Get access

Chinese medicinal herbs for chronic hepatitis B: a systematic review

Authors

  • Jianping Liu,

    Corresponding author
    1. The Cochrane Hepato-Biliary Group, The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, H:S Rigshospitalet, Copenhagen, Denmark
      Jianping Liu, The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Department 7701, H:S Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
      Tel: 45 3545 7163. Fax: 45 3545 7101. e-mail: JianpingLiu@ctu.rh.dk
    Search for more papers by this author
  • Heather McIntosh,

    1. NHS Centre for Reviews and Dissemination, University of York, York, UK
    Search for more papers by this author
  • Hui Lin

    1. The Department of Epidemiology, Third Military Medical University, Chongqing, China
    Search for more papers by this author

Jianping Liu, The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Department 7701, H:S Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
Tel: 45 3545 7163. Fax: 45 3545 7101. e-mail: JianpingLiu@ctu.rh.dk

Abstract

Abstract:Aims/Background: Chronic hepatitis B is a serious health problem worldwide. Chinese medicinal herbs are widely used for treatment of chronic hepatitis B in China and many clinical trials have been conducted. This systematic review is to assess the efficacy and safety of Chinese medicinal herbs for chronic hepatitis B. Methods: Randomised clinical trials comparing Chinese medicinal herbs versus placebo, no intervention, nonspecific treatment, or interferon treatment for chronic hepatitis B with ≥3 months follow-up were included. No language and blinding limitations were applied. The electronic databases were searched, combined with handsearches on Chinese literature. Data were extracted independently by two reviewers. The methodological quality of trials was assessed by the Jadad-scale plus allocation concealment. Results: Nine randomised trials (n=936) were included, with only one being of high quality. There was a funnel plot asymmetry (intercept 3.37, p=0.047). Compared to nonspecific treatment or placebo, the herbal compound Fuzheng Jiedu Tang showed an effect on clearance of serum HBsAg (relative risk 5.19, 95% CI 1.24–21.79), HBeAg (10.85, 3.56–33.06), and HBV DNA (8.50, 1.23–58.85). Polyporus umbellatus polysaccharide showed an effect on serum HBeAg (3.06, 1.13–8.29) and HBV DNA (4.14, 1.0–17.19); Phyllanthus amarus showed an effect on serum HBeAg (3.35, 1.49–7.56). Phyllanthus compound and kurorinone showed no significant difference on clearance of serum HBeAg and HBV DNA and on alanine aminotransferase normalisation compared to interferon. No serious adverse event was observed. Conclusions: Chinese medicinal herbs are not recommended for chronic hepatitis B because of the publication bias and low quality of the trials. Rigorously designed, randomised, double-blind, placebo-controlled trials are needed.

Get access to the full text of this article

Ancillary