Systemic Reviews Of Clinical Research Of TCM On Treating Liver Fibrosis

Background:Liver fibrosis is an important pathological feature of a variety of chronic liver diseases,and is also inevitable stage of developing to liver cirrhosis.Therefore,finding effective drugs to block or delay or reverse liver fibrosis has become a key problem in treating chronic liver diseases.As the father of the modern hepatology professor Hans Popper had ever said “who can prevent or treat liver fibrosis,who will be able to cure most chronic liver diseases”.Nowadays the treatment of liver fibrosis has not found ideal drugs,meanwhile more and more reports about effective Chinese medicine(TCM)on treating fibrosis were published.However,the curative effect of TCM is not widely recognized by international,and the effect of anti fibrosis of Chinese herbal is also controversial and questioned,therefore this study aims to analysis the objective situation of anti fibrosis of TCM by evidence-based medicine method,which provides the evidence for the clinical application of TCM on anti liver fibrosis.Objective: Through the comprehensive analysis of the literature,to judge whether TCM has exactly curative effect on treating liver fibrosis.Methods: All the trials about TCM in treating Liver fibrosis were searched in CBM Database?CNKI Database?VIP Database?Wan Fang Database?MEDLINE?Pub Med and Google Scholar,and all the relevant references that were checked out were also searched as a supplement.Some authors were contacted for the full text or relevant data.The retrieval date was from construction to January 2016.Trials which did not meet the inclusion criteria were removed by reading articles title,abstract or the full text.As the “gold standard” of liver cirrhosis,tissue pathology was employed as the main indicator,while serum liver fibrosis indexes,liver biochemical and adverse reactions as secondary indicators.After evaluating the literature quality and extracting the data,then Revman5.3 software was applied for statistical analysis.Results: There are 26 literatures met the inclusion standard,a total of 2913 cases were included in the clinical evaluation,including 2424 of TCM group,and 489 of control group.All the research objects are the patients of liver fibrosis with pathological grading S1 to S4,Chinese traditional medicine group are given “TCM or proprietary Chinese medicine or jointly protecting liver medicine” as the main treatment;The control group are given “general protecting liver medicine or placebo” as the main treatment.Statistical analysis show that after treatment for 6 mouths,when compared with control group,the TCM group improved the indicators significantly of the fibrosis degree{WMD=1.97,95%CI[-3.60,-0.33],P=0.02},liver tissue inflammation activity{WMD=1.62,95%CI[-3.19,-0.05],P=0.04},HA{SMD=1.48,95%CI[-2.26,-0.70],P=0.0002},LN{SMD=0.94,95%CI[-1.52,-0.35],P=0.002},PC-?{SMD=1.44,95%CI[-2.45,-0.42],P=0.005},?-C{SMD=0.62,95%CI[-1.11,-0.12],P=0.01},ALT{WMD=13.90,95%CI[-25.55,-2.25],P=0.02} and ALB{WMD=3.06,95%CI[0.65,5.47],P=0.01}.While the effect on reducing TB had no significant difference between TCM and control group,{WMD=3.13,95%CI[-7.17,0.91],P=0.13}.Conclusions: The current study suggests: 1.TCM can ameliorate liver histological fibrosis degree and inflammation activity;2.TCM can significantly reduce serum liver fibrosis indexes;3.TCM has little effect on the metabolism of bile.To sum up,TCM for the treatment of liver fibrosis is exact and effective.