8 best Chinese Patent Medicine for  Chronic Hepatitis B Liver Fibrosis

Liver fibrosis caused by hepatitis B hepatitis is a reversible wound repair response characterized by the accumulation of extracellular matrix, which is the formation of scar tissue, which occurs after chronic or non-self-limiting liver disease, and it will eventually lead to cirrhosis. In recent years, more and more research studies have found that TCM contains multiple active ingredients that can relieve or even reverse hepatitis B liver fibrosis. 

For example, Salvia miltiorrhiza and Cordyceps sinensis, they all have a variety of antifibrotic components, and in clinical use, there are many examples of using them to treat chronic hepatitis B liver fibrosis. Rui’s research further pointed out the pharmacological mechanisms of Salvia miltiorrhiza against liver fibrosis. The results of the study showed that Salvia miltiorrhiza water extract can inhibit the expression of GST-P and α-SMA during the process of hepatic fibrosis, and the alanine transaminase, aspartate aminotransferase, γ-glutamyltransferase, alkaline phosphatase, hyaluronic acid, direct bilirubin, and total bilirubin were significantly inhibited. In addition, Peng et al. found that the main active components of Cordyceps sinensis against liver fibrosis are cordyceps polysaccharide, cordycepic acid, cordycepin, and ergosterol. All these indicate that TCM is likely to play its unique role in the treatment of chronic hepatitis B liver fibrosis.

Traditional Chinese medicine (TCM) is used as an adjuvant drug for the treatment of chronic hepatitis B liver fibrosis and is used frequently.We used the RevMan software (5.3) and Stata software (13.0) to achieve this network meta-analysis (NMA) to know which has the best curative effect as an adjuvant drug. 8 most popular patent medicines for Chronic Hepatitis B Liver Fibrosis were involved in this study. The combination of TCM and entecavir can significantly improve the patients’ HA, LN, PCIII, IV-C, AST, ALT, and HBV-DNA negative conversion rates.

Statistical studies have shown that 3% of patients with chronic hepatitis B (CHB) have decompensated liver cirrhosis every year, 2% to 8% of patients have primary liver cancer, and once they progress to decompensation liver cirrhosis, its 5-year cumulative survival rate was only 14% to 35%. Therefore, for liver fibrosis, which as the starting point for serious liver disease, if this process can be well inhibited, it will be able to prevent liver disease from worsening in time.

In China, there are many types of TCM used by clinicians in the treatment of chronic hepatitis B liver fibrosis. Among them, there are 8 kinds of TCM used as first-line drugs and included in the Chinese Pharmacopoeia: Anluo Huaxian Pill , Dahuang Zhechong Wan, and Tanshinone Capsule, Danshen Injection , Fuzheng Huayu Capsule (FZHY), Biejia Ruangan Tablet, Danshendi Tablet, and Liuwei Wuling Tablet .

We then compared and ranked all of the treatment strategies and obtained the average ranking of the various treatment strategies. We found that BRT (1), LWT (2.5), DZC (3.5), and FHC (4) were more effective as adjuvant drugs in improving liver function

The NMA showed that compared with entecavir, combined TCM did not increase the risk of adverse reactions and could significantly improve the effect of chronic hepatitis B liver fibrosis. In addition, in a variety of therapeutic strategies, the combination of Fuzheng Huayu capsule and entecavir is the best therapeutic strategy.

In this NMA, we found that 8 kinds of TCM as adjuvant medicines can improve liver fibrosis in patients with chronic hepatitis B liver fibrosis. The combination of Fuzheng Huayu capsule and entecavir is the best therapeutic strategy. It not only has a significant effect in improving the state of liver fibrosis in patients but also has a good effect in the improvement of liver function in patients. FZHY capsule is a commonly used TCM formula against liver fibrosis in clinic. It has been verified in research to exert antifibrosis effect through several mechanisms such as antilipid peroxidation and endothelial injury, inhibiting hepatic stellate cell activation, promoting matrix metalloproteinase activity, and degradation of pathological deposition of collagen.In addition, there is an article using transcriptional profiling and miRNA-target network analysis to identify potential biomarkers for efficacy evaluation of FZHY formula-treated hepatitis B caused liver cirrhosis.

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