Contemporary clinical research of traditional Chinese medicines for chronic hepatitis B in China: An analytical review

Authors

  • Lingyi Zhang,

    1. Liver-Biliary-Pancreatic Center and the Liver, Digestive Diseases, and Metabolism Laboratory, NC
    Current affiliation:
    1. Lanzhou University Second Hospital, 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, P. R. China 730030
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  • Guqi Wang,

    1. Liver-Biliary-Pancreatic Center and the Liver, Digestive Diseases, and Metabolism Laboratory, NC
    2. McColl-Lockwood Laboratory, Carolinas Medical Center, Charlotte, NC
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  • Weihong Hou,

    1. Liver-Biliary-Pancreatic Center and the Liver, Digestive Diseases, and Metabolism Laboratory, NC
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  • Ping Li,

    1. Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
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  • Andrea Dulin,

    1. Liver-Biliary-Pancreatic Center and the Liver, Digestive Diseases, and Metabolism Laboratory, NC
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  • Herbert L. Bonkovsky

    Corresponding author
    1. Liver-Biliary-Pancreatic Center and the Liver, Digestive Diseases, and Metabolism Laboratory, NC
    2. Department of Biology, The University of North Carolina at Charlotte, Charlotte, NC
    3. Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
    4. Departments of Medicine and Molecular, Microbial & Structural Biology, The University of Connecticut Health Center, Farmington, CT
    • Carolinas Medical Center, Suite 201, Cannon Research Center, 1542 Garden Terrace, Charlotte, NC, 28203===

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    • fax: 704-355-7648


  • Potential conflict of interest: Dr. Bonkovsky is a consultant for and advises Boehringer-Ingelheim, and Novartis. He advises and is on the speakers' bureau of Lundbeck Pharma. He received grants from Hoffman-LaRoche, Merck, and Vertex.

Abstract

Chronic hepatitis B (CHB) is major global health problem. In China, where about 120,000,000 persons are chronically infected, CHB has been treated for centuries with traditional Chinese medicines (TCMs). This review summarizes and meta-analyzes the results of randomized controlled trials (RCTs) of TCM formulations reported in China in 1998-2008 for treatment of CHB. RCTs comparing either TCM formulations alone or in combination with interferon (IFN) or lamivudine (LAM) versus IFN or LAM were included. Chinese electronic databases were searched. The methodological quality of RCTs was assessed using the Jadad scale. TCMs had a greater beneficial effect (P = 0.0003) than IFN and a slightly better effect (P = 0.01) than LAM on the normalization of serum alanine aminotransferase. TCMs had a similar beneficial effect when compared with IFN or LAM for CHB on antiviral activity as evidenced by the loss of serum hepatitis B e antigen and hepatitis B virus (HBV) DNA. TCMs enhanced IFN and LAM antiviral activities and improvements of liver function. The quality of many studies was poor; reports often lacked information regarding methods of randomization or blinding and adverse events. Conclusion: Some TCMs seem effective as alternative remedies for patients with CHB, suggesting that further study of TCMs in the treatment of CHB is warranted, both in preclinical models of HBV infection and in higher quality RCTs worldwide. (HEPATOLOGY 2010;51:690–698.)

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