionALT-3.150.003-3.150.003

Li 2006aXiaozhi powder + lifestyle intervention versus lifestyle interventionALT-0.210.836-0.210.836

Li 2006bBaogan Xiaozhi pellet + lifestyle intervention versus vitamin E nicotinicate capsules + lifestyle interventionALT-8.02< 0.001-8.02< 0.001

Liang 2008Colon herbs dialysis therapy + lifestyle intervention versus PPC + simvastatin + silybin meglumine tablets + lifestyle interventionALT-9.14< 0.001-9.14< 0.001

Liang 2010Jianpihuazhuo formula + lifestyle intervention versus PPC capsules + lifestyle interventionALT-1.080.282-1.080.282

Liang 2011Baogan Xiaozhi pellet versus Dongbao gantaiALT-2.950.004-2.950.004

Lin 2011Yunpi Tongluo formula + lifestyle intervention versus UDCA + lifestyle interventionALT-6.23< 0.001-6.23< 0.001

Lin 2010aXiaozhi Jiangpi decoction + lifestyle intervention versus PPC capsules + lifestyle interventionALT-1.400.167-1.400.167

Lin 2010bZini Jianpi Huatan formula + lifestyle intervention versus PPC capsules + lifestyle interventionALT-10.85< 0.001-10.85< 0.001

Liu 2008Qiyin granules + lifestyle intervention versus Essentiale + lifestyle interventionALT3.050.0033.050.003

Liu 2009Xiaoyu Huatan decoction + lifestyle intervention versus compound methionine and choline bitartrate tablets + lifestyle interventionALT-30.64< 0.001-30.64< 0.001

Lou 2008Yiqi Sanju formula + lifestyle intervention versus Yiqi Sanju placebo + lifestyle interventionALT-9.61< 0.001-9.61< 0.001

Ma 2009Zhiganqing granules + lifestyle intervention versus tiopronin + lifestyle interventionALT-10.84< 0.001-10.84< 0.001

Ma 2010Qinggan Xiaozhi decoction + reduced glutathione tablets + lifestyle intervention versus reduced glutathione tablets + lifestyle interventionALT-4.64< 0.001-4.64< 0.001

Mi 2010Jiangan Jiangzhi tablets + lifestyle intervention versus silibinin capsules + lifestyle interventionALT-1.510.133-1.510.133

Pu 2009Modified Wendan decoction + lifestyle intervention versus PPC capsules + lifestyle interventionALT-3.78< 0.001-3.78< 0.001

Song 2006Diammonium glycyrrihizinate capsules with Panax Notoginseng powder + lifestyle intervention versus tiopronin + lifestyle interventionALT-4.19< 0.001-4.19< 0.001

Wang 2006Chuige Jiugan decoction + tiopronin + lifestyle intervention versus tiopronin + lifestyle interventionALT-1.290.203-1.290.203

Wang 2011aTiaogan Lizhong decoction with Qingbai powder + lifestyle intervention versus conventional therapy + lifestyle interventionALT-9.11< 0.001-9.11< 0.001

Wang 2008aSisheng Jiangzhi formula versus simvastatinALT-3.91< 0.001-3.91< 0.001

Wang 2008bJiangzhi Ligan decoction + lifestyle intervention versus lifestyle interventionALT-1.790.076-1.790.076

Wang 2011bBushen Yipi Fa versus PPC capsulesALT4.29< 0.0014.29< 0.001

Wu 2006Shanzha Beimu decoction + lifestyle intervention versus Duoxi Kangzhi capsules + lifestyle interventionALT-7.85< 0.001-7.85< 0.001

Wu 2008Herbal formula versus PPC capsulesALT0.830.4120.830.412

Wu 2010Zini Jianpi Huatan formula + lifestyle intervention versus PPC capsules + lifestyle interventionALT-7.41< 0.001-7.41< 0.001

Xin 2005Qingre Huatan Huoxue formula versus tiopronin tabletsALT-1.950.056-1.950.056

Xu 2008Huganning tablets + metformin hydrochloride tablets + lifestyle intervention versus metformin hydrochloride tablets + lifestyle interventionALT-2.410.020-2.410.020

Xu 2010Jiejiu Hugan decoction + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionALT-3.420.001-3.420.001

Yang 2004Zini Xiaozhi Jianggan decoction + lifestyle intervention + diammonium glycyrrihizinate versus lifestyle intervention + diammonium glycyrrihizinateALT-11.98< 0.001-11.98< 0.001

Yang 2006Guben Xiaozhuo decoction + lifestyle intervention versus fenofibrate tablets + lifestyle interventionALT-9.14< 0.001-9.14< 0.001

Yang 2009Shengnong Ganzhi tablets + lifestyle intervention versus lifestyle interventionALT-3.70< 0.001-3.70< 0.001

Zeng 2007Xiaozhi decoction + lifestyle intervention versus Essentiale + lifestyle interventionALT-0.880.383-0.880.383

Zhang 2002Clearing heat and removing dampness + lifestyle intervention versus conventional therapy + lifestyle interventionALT4.49< 0.0014.49< 0.001

Zhang 2003Hugan tablets + UDCA + lifestyle intervention versus UDCA + lifestyle interventionALT-5.12< 0.001-5.12< 0.001

Zhang 2005aQuganzhi decoction + lifestyle intervention versus diisopylamini dichlorovacetas + lifestyle interventionALT4.49< 0.0014.49< 0.001

Zhang 2006bGanzhikang capsules versus rosiglitazone hydrochloride tabletsALT-3.91< 0.001-3.91< 0.001

Zhang 2007Sanyu Huazhuo decoction versus EssentialeALT-8.04< 0.001-8.04< 0.001

Zhang 2008Quyuhua Tan Tongluo decoction versus UDCAALT-6.53< 0.001-6.53< 0.001

Zhang 2011Kangzhi formula versus tioproninALT-2.360.019-2.360.019

Zhao 2009Herbal therapy + lifestyle intervention versus Essentiale + lifestyle interventionALT-19.11< 0.001-19.11< 0.001

Zhao 2010Qiyin tea + lifestyle intervention versus PPC capsules + lifestyle interventionALT-0.430.665-0.430.665

Zhou 2008Kezhi capsules + lifestyle intervention versus lifestyle interventionALT-40.51< 0.001-40.51< 0.001

Zhou 2009Lishi Huoxue Tongluo decoction + lifestyle intervention versus tiopronin tablets + lifestyle interventionALT-15.20< 0.001-15.20< 0.001

Zhu 2006Zhixiao capsules versus ethyl polyenoate soft capsulesALT-4.59< 0.001-4.59< 0.001

Zhu 2010Xiaotan Hugan decoction + Essentiale Forte + vitamin versus Essentiale Forte + vitaminALT-3.560.001-3.560.001

Chou 2006Gynostemma pentaphyllum + lifestyle intervention versus placebo + lifestyle interventionALP-2.600.012-2.600.012

Dang 2007Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tabletsALP-5.85< 0.001-5.85< 0.001

Wang 2011bBushen Yipi Fa versus PPC capsulesALP-1.440.156-1.440.156

Zhang 2011Kangzhi formula versus tioproninALP-0.860.390-0.860.390

Zhu 2006Zhixiao capsules versus ethyl polyenoate soft capsulesALP-5.85< 0.001-5.85< 0.001

Cao 2011Huazhuo Xiaozhi decoction + lifestyle intervention versus Baisainuo + lifestyle interventionGGT-18.55< 0.001-18.55< 0.001

Chen 2007aZini Zhigan prescription versus liptorGGT-1.220.229-1.220.229

Cheng 2006Zhiyan Xiao decoction + lifestyle intervention versus UDCA capsules + lifestyle interventionGGT-3.78< 0.001-3.78< 0.001

Dai 2009Shuli Qingzhi powder + lifestyle intervention versus simvastatin tablets + lifestyle interventionGGT-2.460.017-2.460.017

Dang 2007Shiwei Ganzhikang capsules versus Dong Bao Gan Tai tabletsGGT40.52< 0.00140.52< 0.001

Deng 2010Xiaoyao tablets + Legalon + lifestyle intervention versus Legalon + lifestyle interventionGGT-2.570.012-2.570.012

Gu 2007aTiaozhi Yanggan decoction + lifestyle versus Thiola tablets + lifestyleGGT-2.010.047-2.010.047

Guo 2007Hegan Yin + tiopronin + lifestyle intervention versus tiopronin + lifestyle interventionGGT-2.420.018-2.420.018

Guo 2010Xiaogan Jiangzhi formula + lifestyle intervention versus diisopropylamini dichlorocacetas + lifestyle interventionGGT-4.50< 0.001-4.50< 0.001

Huang 2005Shugan Lipi San + GSH + lifestyle intervention versus GSH + lifestyle interventionGGT-16.55< 0.001-16.55< 0.001

Ji 2005Danning tablets + lifestyle intervention versus UDCA capsules + lifestyle interventionGGT-1.570.118-1.570.118

Jia 2003Juge Yigan decoction + lifestyle intervention versus vitamin B and folic acid + lifestyle interventionGGT-12.30< 0.001-12.30< 0.001

Jiang 2009Zhishi Xiaopi decoction + lifestyle intervention versus PPC capsules + lifestyle interventionGGT-6.66< 0.001-6.66< 0.001

Li 2005Huoxue Qinggan decoction + PPC capsules + lifestyle intervention versus PPC capsules + lifestyle interventionGGT0.470.6420.470.642

Li 2007Shuanghu Qinggan granules + tiopronin tablets + lifestyle intervention versus tiopronin tablets + lifestyle interventionGGT-7.46< 0.001-7.46< 0.001

Li 2008Shenlingbaizhu powder with Erchen decotion + lifestyle intervention versus Zocor + diammonium glycyrrihizinate + lifestyle