Meta-analysis Of Complex Prescription Of Traditional Chinese Medicine On Chronic Viral Hepatitis Fibrosis And Further Study Of Effective Herbs And Its Extracts

Objective To perform a meta-analysis of complex prescription of traditional Chinese medicineon chronic viral hepatitis fibrosis, further, to find out the more effective herbs and extracts intreatment.Methods Extensive retrieved literature searches for human studies were performed, usingsuitable key words, in near35years up to January2011. Index included Chinese NationalKnowledge Infrastructure (CNKI), China Biomedicine Literature Database (CBM), Chinesescience and technology journal full-text database, MEDLINE and Cochrane Controlled TrailsRegister (CCTR). Randomized clinical trials (RCT) on the treatment group with compoundChinese medicine compared with control group with other drugs (antivirus and/or preventionliver medicine) were enrolled in this study. The standard of inclusion and exclusion wereformulated. Research results were studied by Jadad’s score and RevMan5.1software ofMeta-analysis, and funnel plot was used to find out the potential publication bias. All theeffective herbal, their active components and finger printing were identified by cyberbibliographic database or High Performance Liquid Chromatograph (HPLC).Results There were6clinical trials with430cases were involved. There were significantdifferences in the test for overall effect between therapeutic groups and control groups(RR=2.30，95%CI[1.77,2.99]，Z=6.23，P<0.00001). No adverse effect was observed. Tentraditional Chinese medicine herbs were selected because of high frequency in the six complexprescriptions. They were Radix Salviae Miltiorrhizae, Radix Astragali, Radix CodonopsisPilosulae, Cordyceps, Radix Curcumae, Angelicae sinensis, Panax notoginseng, CurcumaeRhizoma, Pericarpium Citri Reticulatae and Isatidis Radix. And the effective extracts weretanshinone II-A, salvianolic acid B, salvianolic acid A, Salvia miltiorrhiza monomer IH764-3,astragalosides, flavonoids, cordyceps polysaccharide, curcumin, ferulic acid, Panax notoginsengsaponins, ginseng saponins. Some of the herbs share the same pharmacological mechanisms ofanti-fibrosis. But Salvia miltiorrhiza and Radix Astragali were all of the pharmacologicalmechanisms.Conclusion Compound traditional Chinese medicine on treatment of hepatic fibrosis hasobvious effect without adverse effect. Compound traditional Chinese medicine alleviate liverfibrosis in multiple-target and multi-path pharmacological mechanisms. Different activeingredients share the same mechanisms. Salvia Miltiorrhiza and Radix Astragali involved inmost of the mechanisms.