Meta-analysis of efficacy and safety of Liuwei Wuling Tablets combined with conventional drugs in treatment of liver fibrosis and cirrhosis in chronic hepatitis B / 中国中药杂志

The present study evaluated the clinical efficacy and safety of Liuwei Wuling Tablets combined with conventional drugs for the treatment of liver fibrosis and cirrhosis in chronic hepatitis B. CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library were searched for the relevant randomized controlled trials(RCTs) published from database inception to February 2021. All the retrieved papers were independently screened, extracted and evaluated by two researchers, followed by Meta-analysis by Review Manager 5.4. Finally, 18 RCTs were included, involving 2 168 patients(1 106 in the treatment group and 1 062 in the control group). The Meta-analysis results showed that compared with conventional drugs alone, Liuwei Wuling Tablets combined with conventional drugs could increase the effective rate of clinical treatment by reducing serum hyaluronic acid(HA), laminin(LN), procollagen type Ⅲ(PCⅢ), and type Ⅳ collagen(Ⅳ-C) to improve liver function, decreasing the levels of total bilirubin(TBiL), alanine amino-transferase(ALT), and aspartate aminotransferase(AST), and improving the negative conversion ratio of hepatitis B virus(HBV) DNA. In terms of safety, there were no serious adverse reactions in the treatment group and the control group. The results showed that Liuwei Wuling Tablets combined with antiviral or other conventional liver-protecting drugs could improve liver function, treat liver cirrhosis, and reduce liver fibrosis with high safety. However, due to the influence of literature quality and quantity, multi-center and high-quality RCTs with large sample size are needed for verification.

Meta-analysis of Liuwei Wuling Tablets Combined with Entecavir in the Treatment of Chronic Hepatitis B / 中国药房

OBJECTIVE:To evaluate the effectiveness of Liuwei wuling tablets combined with entecavir in the treatment of chronic hepatitis B (CHB),and to provide evidence-based reference in clinic.METHODS:Retrieved from Cochrane library,PubMed,Web of Science,CJFD,Wanfang database and VIP,randomized controlled trials (RCTs) about Liuwei wuling tablets combined with entecavir (trial group) vs.entecavir alone (control group) in the treatment of CHB were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 8 RCTs were included,involving 728 patients.Results of Meta-analysis showed that the levels of ALT [MD=-16.67,95 ％ CI (-19.83,-13.51),P＜ 0.001],AST [MD =-20.52,95％ CI (-25.65,-15.39),P＜0.001] and TBIL [MD=-5.85,95％CI(-11.31,-0.38),P=0.04] in trial group were significantly lower than control group;clinical total response rate [RR=1.23,95％CI(1.03,1.46),P=0.02] and HBeAg negative conversion rate [RR=1.26,95％CI(1.03,1.54),P=0.02] were significantly higher than control group,with statistical significance.There was no statistical significance in the rate of serum HBV DNA negative conversion [RR=1.22,95％ CI(0.99,1.52),P=0.07] between 2 groups.CONCLUSIONS:Compared with entecavir alone,Liuwei wuling tablets combined with entecavir in the treatment of CHB have better efficacy,can significantly improve the biochemical indexes of liver function in patients.

Determination of Six Kinds of Components in Liuwei Wuling Tablets by QAMS / 中国药师

Objective:To establish a quantitative analysis of multi-components by single marker ( QAMS) method for the determi-nation of six components ( phillyrin, schizandrol, schisandra ester, deoxyschizandrin, schisandrin B and schisandrin C ) in Liuwei Wuling tablets,and verify the accuracy and feasibility of the method applied in the preparation. Methods:The relative correction factor ( f) of schisandrin B, schisandrin C, schisandra ester, schizandrol, phillyrin and deoxyschizandrin was detected by HPLC at the detec-tion wavelength of 230nm, and the contents of the components in Liuwei Wuling tablets were calculated to achieve the multi evaluation. Meanwhile, the contents of the six components were analyzed by an external standard method and the relative error between the calcula-tion of QAMS method ( Wf ) and the result of the external standard method ( Ws ) was calculated to verify the accuracy of QAMS. The reproducibility of the method was also investigated. Results:The QAMS method was established to determine the contents of 6 compo-nents in Liuwei Wuling tablets, and the components in 10 batches of Liuwei Wuling tablets were determined. The differences between the calculated values and the measured values were small ( RSD < 5%) . Conclusion:The QAMS method is simple, effective and ac-curate in determining the contents of 6 effective components in Liuwei Wuling tablets. The quality evaluation model of QAMS for Liuwei Wuling tablets is validated, which can be used for the quality control of Liuwei Wuling tablets and provide reference for the further study.