| Objective:To investigate the efficiency and safety of combining traditional Chinese medication with western medication to treat chronic hepatitis B through meta analysis on data collected from patients with chronic hepatitis B and to provide evidence-based medical basis for the clinical practice of combining traditional Chinese medication with western medication.Method:Researching literature at home and abroad, two researchers extract data independently from data extraction table following predetermined inclusion and exclusion criteria, and select patients with chronic hepatitis B who meet the inclusion criterion since the data base was established. Then, a randomized controlled trial will be conducted to analyze the treatment for chronic hepatitis B between two groups---Group One is treated by telbivudine in combination with traditional Chinese medicine; Group Two is treated solely by telbivudine. According to Jadad standards, randomized group sequencing, allocation concealment, blinding, quitting/loss to follow-up will be included in the quality of research documents. Discrepancy of efficiency of treatment for chronic hepatitis B is analyzed between traditional Chinese medication in combination with western medication and telbivudine. Meanwhile, selected documents will be meta analyzed using RevMan5.3.Results:There are 14 randomized controlled trials about treatment for chronic hepatitis B using telbivudine in combination with traditional Chinese medicine and solely using telbivudine. Among 1314 patients with chronic hepatitis B, there are 680 in experimental group and 661 in control group. Therefore, this methodology is not quite good. Meta analysis shows that treatment for chronic hepatitis B by traditional Chinese medication in combination with western medication is superior to that of solely using telbivudine in terms of HbeAg negative conversion rate, HbeAg conversion rate, and HBV DNA negative conversion rate. HbeAg negative conversion rate:RR=1.41,95% CI [1.17,1.70] indicates that this rate of the group using traditional Chinese medication in combination with western medication is 1.41 times than that of the group solely using telbivudine and the effect size Z=3.57 (P=0.00004) shows the discrepancy is statistically meaningful. HbeAg conversion rate:RR=1.79,95%CI[1.37,2.33] indicates that this rate of the group using traditional Chinese medication in combination with western medication is 1.79 times than that of the group solely using telbivudine and the effect size Z=4.31 (P<0.00001) shows the discrepancy is statistically meaningful. HBV DNA negative conversion rate:RR=1.27,95%CI[1.17,1.38] indicates that this rate of the group using traditional Chinese medication in combination with western medication is 1.27 times than that of the group solely using telbivudine and the effect size Z=5.77 (P<0.00001) shows the discrepancy is statistically meaningful. Meanwhile, treatment by combining traditional Chinese medication with western medication is superior to that by solely using telbivudine in terms of reducing ALT, AST, TBiL. The change of ALT: MD=-16.17,95%CI[-25.34,-7.01] indicates that ALT in the group using traditional Chinese medication in combination with western medication is lower than that in the group solely using telbivudine and effect size Z=3.46 (P<(0.00001) shows the discrepancy is statistically meaningful and is beneficial. The change of TBiL: MD=-5.92,95%CI[-9.67,-2.18] indicates that TBiL in the group using traditional Chinese medication in combination with western medication is lower than that in the group solely using telbivudine and effect size Z=3.10 (P=0.002) shows the discrepancy is statistically meaningful and is beneficial. The change of AST:MD=-16.17,95%CI[-25.34,-7.01] indicates that AST in the group using traditional Chinese medication in combination with western medication is lower than that in the group solely using telbivudine and effect size Z=3.46 (P=0.0005) shows the discrepancy is statistically meaningful and is beneficial. Among all the researches, side effects are mainly fatigue, diarrhea, rash, and increasing CK. However, they are all alleviated without the interference of medicine. There is no obvious myalgia and impairment of renal function and there are no meaningful clinical changes of laboratory indexes, such as hepatic and renal function, blut-routine-untersuchung, and harn-routine-untersuchung. The result is reasonably reliable since no dramatic changes of the result of meta analysis occur when sensitivity analysis of various effect size is conducted and factors such as sample size, medication, and method of analysis change.Conclusion:The overall treatment for chronic hepatitis B using telbivudine in combination with traditional Chinese medicine is more efficient than that of solely using telbivudine. However, since the clinical research methodology lacks quality and the research time is relatively short, a confirmative conclusion cannot be reached. In the future, it will still need clinical trials and summaries with high quality to further verify the clinical efficiency of treatment for chronic hepatitis B by combining traditional Chinese medication with western medication.
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