A PRISMA-compliant systematic review and meta-analysis of integrated Chinese and Western medicine in treating hepatitis C

Medicine (Baltimore). 2020 Aug 28;99(35):e21825. doi: 10.1097/MD.0000000000021825.

Abstract

Objective: To conduct a meta-analysis evaluating the effect of combining traditional Chinese medicine (TCM) with Western medicine in treating hepatitis C, and to provide an evidence-based medical strategy.

Methods: Randomized controlled trials (RCTs) comparing the effect of pegylated interferon (Peginterferon) combined with ribavirin (PR) alone and its combination with TCM were manually retrieved from the Weipu Information Resources System (VIP), Wan Fang Database, PubMed, and the Chinese Journal Full Text Database (CNKI). Studies meeting the inclusion criteria were selected and analyzed using the Review Manager 5.3 software. Suitable tests were also performed to determine the quality, heterogeneity, and sensitivity of the studies included in the meta-analysis.

Results: Twenty-eight RCTs met the inclusion criteria. The combination therapy or intervention group showed significantly greater HCV-RNA negative rate post-treatment compared to the monotherapy or the control group (P < .05). In addition, the serum levels of the liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were significantly improved after the combination therapy compared to PR alone (P < .05), while total bilirubin (TB) and r-glutamyltransferase (GGT) levels were not affected by TCM (P > .05). Finally, the parameters of liver fibrosis were also reduced by the combination therapy more effectively than the monotherapy.

Conclusion: The combination of TCM and PR can improve the Comprehensive Clinical Efficacy of hepatitis C and have a better negative rate of HCV-RNA with a better benefit in the liver function. The effect of TCM + PR is better than that of PR alone in treating hepatitis C.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Alanine Transaminase / blood
  • Antiviral Agents / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Hepacivirus / genetics
  • Hepatitis C / therapy*
  • Humans
  • Interferon-alpha / therapeutic use
  • Liver Cirrhosis / drug therapy
  • Medicine, Chinese Traditional*
  • Polyethylene Glycols / therapeutic use
  • RNA, Viral / blood
  • Recombinant Proteins / therapeutic use
  • Ribavirin / therapeutic use
  • Serum Albumin
  • gamma-Glutamyltransferase / blood

Substances

  • Antiviral Agents
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins
  • Serum Albumin
  • Polyethylene Glycols
  • Ribavirin
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • peginterferon alfa-2a
  • Bilirubin