Qingre Lishi Tuihuang therapy for acute icteric hepatitis B: A systematic review

Objective: To assess the efficacy of Qingre Lishi Tuihuang therapy (QLTT) for acute icteric hepatitis B infection. Methods: Eight electronic databases were searched from inception to December 2016 with no language restrictions for reports of randomized controlled trials evaluating the effect of QLTT treating acute icteric hepatitis B. Two researchers independently extracted detailed data and assessed methodological quality. Review Manager 5.3.0 software was used to analyze the data. Results: A total of 13 randomized controlled trials involving 2238 participants were included in this review. The methodological quality was generally poor. The results indicated that supplemented Yinchenhao decoction combined with non-specific treatments was more effective in improving the cure rate (risk ratio = 1.80; 95% CI 1.21–2.68) and reducing the serum levels of total bilirubin (mean difference = −29.74; 95% CI −31.91 to −27.57) and aspartate aminotransferase. Other self-made prescriptions conforming to QLTT plus non-specific treatments had beneficial effect for acute icteric hepatitis B in curing this disease (risk ratio = 1.48; 95% CI 1.27–1.73), as well as for negative seroconversion of HBeAg (risk ratio = 1.39; 95% CI 1.11–1.74). Supplemented Yinchenhao decoction plus non-specific treatments was more effective than other self-made prescriptions conforming to QLTT in reducing serum total bilirubin level. Conclusion: Qingre Lishi Tuihuang therapy appears to improve effect based on non-specific treatments for the treatment of acute icteric hepatitis B. However, it is premature to draw confirmative conclusions, owing to the poor methodological quality and high clinical heterogeneity of the included trials. Further well-designed clinical randomized controlled trials with large sample sizes should be undertaken