The Role of Traditional Chinese Medicines (TCM) and Other Complementary and Alternative Medicines (CAM) in the Management of Chronic Hepatitis B

Abstract

To provide a review and update of complementary and alternative medicine (CAM) approaches to the management of chronic hepatitis B, with particular emphasis upon traditional Chinese medicines (TCM). The major findings are as follows: (1) TCMs were better than interferons [IFN] in lowering serum HBeAg and normalizing serum ALT, and equivalent to IFN in clearing serum HBV DNA; (2) TCMs were equivalent to lamivudine [LAM] in lowering serum HBeAg, normalizing serum ALT, and clearing serum HBV DNA; (3) TCMs along with IFN or LAM significantly lowered serum HBeAg and improved the clearance of serum HBV DNA and the normalization of serum ALT, compared with IFN or LAM alone; (4) no serious adverse reactions of TCM were reported in all cited clinical trials. Although the composition of traditional medicines in the TCMs varied among RCTs, about 60% of the used herbs were homologous. Our major overarching conclusion was that TCMs seem effective as alternative remedies for patients with CHB. Other CAM approaches also are widely used, especially in east Asian countries, and there is limited evidence of benefit for some. CHB continues to be a major health problem worldwide. Although nucleosides such as tenofovir and entecavir are highly effective at suppression of HBV replication, they are expensive and often beyond reach of patients, especially in resource-limited nations and regions. Many such patients will continue to rely upon CAM and TCM for management of their chronic hepatitis B infections. Additional carefully done, placebo-controlled prospective randomized trials of CAM and TCM in chronic hepatitis B should be performed.