Effects of Chinese herbal medicine therapy on survival and hepatic outcomes in patients with hepatitis C virus infection in Taiwan

Tsai, Fuu Jen; Cheng, Chi Fung; Chen, Chao‐Jung; Lin, Chih Ying; Wu, Yi Fang; Li, Te Mao; Chuang, Po‐Heng; Wu, Yang; Lai, Chih Ho; Xiang, Lei; Tsang, Hsinyi; Lin, Ting Hsu; Liao, Chien-Chang; Huang, Shao Mei; Li, Ju Pi; Lin, Ji-Ping; Lin, Chih-Chien; Liang, Wen Miin; Lin, Ying

doi:10.1016/j.phymed.2018.09.237

Cited by 21 publications

(23 citation statements)

References 44 publications

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“…), ZZ (Gardenia jasminoides J.Ellis), and DaH (Rheum palmatum L.). YCWLS is a herbal formula derived from YCHT and is frequently prescribed for chronic hepatitis and liver cirrhosis in Taiwan [15,27]. YCHT has been shown to protect the liver from fibrosis and oxidative stress in rat or mouse models [29][30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…S 3 ). Truly, there is increasing evidence that CHM has long been used for the clinical treatment of liver diseases in Taiwan [ 15 , 23 – 26 ]. Our results provide a motivation to investigate these CHM for pharmacological effects in decompensated liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…Traditional Chinese medicine (TCM) is popular as adjunct treatment and has the potential to reduce the morbidity and mortality in liver diseases [5]. Chinese herbal medicine (CHM) belongs to TCM and has been applied as adjunct therapy for several diseases to improve diseaserelated complications and mortality in Taiwan [6][7][8][9][10][11][12][13][14][15]. Given that liver cirrhosis is one of the top ten leading causes of death in Taiwan, this study focused on patients with decompensated liver cirrhosis from the registry for catastrophic illness patients in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Decreased overall mortality rate with Chinese herbal medicine usage in patients with decompensated liver cirrhosis in Taiwan

Tsai

Yang

Chen

et al. 2020

BMC Complement Med Ther

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Background: Liver cirrhosis is one of the main causes of the morbidity and mortality in liver diseases. Chinese herbal medicine (CHM) has long been used for the clinical treatment of liver diseases. This study was designed to explore the usage frequency and prescription patterns of CHM for patients with decompensated liver cirrhosis and to evaluate the long-term effects of CHM on overall mortality. Methods: Two thousand four hundred sixty-seven patients with decompensated liver cirrhosis (ICD-9-CM code: 571.2, 571.5, and 571.6) diagnosed between 2000 and 2009 in Taiwan were identified from the registry for catastrophic illness patients. Of these, 149 CHM users and 298 CHM non-users were matched for age, gender, and Charlson comorbidity index score. The chi-squared test, paired Student's t-test, Cox proportional hazard model, and Kaplan-Meier method were applied for various comparisons between these groups of patients. Results: CHM-treated patients showed a lower overall mortality risk compared with non-treated patients (Multivariable: p < 0.0001; HR: 0.54, 95% CI: 0.42-0.69). The cumulative incidence of overall mortality was lower in the CHM-treated group (stratified log-rank test, p = 0.0002). The strongest CHM co-prescription pattern-Yin-Chen-Hao-Tang (YCHT) → Long-Dan-Xie-Gan-Tang (LDXGT) had the highest support, followed by Zhi-Zi (ZZ) → Yin-Chen-Wu-Ling-San (YCWLS) and Bai-Hua-She-She-Cao (BHSSC) → Da-Huang (DaH). Conclusion: CHM, as adjunct therapy, might decrease the risk of overall mortality in patients with decompensated liver cirrhosis. CHM co-prescription patterns and network analysis showed that comprehensive herbal medicines have a protective role against liver fibrosis. Further studies are required to enhance the knowledge of safety and efficacy of CHM in patients with decompensated liver cirrhosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Decreased overall mortality rate with Chinese herbal medicine usage in patients with decompensated liver cirrhosis in Taiwan

Tsai

Yang

Chen

et al. 2020

BMC Complement Med Ther

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“…In particular, TCM theory suggests that JWXYS and Xue-Fu-Zhu-Yu-Tang (XFZYT) may serve to soothe liver Qi and relieve blood stasis. Studies have reported that JWXYS may improve the survival rate in HBV patients when combined with lamivudine treatment [30] and decrease the mortality rate and risk of liver cirrhosis in HCV patients [31]. Furthermore, JWXYS has been shown to elevate serum albumin levels and prevent liver fibrosis [32].…”

Section: Discussionmentioning

confidence: 99%

Chinese Herbal Medicine Ameliorated the Development of Chronic Kidney Disease in Patients with Chronic Hepatitis C: A Retrospective Population-Based Cohort Study

Chang

Lin

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Chronic kidney disease (CKD) is a serious complication affecting patients with chronic hepatitis. The effectiveness of CHM for the prevention of CKD in hepatitis patients remains unclear. Therefore, we conducted a retrospective cohort study to investigate the effectiveness of CHM in preventing the development of CKD in hepatitis patients. From a subdataset of the Taiwan National Health Insurance Research Database (NHIRD), we included 19,409 patients newly diagnosed with hepatitis B and hepatitis C between the years 2000 and 2010. After exclusion criteria and 1 : 1 propensity score matching process, we compared demographic factors, comorbidities, and correlated drugs between the CHM and non-CHM cohorts. Statistical analysis was applied to evaluate the differences in characteristic distributions and to compare the cumulative incidence of CKD between the CHM and non-CHM cohorts. This study showed that the patients suffering from hepatitis C with CHM treatment more than 90 days as an adjuvant therapy combined with western medical treatment modalities exhibited a decreased risk of developing CKD (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.21–0.76, p value <0.01). The Kaplan–Meier curve revealed a lower cumulative incidence rate of CKD (p value = 0.004) for the CHM cohort. For further reference, we herein offer the ten most frequently prescribed single herbs and herbal formulas; as such, Salviae miltiorrhizae and Jia-Wei-Xiao-Yao-San were the most commonly prescribed single herb and formula, respectively. This nationwide retrospective cohort study provides evidence that CHM is an effective adjuvant treatment to decrease the risk of developing CKD in hepatitis C patients.

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“…To evaluate the clinical efficacy and safety of herbal medicines in patients with CHC, many clinical studies, including randomized controlled trials (RCTs), have been carried out. Although herbal medicines perform well in reducing risk of liver cirrhosis and overall mortality in the patients with HCV, 12 their clinical efficacy, in terms of clearance of serum HCV RNA, remains inconclusive. In this article, we review the anti-HCV effects of herbal medicines from experimental to clinical evidence, and discuss the current issues and hurdles, and future perspectives for their application from bench to bedside.…”

Section: Introductionmentioning

confidence: 99%

Herbal Medicines for Hepatitis C Virus Infection: The Exploratory Journey from Bench to Bedside Still Has a Long Way to Go

Xiao-ya¹,

Zhang²,

Xie³

et al. 2019

Journal of Exploratory Research in Pharmacology

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Hepatitis C virus (HCV) infects at least 150 million people chronically worldwide. It is a major risk factor for cirrhosis, hepatocellular carcinoma, and death. Direct-acting antiviral therapy is very efficacious in treating HCV infection but it is inaccessible and unavailable in some developing countries. Therefore, searching for more effective and easily accessible regimens remains an urgent need. The aim of this article is to review the anti-HCV effects of herbal medicines from experimental to clinical evidence, and discuss current issues, hurdles and future perspectives for their application from bench to bedside. Numerous in vitro studies have indicated that many herbs work effectively in exerting anti-HCV activities. Yet, only a few animal experiments have been conducted that demonstrate the anti-HCV effects of these medicines; in addition, these results do not show an ability to eliminate the virus completely from the infected animals. Thus far, clinical trials have produced inconclusive anti-HCV results in terms of efficacy and safety, presumably due to the lack of the quality of methodologies used in the trials. In conclusion, despite apparent anti-HCV activities in vitro, clinical efficacy and safety of herbal medicines for the treatment of HCV infection have not been revealed convincingly. More animal studies using ideal models and more well-designed clinical trials with a larger sample sizes and longer treatment periods, taking the body habitus into consideration, are required to further assess the efficacy and safety of herbal medicines for HCV infection.

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Effects of Chinese herbal medicine therapy on survival and hepatic outcomes in patients with hepatitis C virus infection in Taiwan

Cited by 21 publications

References 44 publications

Decreased overall mortality rate with Chinese herbal medicine usage in patients with decompensated liver cirrhosis in Taiwan

Decreased overall mortality rate with Chinese herbal medicine usage in patients with decompensated liver cirrhosis in Taiwan

Chinese Herbal Medicine Ameliorated the Development of Chronic Kidney Disease in Patients with Chronic Hepatitis C: A Retrospective Population-Based Cohort Study

Herbal Medicines for Hepatitis C Virus Infection: The Exploratory Journey from Bench to Bedside Still Has a Long Way to Go

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