Systematic evaluation of Liuweiwuling Tablets for treatment of liver fibrosis resulting from chronic hepatitis B / 中草药

ABSTRACT

Objective: To systematicly evaluate the efficacy and safety of Liuweiwuling Tablets combined with nucleotide drugs for the treatment of liver fibrosis resulting from chronic hepatitis B. Methods: Major databases (such as Pubmed, Embase, Cochrane Library (Issue 9, 2015), Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and WanFang Data were searched from their inception to September 9, 2015 to collect comprehensively randomized controlled trials (RCT) of Liuweiwuling Tablets combined with nucleotide drugs on the treatment of liver fibrosis resulting from chronic hepatitis B. After two reviewers separately screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies, data were analyzed with RevMan 5.3 software. Results: The total seven RCTs were included. Among all 1 021 patients involved, 529 cases were in the treatment group, while the other 492 cases were in the control group. The findings showed that compared with using nucleotide drugs alone for antiviral treatment, Liuweiwuling Tablets combined with nucleotide drugs were more efficiently in downregulating serum liver fibrosis index HA [SMD = -1.26, 95% CI (-1.92, -0.59), P = 0.000 2], LN [SMD = -1.55, 95% CI (-2.27, -0.83), P < 0.000 1], PC-III [SMD = -1.39, 95% CI (-2.21, -0.58), P = 0.000 8], IV-C [SMD = -1.49, 95% CI (-2.25, -0.72), P = 0.0001]; improved the liver function ALT [SMD = -1.17, 95% CI (-1.41, -0.94), P < 0.000 01], AST [SMD = -1.25, 95% CI (-1.54, -0.96), P < 0.000 01], TBIL [SMD = -0.87, 95% CI (-1.21, -0.53), P < 0.000 01]; increased total clinical effective rate [OR = 4.59, 95% CI (2.05, 10.25), P = 0.000 2]. While no advantage was found in reducing the incidences of HBV DNA overcast [OR = 1.51, 95% CI (0.96, 2.39), P = 0.08]; No significant adverse reactions were reported. Conclusion: Liuweiwuling Tablets combined with nucleotide drugs could be effective in improving liver function, controlling liver fibrosis, and increasing total clinical effective rate while its antiviral efficacy approximate with using the nucleotide drugs alone, less adverse reaction, and better tolerability; Although in recent years, the quantity and quality of RCTs research have a rising trend year by year, but still need to be from the clinical design of scientific, the standardization of the report, and many other links to improve research level.