[Auxiliary treatment of HBV correlated hepatic failure by Chinese herbs: a systematic review of randomized controlled trials].
OBJECTIVE
To evaluate the effectiveness and safety of Chinese herbs as an adjuvant treatment for hepatitis virus B (HBV)-related hepatic failure.


METHODS
Data were retrieved through the Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Library, PubMed, CNKI, VIP, Wanfang Database, and ChiCTR by key words or free words such as hepatic failure, severe hepatitis, HBV, Chinese medicine, randomization, and control. Appendix references of related papers were taken as supplementary indices. According to requirement for Cochrane systematic evaluation, randomized clinical trials on assessing the effectiveness and safety of Chinese herbs as main or adjuvant treatment in treating HBV-related hepatic failure were methodologically assessed, data extracted and analyzed.


RESULTS
Totally 21 trials on Chinese herbal medicine therapy versus standard medical therapy (involving 1 881 patients) were included. Most trials had unclear risk bias. In 5 studies on the mortality, 3 trials showed that the mortality was lower in the test group than in the control group [RR 0.40, 95% CI (0.20, 0.79), P = 0.0002]. In 6 randomized control trials, totally 20 papers reported the control of complications. Eight results showed Chinese herbal medicine therapy had better effect in controlling complications. The recurrence rate and assessment of the survival quality were reported. Considering secondary indicators, four trials showed Chinese herbal medicine therapy had better effect in lowering the ineffective rate, decreasing total bilirubin (TBIL), and elevating prothrombin activity (PTA). Other prescriptive analyses found that the overall effect on secondary indicators was better in the test group than in the control group, but not all the indicators were statistically different. Adverse reactions were only reported in two papers, showing no severe adverse reaction.


CONCLUSIONS
According to present evidence, till now, we could not judge whether Chinese herbs, as an adjuvant treatment, could do any favor for lowering the incidence and recurrence of hepatic failure patients, and improving their survival qualities.
Liver Disease Center, First Hospital Affiliated to Hunan University of Traditional Chinese Medicine, Changsha (410007), China.
Ruo-yu
RY
Wang
Center for Liver Transplant, Xiangya Hospital, Central Southern University, Changsha (410001), China.
Yu-fan
YF
Zhou
Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing (100029), China.
Yu-tong
YT
Fei
Liver Disease Center, First Hospital Affiliated to Hunan University of Traditional Chinese Medicine, Changsha (410007), China.
Ke-wei
KW
Sun
D000529:Complementary Therapies; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017093:Liver Failure / Q000188:drug therapy* / Q000209:etiology; D008517:Phytotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
D004365:Drugs, Chinese Herbal