[Therapeutic efficacy and quality of life investigation of traditional Chinese medicine-based therapy of chronic hepatitis B-related liver fibrosis].

Posted by on 17 Dec 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles [Therapeutic efficacy and quality of life investigation of traditional Chinese medicine-based therapy of chronic hepatitis B-related liver fibrosis]. Zhonghua Gan Zang Bing Za Zhi. 2014 Jan;22(1):30-2 Authors: An J, Ni W, Qiao J Abstract OBJECTIVE: To prospectively evaluate the efficacy of a traditional Chinese medicine (TCM)-based therapy for treating liver fibrosis in patients with chronic hepatitis B (CHB), and to investigate the patients’ perception of the treatment’s effects on quality of life (QoL). METHODS: A total of 430 patients with CHB-related liver fibrosis were randomly assigned to treatment groups for receipt of a 12-month course of the antiviral drug entecavir alone (control group) or in combination with the TCM Liuweiwuling tablets. Patients were assessed before (pre-treatment) and after therapy and the treatment-related differences in clinical manifestations, levels of liver function markers and liver fibrosis indexes, color ultrasound images, and hepatitis B virus (HBV) DNA load were compared between the two groups by statistical analysis. The generic QoL scale developed by the World Health Organization (WHOQOL-BREF) was used to score the patients’ perceptions of treatment outcome. RESULTS: After treatment, the patients in both groups showed significant improvement in the majority of clinical manifestations (both P less than 0.05), with the exception of bloating. In addition, both groups showed significant improvements of liver function markers and in signs of liver fibrosis (both P less than 0.05). Both groups also showed significant reductions in the diameters of the portal and splenic (both P less than 0.05), as well as increases in the rate of undetectable HBV DNA (with a statistically similar outcome achieved in the two groups). Finally, both groups had higher QoL scores after treatment, with all assessed parameters except environment showing a significant improvement (all P less than 0.05). CONCLUSION: When used in combination with entecavir, the TCM Liuweiwuling tablet is a safe therapy for CHB and its related liver fibrosis and may help to improve the QoL of these patients. PMID: 24721240 [PubMed - indexed for MEDLINE]

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[Therapeutic efficacy and quality of life investigation of traditional Chinese medicine-based therapy of chronic hepatitis B-related liver fibrosis].

[Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus-related cirrhosis].

Posted by on 17 Dec 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles [Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus-related cirrhosis]. Zhonghua Gan Zang Bing Za Zhi. 2014 Aug;22(8):604-8 Authors: Wu G, He H, Li H, Chen W Abstract OBJECTIVE: To investigate the clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus (HBV)-related cirrhosis. METHODS: A total of 163 patients with HBV-related cirrhosis were recruited for treatment between March 2010 and August 2012, and divided into the following three groups:group A (n =56) received Fufang Biejia Ruangan Tablet plus entecavir; group B (n =52) received entecavir only; and group C (n =55) received Fufang Biejia Ruangan tablet only. Enzyme-linked immunoassay methods were used to measure serum levels of hyaluronic acid (HA), laminin (LN), collagen (PCIV) and prolyl endopeptidase (PLD). The grade of liver fibrosis was determined upon liver biopsy, and score of liver stiffness was measured by FibroScan. RESULTS: All three treatment groups showed significant decreases from baseline in serum levels of alanine aminotransferase, aspartate aminotransferase, HBV DNA, HA, LN, PCIV and PLD (all P < 0.05). However, the changes in HA, LN, PCIV and PLD levels were significantly greater in group A than in either group B or C (P < 0.05). All three treatment groups showed significant improvements from baseline in liver fibrosis grade and liver stiffness score (P < 0.05). The total effective rate of group A was 82.14%, which was significantly higher than that of groups B and C (P < 0.05). CONCLUSION: Combination therapy of Fufang Biejia Ruangan tablet plus entecavir is effective for treating HBV-related cirrhosis. PMID: 25243962 [PubMed - indexed for MEDLINE]

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[Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus-related cirrhosis].

[Supplemental Fuzhenghuayu capsule therapy for improving liver fibrosis markers in patients with chronic hepatitis B following unsatisfactory outcome...

Posted by on 15 Dec 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles [Supplemental Fuzhenghuayu capsule therapy for improving liver fibrosis markers in patients with chronic hepatitis B following unsatisfactory outcome of nucleos(t)ide analogue monotherapy]. Zhonghua Gan Zang Bing Za Zhi. 2013 Jul;21(7):514-8 Authors: Tian YL, Zhu XY, Yin WW, Zang ZD, Wang L, Fu XL Abstract OBJECTIVE: To investigate the ability of Fuzhenghuayu capsule to improve markers of liver fibrosis when provided as supplemental therapy in patients with chronic hepatitis B (CHB) who achieved complete virological response but unsatisfactory resolution of fibrosis markers with nucleos(t)ide analog (NAs) monotherapy. METHODS: One-hundred-and-ten patients with CHB-related liver fibrosis who had received NA for more than or equal to 2 years and achieved sustained virological response (SVR) but no improvement in liver fibrosis index were randomly divided into two equal groups: experimental group, continued oral NAs (one tablet, 1 time/day) with simultaneous Fuzhenghuayu capsule (1.5 g, 3 times/day) for 48 weeks; control group, continued oral NAs only for 48 weeks. Serum fibrosis markers (hyaluronic acid (HA), laminin (LN), amino terminal propeptide of type III procollagen (PIIIP) and IV collagen (IV-C)), liver fibrosis stages, B ultrasonic wave, and liver function were observed before (baseline) and after treatment and compared by statistical analysis. RESULTS: The baseline levels of fibrosis markers were not significantly different between the experimental and control groups. After treatment, the levels of all of the fibrosis markers were lower in the experimental group (P less than 0.05 vs. control group; HA t = 19.548, LN t = 2.264, PIIIP t = 2.230, and IV-C t = 6.649) and lower than the baseline levels (P less than 0.01; HA t = 12.458, LN t = 7.402, PIIIP t = 4.620, IV-C t = 8.937). The control group also showed a significant reduction in HA and LN levels after treatment (P less than 0.01 vs. baseline; t = 5.202 and 3.444), but PIIIP and IV-C were unaffected. The baseline liver fibrosis stages were not significantly different between the experimental and control groups. After treatment, only the experimental group showed significant improvement in liver fibrosis stages (P less than 0.01). The rates of excellent therapeutic outcome, effectiveness, and non-effectiveness were significantly different between the experimental group (11.3%, 43.4%, and 45.3%) and the control group (1.0%, 22.2%, and 75.6%) (x2 = 9.408, P less than 0.01). Similar trends were observed for improvements in B ultrasonic wave for liver and spleen and in markers of liver function. Finally, neither treatment group experienced adverse effects. CONCLUSION: For CHB patients who achieve SVR by antiviral treatment with NAs, but unsatifactory improvement in liver fibrosis indices, administration of supplemental Fuzhenghuayu capsule with continued NAs therapy may represent a safe and effective treatment. PMID: 24074710 [PubMed - indexed for MEDLINE]

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[Supplemental Fuzhenghuayu capsule therapy for improving liver fibrosis markers in patients with chronic hepatitis B following unsatisfactory outcome...

Clinical Events after Cessation of Lamivudine Therapy in Patients Recovered from a Hepatitis B Flare with Hepatic Decompensation.

Posted by on 03 Dec 2014 | Tagged as: Hepatitis B Alternative Medicine

Clinical Events after Cessation of Lamivudine Therapy in Patients Recovered from a Hepatitis B Flare with Hepatic Decompensation. Clin Gastroenterol Hepatol. 2014 Oct 28; Authors: Chang ML, Jeng WJ, Liaw YF Abstract BACKGROUND: & Aims: Before guidelines were issued, instead of indefinite therapy, many patients with hepatitis B flare and hepatic decompensation had discontinued lamivudine therapy. We investigated heir outcomes. METHODS: We performed a retrospective cohort study of 263 consecutive patients with chronic hepatitis B (94 with cirrhosis) who recovered from a flare of hepatitis with hepatic decompensation and were followed after cessation of lamivudine therapy. Clinical events that occurred during the follow-up period were assessed by chart review and retrospective analysis of results from assays. RESULTS: The mean duration of lamivudine therapy was 12.1±8.6 months; data were collected from patients for 89.1±38.7 months after therapy ended. In the first year off therapy, 29.9% of patients had clinical relapse, 16.2% had hepatitis flares, and 8.2% had hepatic decompensation. There was no significant difference in the incidence of hepatic decompensation between patients with and without cirrhosis. Hepatocellular carcinoma developed in 14 patients after cessation of therapy (within 20-109 months), with a 5-year cumulative incidence of 5.2% in patients with cirrhosis. Three patients with cirrhosis died of hepatic decompensation after cessation of therapy (within 38-76 months; 5 year cumulative mortality, 2.9%). Multivariate analyses showed that men were more likely than women to have recurrence of hepatic decompensation (hazard ratio [HR], 4.339; P=.014). Liver cirrhosis (HR, 2.766; P=.041) and age (HR, 1.054; P=.023) increased risk for hepatocellular carcinoma. CONCLUSIONS: Cessation of lamivudine therapy after recovery from a hepatitis B flare with decompensation was safe for most patients. However, 8.2% develop decompensation within 1 year and can be rescued by timely retreatment. With close monitoring, the stopping strategy could be a feasible alternative to indefinite therapy, especially in low resource settings. PMID: 25445774 [PubMed - as supplied by publisher]

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Clinical Events after Cessation of Lamivudine Therapy in Patients Recovered from a Hepatitis B Flare with Hepatic Decompensation.

Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase.

Posted by on 13 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase. Chin J Integr Med. 2014 Feb;20(2):94-100 Authors: Xie HP, Yang HZ, Wu WK, Guan WB, Ke QS, Li YW, Dai M, Xiao GM, Zhang JS, Li YM Abstract OBJECTIVE: To explore Chinese medicine (CM) syndrome distribution of chronic hepatitis B virus (HBV) carriers in immunotolerant phase (ITP). METHODS: One hundred and eighty-five chronic HBV carriers in ITP, seen in the Third Affiliated Hospital of Sun Yat-sen University from May 2009 to December 2010, were admitted in an observational study under the guidance of CM. Patients’ CM symptoms and signs, demographics, liver biochemistries, and qualitative HBV DNA were recorded in the questionnaires. CM syndromes were then differentiated to 15 detailed types and analyzed by generalization. Lastly, the location, pathogenic factors and nature of the disease were also assessed. RESULTS: When CM syndrome patterns were differentiated to 15 types, there were 27 (15%) no syndrome cases, 94 (50%) single syndrome cases and 64 (35%) compound syndromes cases. The main detailed syndromes included Liver (Gan)-qi depression (LQD), Kidney (Shen)-qi deficiency (KQD), Spleen (Pi)-qi deficiency (SQD) and Kidney-yang deficiency (KYAD). After CM syndromes generalized to five types, their frequency was Spleen-Kidney deficiency (SKD)>LQD>inner dampness-heat retention (IDHR)>Liver-Kidney deficiency (LKD)>blood stasis blocking collateral (BSBC). SKD and LQD occupied 64%. The disease location included Liver, Gallbladder (Dan), Spleen, Stomach (Wei) and Kidney. The pathogenic factors were mainly qi stagnation, qi deficiency, yang deficiency, concurrently dampness-heat and blood stasis. The deficiency syndrome was more than excess syndrome in its nature. CONCLUSIONS: Most of chronic HBV carriers in ITP have their CM syndrome, and the most common types are SKAD, LQD. This study suggests that the natural history may be improved through breaking the state of immune tolerance or shorten the time of ITP by strengthening Spleen-Kidney and reliving Liver qi. PMID: 24619234 [PubMed - indexed for MEDLINE]

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Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase.

Four homoisoflavonoids isolated from traditional Chinese medicine: "gan luo xin".

Posted by on 02 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Four homoisoflavonoids isolated from traditional Chinese medicine: “gan luo xin”. J Asian Nat Prod Res. 2014;16(8):813-8 Authors: Li LM, Yuan QP, Chen G Abstract Two new homoisoflavonoids, ( ± )-5,7-dihydroxy-8-methyl-3-(2′,4′-dihydroxybenzyl) chroman-4-one (1) and ( ± )-5,7-dihydroxy-6,8-dimethyl-3-(2′,4′-dihydroxybenzyl) chroman-4-one (2), along with two known homoisoflavonoids, 5,7-dihydroxy-6-methyl-3-(2′,4′-dihydroxybenzyl)chroman-4-one (3) and disporopsin (4), were isolated from the EtOAc extract of traditional Chinese medicine–”Gan Luo Xin.” Their structures were determined on the basis of spectroscopic analysis (UV, IR, HR-ESI-MS, 1D NMR, and 2D NMR). PMID: 24993400 [PubMed - indexed for MEDLINE]

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Four homoisoflavonoids isolated from traditional Chinese medicine: "gan luo xin".

Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B.

Posted by on 02 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B. PLoS One. 2014;9(10):e111641 Authors: Hong MZ, Zhang RM, Chen GL, Huang WQ, Min F, Chen T, Xu JC, Pan JS Abstract OBJECTIVES: Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers. METHODS: The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement. RESULTS: An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3). CONCLUSIONS: Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation. PMID: 25360742 [PubMed - as supplied by publisher]

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Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B.

Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome.

Posted by on 24 Oct 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome. World J Gastroenterol. 2014 Oct 21;20(39):14142-14155 Authors: Ghaziani T, Sendi H, Shahraz S, Zamor P, Bonkovsky HL Abstract Hepatitis B virus (HBV) continues to be a major cause of morbidity and mortality worldwide. It is estimated that about 350 million people throughout the world are chronically infected with HBV. Some of these people will develop hepatic cirrhosis with decompensation and/or hepatocellular carcinoma. For such patients, liver transplantation may be the only hope for cure or real improvement in quality and quantity of life. Formerly, due to rapidity of recurrence of HBV infection after liver transplantation, usually rapidly progressive, liver transplantation was considered to be contraindicated. This changed dramatically following the demonstration that hepatitis B immune globulin (HBIG), could prevent recurrent HBV infection. HBIG has been the standard of care for the past two decades or so. Recently, with the advent of highly active inhibitors of the ribose nucleic acid polymerase of HBV (entecavir, tenofovir), there has been growing evidence that HBIG needs to be given for shorter lengths of time; indeed, it may no longer be necessary at all. In this review, we describe genetic variants of HBV and past, present, and future prophylaxis of HBV infection during and after liver transplantation. We have reviewed the extant medical literature on the subject of infection with the HBV, placing particular emphasis upon the prevention and treatment of recurrent HBV during and after liver transplantation. For the review, we searched PubMed for all papers on the subject of “hepatitis B virus AND liver transplantation”. We describe some of the more clinically relevant and important genetic variations in the HBV. We also describe current practices at our medical centers, provide a summary and analysis of comparative costs for alternative strategies for prevention of recurrent HBV, and pose important still unanswered questions that are in need of answers during the next decade or two. We conclude that it is now rational and cost-effective to decrease and, perhaps, cease altogether, the routine use of HBIG during and following liver transplantation for HBV infection. Here we propose an individualized prophylaxis regimen, based on an integrated approach and risk-assessment. PMID: 25339803 [PubMed - as supplied by publisher]

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Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome.

Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller.

Posted by on 30 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller. Am J Gastroenterol. 2014 Aug;109(8):1234-40 Authors: Kim JW, Kim JH, Sung KB, Ko HK, Shin JH, Kim PN, Choi HK, Ko GY, Yoon HK, Chun SY, Gwon DI Abstract OBJECTIVES: To compare the effectiveness of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for treating small (≤2 cm) hepatocellular carcinomas (HCCs). METHODS: This retrospective study consisted of 287 patients (mean age, 57.1 years; age range, 29-84 years; 221 men, 66 women; 73.5% with HBV; 100% with liver cirrhosis) with Barcelona Clinic Liver Cancer very early-stage HCC (≤2 cm single HCC) who were initially treated with TACE (n=122) or RFA (n=165). The primary study end point was overall patient survival. Secondary study end points were time to progression and tumor response. RESULTS: The RFA and TACE groups were well balanced in terms of baseline variables. The two groups did not differ significantly in overall survival (P=0.079) or major complication (P>0.999) rates. The respective cumulative survival rates at 1, 3, 5, and 8 years were 97.6, 86.7, 74.5, and 60.0% for RFA and 93.4, 75.4, 63.1, and 51.1% for TACE. Their objective tumor regression (complete or partial response) rates were 100% (165/165) and 95.9% (117/122), respectively (P=0.013). The median times to progression for RFA and TACE were 27.0±3.8 (95% confidence intervals (CIs): 19.6-34.4) and 18.0±2.9 (95% CIs: 12.2-23.8) months, respectively. RFA yielded a significantly longer time to progression (P=0.034). CONCLUSIONS: TACE may be a viable alternative treatment for ≤2 cm HCCs when RFA is not feasible. PMID: 24935276 [PubMed - indexed for MEDLINE]

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Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller.

Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection.

Posted by on 26 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection. Drug Discov Ther. 2013 Dec;7(6):212-24 Authors: Qi FH, Wang ZX, Cai PP, Zhao L, Gao JJ, Kokudo N, Li AY, Han JQ, Tang W Abstract Since the significant public health hazard of Hepatitis B virus (HBV) infection and obvious drug resistance and dose-dependent side effects for common antiviral agents (e.g., interferon α, lamivudine, and adefovir), continuous development of agents to treat HBV infection is urgently needed. Traditional Chinese medicine (TCM) is an established segment of the health care system in China. Currently, it is widely used for chronic hepatitis B (CHB) in China and many parts of the world. Over a long period of time in clinical practice and in basic research progress, the effectiveness and beneficial contribution of TCM on CHB have been gradually known and confirmed. Based upon our review of related papers and because of our prior knowledge and experience, we have selected some Chinese medicines, including Chinese herbal formulas (e.g., Xiao-Chai-Hu-Tang, Xiao-Yao-San, and Long-Dan-Xie-Gan-Tang), single herbs (e.g., Phyllanthus niruri, Radix astragali, Polygonum cuspidatum, Rheum palmatum, and Salvia miltiorrhiza) and related active compounds (e.g., wogonin, artesunate, saikosaponin, astragaloside IV, and chrysophanol 8-O-beta-Dglucoside) and Chinese medicine preparations (e.g., silymarin, silibinin, kushenin, and cinobufacini), which seem effective and worthy of additional and indepth study in treating CHB, and we have given them a brief review. We conclude that these Chinese herbal medicines exhibit significant anti-HBV activities with improved liver function, and enhanced HBeAg and HBsAg sero-conversion rates as well as HBV DNA clearance rates in HepG2 2.2.15 cells, DHBV models, or patients with CHB. We hope this review will contribute to an understanding of TCM and related active compounds as an effective treatment for CHB and provide useful information for the development of more effective antiviral drugs. PMID: 24423652 [PubMed - indexed for MEDLINE]

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Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection.

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