<p><b>OBJECTIVE</b>To evaluate the
clinical efficacy and
safety of Yinchen Zhufu Decoction (, YCZFD) in the
treatment of
acute-on-chronic liver failure caused by
hepatitis B virus (HBV-ACLF) with
cold pattern in
Chinese medicine (CM).</p><p><b>
METHODS </b>This is a multi-center
randomized controlled trial of integrative
treatment of CM and Western
medicine (WM) for the management of HBV-ACLF
patients . A total of 200 HBV-ACLF
patients with
cold pattern were equally randomly assigned to receive YCZFD and WM (integrative
treatment ) or WM conventional
therapy alone respectively for 4 weeks. The primary end point was the
mortality for HBV-ACLF
patients .
Secondary outcome measures included Model for End-Stage
Liver disease (MELD) score,
liver biochemical function, coagulation function and
complications . Adverse events during
treatment were reported.</p><p><b>RESULTS</b>The
mortality was decreased 14.28% in the integrative
treatment group compared with WM group (χ(2) =6.156, P=0.013). The integrative
treatment was found to signifificantly improve the MELD score (t=2.353, P=0.020). There were statistically signifificant differences in
aspartate transaminase , total
bilirubin , indirect
bilirubin , direct
bilirubin and
prothrombin time between the two groups (P<0.05 or P<0.01). The
complications of
ascites (χ(2)=9.033, P=0.003) and spontaneous
bacteria peritonitis (χ(2)=4.194, P=0.041) were improved signifificantly in the integrative
treatment group. No serious
adverse event was reported.</p><p><b>CONCLUSIONS</b>The integrative
treatment of CM and WM was effective and safe for HBV-ACLF
patients with
cold pattern in CM. The
Chinese therapeutic principle "treating
cold pattern with hot herbs" remains valuable to the clinical
therapy . (Trial registration No. ChiCTR-TRC-10000766).</p>