title: Therapeutic Efficacy and Safety of Paeoniae Radix Rubra Formulae in Relieving Hyperbilirubinemia Induced by Viral Hepatitis: A Meta-Analysis.
abstract: OBJECTIVE
  Hyperbilirubinemia is one of the most devastating pathologies induced by various liver diseases. Formulae related to Paeoniae Radix Rubra (PRR) at high doses have been applied to treat hyperbilirubinemia in traditional Chinese medicine (TCM). The aim of this systematic review and meta-analysis is to assess the efficacy and safety of formulae relevant to high-dose PRR in patients suffering from hyperbilirubinemia induced by viral hepatitis.
  
  
  METHODS
  We performed a meta-analysis of randomized-controlled clinical trials to evaluate the efficacy and safety of formulae that apply a high dose of PRR for hyperbilirubinemia. Seven databases were searched until April, 2015. All studies were included according to detailed criteria and assessed for methodological quality. The outcome measurements were recorded for further analysis using the RevMan 5.2.11 software.
  
  
  RESULTS
  Fifteen articles involving 1323 patients with hyperbilirubinemia were included. Formulae with high-dose PRR might promote the efficacy of either a combined application ([OR: 3.98, 95% CI (2.91, 5.43)]; P < 0.01) or a single application ([OR: 4.00, 95% CI (1.50, 10.68)]; P < 0.01) for hyperbilirubinemia. The indices of TBIL, ALT, and AST significantly decreased ([MD: -75.57, 95% CI (-94.88, -56.26)], [MD: -26.54, 95% CI (-36.19, -16.88)], and ([MD: -28.94, 95% CI (-46.26, -11.61)]; P < 0.01), respectively. In addition, formulae with high-dose PRR could enhance the treatment efficacy of hyperbilirubinemia triggered by hepatitis B ([OR: 2.98, 95% CI (1.75, 5.05)]; P < 0.01). Furthermore, the efficacy was enhanced with an increasing dosage of PRR. Two articles reported that no side effects occurred in clinical trials, and three studies noted that patients presented light digestive tract symptoms.
  
  
  CONCLUSIONS
  Formulae relevant to high-dose PRR ameliorate hyperbilirubinemia and might constitute a promising therapeutic approach. For widespread acceptance by practitioners, more rigorously designed multicenter, double-blind, randomized, and large-scale controlled trials are required.
authors.affiliation: Pharmacy College, Chengdu University of Traditional Chinese MedicineChengdu, China; Department of Pharmacy, 302 Military Hospital of ChinaBeijing, China.
authors.forename: Yin-Qiu
authors.initials: YQ
authors.lastname: Huang
authors.affiliation: Pharmacy College, Chengdu University of Traditional Chinese MedicineChengdu, China; Department of Pharmacy, 302 Military Hospital of ChinaBeijing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.affiliation: Pharmacy College, Chengdu University of Traditional Chinese Medicine Chengdu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, 302 Military Hospital of China Beijing, China.
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Zhao
authors.affiliation: China Military Institute of Chinese Medicine, 302 Hospital of People's Liberation Army Beijing, China.
authors.forename: Jia-Bo
authors.initials: JB
authors.lastname: Wang
authors.affiliation: Pharmacy College, Chengdu University of Traditional Chinese MedicineChengdu, China; Department of Pharmacy, 302 Military Hospital of ChinaBeijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Integrative Medical Center, 302 Hospital of People's Liberation Army Beijing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Integrative Medical Center, 302 Hospital of People's Liberation Army Beijing, China.
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Shan
authors.affiliation: Pharmacy College, Chengdu University of Traditional Chinese MedicineChengdu, China; Department of Pharmacy, 302 Military Hospital of ChinaBeijing, China.
authors.forename: Shi-Zhang
authors.initials: SZ
authors.lastname: Wei
authors.affiliation: Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University Chengdu, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Wang
authors.affiliation: China Military Institute of Chinese Medicine, 302 Hospital of People's Liberation Army Beijing, China.
authors.forename: Xiao-He
authors.initials: XH
authors.lastname: Xiao
keywords: Paeoniae Radix Rubra formulae; efficacy and safety; high dose Paeoniae Radix Rubra; hyperbilirubinemia; meta-analysis; viral hepatitis