Chinese herbal medicine Xiaoyao san (XYS) for chronic hepatitis B (CHB): a meta-analysis of randomized controlled trials

摘要

Objective: To assess the beneficial and adverse effects of XYS for CHB. Methods: Seven databases were searched to retrieve RCTs evaluating clinical effectiveness of XYS. Primary outcome measures were negative conversion of serum HBeAg and/or serum HBV-DNA. Secondary outcome measures were serum ALT, AST, and clinical comprehensive effect. All data were analyzed using Review Manager 5.1 software. 9 RCTs were included. Most of the RCTs were of poor methodological quality. Results: Four trails reported XYS plus hepatoprotective drugs showed significant difference on the normalization of ALT (OR: 4.26 [1.26,14.41]; P=0.02) and clinical comprehensive effect (OR: 4.55 [2.03,10.19]; P=0.0002). Four RCTs reported XYS plus antivirus drugs versus antivirus drugs. As compared to antivirus drugs, XYS showed significant beneficial on the reduced amount of serum ALT (MD: -18.65 [-22.29, -15.01]; P<0.00001) and clinical comprehensive effect (OR: 2.56 [1.30, 5.03]; P=0.006). One trail compared XYS plus hepatoprotective and antivirus drugs versus hepatoprotective and antivirus drugs. It showed that the former therapy has significant beneficial on the reduced amount of serum ALT (MD: -40.52 [-45.51,-35.53]; P<0.00001), AST (MD: -36.70 [-40.83, -32.57]; P<0.00001). Most studies did not mention adverse events. Conclusion: There is no convincing evidence of XYS for CHB because of low methodological quality. Rigorously designed trials are warranted to justify their clinical use.