<b>OBJECTIVEb>To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (, YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus (HBV-ACLF) with cold pattern in Chinese medicine (CM).

<b>METHODSb>This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine (WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM (integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease (MELD) score, liver biochemical function, coagulation function and complications. Adverse events during treatment were reported.

<b>RESULTSb>The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ(2) =6.156, P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353, P=0.020). There were statistically signifificant differences in aspartate transaminase, total bilirubin, indirect bilirubin, direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ(2)=9.033, P=0.003) and spontaneous bacteria peritonitis (χ(2)=4.194, P=0.041) were improved signifificantly in the integrative treatment group. No serious adverse event was reported.

<b>CONCLUSIONSb>The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle "treating cold pattern with hot herbs" remains valuable to the clinical therapy. (Trial registration No. ChiCTR-TRC-10000766).

Acute-On-Chronic Liver Failure ; complications ; drug therapy ; mortality ; virology ; Adult ; Ascites ; complications ; Demography ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Electrolytes ; Female ; Hepatitis B ; complications ; drug therapy ; mortality ; physiopathology ; Hepatitis B virus ; physiology ; Humans ; Integrative Medicine ; Liver ; drug effects ; pathology ; physiopathology ; virology ; Liver Function Tests ; Male ; Peritonitis ; complications ; Time Factors ; Treatment Outcome

<b>OBJECTIVEb>To study the clinical therapeutic effects and safety of Fufang Biejia Ruangan tablet (FBRt) in patients with chronic hepatitis B complicated with hepatic fibrosis.

<b>METHODSb>Totally 420 patients were randomly divided into two groups, FBRt group (300 cases) were treated with Fufang Biejia Ruangan tablets and control group (120 cases) were treated with He Luo Shu Gan capsule, the patients in both groups were treated for 6 months.

<b>RESULTSb>The cure rate and total effective rate of FBRt group were significantly higher than those of control group (55.67 percent and 81.67 percent vs. 15.8 percent and 60.00 percent, P less than 0.01).

<b>CONCLUSIONb>Fufang Biejia Ruangan tablet could alleviate clinical symptoms and hepatic fibrosis. Fufang Biejia Ruangan tablet is effective and safe in treatment of patients with chronic hepatitis B complicated with liver fibrosis.

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; pathology ; Humans ; Liver ; pathology ; physiopathology ; Liver Cirrhosis ; drug therapy ; etiology ; pathology ; Medicine, Chinese Traditional ; Middle Aged ; Tablets

<b>OBJECTIVEb>To study the effect of Xuesaitong soft capsule (XST) on liver fibrosis criteria in patients with post-hepatitis fibrosis.

<b>METHODSb>Sixty-four patients with such fibrosis were randomly divided into the treated group and control group. They were treated with XST and Dahuang Zhechong pill (NFDA1) for 3 months respectively. Their liver fibrosis criteria were examined before and after treatment.

<b>RESULTSb>The levels of serum procollagen III, hyaluronic acid, collagen IV, laminin in the two groups were significantly lower (P < 0.01) than those before treatment. The differences between the two groups were insignificant (P > 0.05).

<b>CONCLUSIONb>XST could recover liver dysfunction and had anti-liver fibrosis function.

Adult ; Capsules ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; drug therapy ; pathology ; physiopathology ; virology ; Male ; Middle Aged ; Treatment Outcome

<b>OBJECTIVEb>To observe the effect of Xuefu Zhuyu decoction (XZD) on the chronic hepatitis B caused liver fibrosis (CHBLF) and the portal hemodynamics.

<b>METHODSb>Sixty patients with CHBLF were randomly divided into two groups, the 28 patients in the treated group were treated with oral intake of XZD and conventional liver protective treatment, the 32 patients in the control group were treated with conventional liver protective treatment alone, the therapeutic course for both groups was 3 months. Serum liver fibrosis criteria and portal dynamical criteria were observed before and after treatment.

<b>RESULTSb>Comparison of the remarkable effective rate between the two groups showed significant difference. After treatment, in the treated group, all the serum criteria for liver fibrosis (HA, PCIII, LN) and criteria for portal trunk hemodynamics, such as mean velocity and quantity of blood flow were significantly improved (P < 0.05 or P < 0.01), as compared with those in the control group, the difference was also significant (P < 0.05 or P < 0.01).

<b>CONCLUSIONb>XZD has definite therapeutic effect on chronic hepatitis B caused liver fibrosis.

Adolescent ; Adult ; Collagen Type III ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemodynamics ; Hepatitis B, Chronic ; blood ; complications ; Humans ; Hyaluronic Acid ; blood ; Liver Cirrhosis ; blood ; drug therapy ; etiology ; Male ; Middle Aged ; Phytotherapy ; Portal Vein ; physiopathology

BACKGROUND/AIMS: The aim of this study was to evaluate the estimated glomerular filtration rate (eGFR) during telbivudine (LdT) versus entecavir (ETV) treatment in chronic hepatitis B (CHB) patients with underlying comorbidities such as diabetes mellitus (DM), hypertension, and cirrhosis. METHODS: From 2010 to 2012, 116 CHB patients treated with LdT and 578 treated with ETV were compared in this real-practice cohort. The mean changes in eGFR (Modification of Diet in Renal Disease [MDRD] formula) from baseline to months 6, 12, and 18 were analyzed using a linear mixed model. RESULTS: In LdT-treated patients, the mean eGFR increased by 7.6% at month 18 compared with the eGFR at baseline (MDRD formula in mL/min/1.73 m2). However, in ETV-treated patients, the mean eGFR decreased by 4.1% at month 18 compared with the eGFR at baseline. In the LdT-treated patients with DM, hypertension, cirrhosis or low eGFR <90 mL/min/1.73 m2, the mean eGFR showed a steady improvement, whereas the mean eGFR was reduced in the same subgroups of ETV-treated patients. CONCLUSIONS: The eGFR gradually increased over time during LdT treatment, especially in patients with mild abnormal eGFR at baseline, and in those with DM, hypertension, and cirrhosis, whereas a reduction in eGFR was seen with ETV treatment.
Adult ; Antiviral Agents/*administration & dosage ; Diabetes Complications ; Diabetes Mellitus ; Drug Administration Schedule ; Female ; Fibrosis/complications ; Glomerular Filtration Rate/*drug effects ; Guanine/administration & dosage/*analogs & derivatives ; Hepatitis B, Chronic/complications/*drug therapy/physiopathology ; Humans ; Hypertension/complications ; Linear Models ; Male ; Middle Aged ; Thymidine/administration & dosage/*analogs & derivatives ; Time Factors ; Treatment Outcome

Polymyositis is a rare complication of interferon alpha treatment as a result of immunemodulating role of the drug itself. In this case, interferon alpha induced polymyositis and cardiomyopathy is diagnosed in a 33-yr-old male patient with history of chronic hepatitis B. To treat hepatitis B, interferon alpha was administered until the proximal muscle weakness developed. Thereafter, sixteen cycles of immunoglobulin treatment (400 mg/kg) along with corticosteroids were instituted and led to an improvement in subjective symptoms with decreases in level of CPK and LDH. However, dilated cardiomyopathy has not improved in spite of the cessation of interferon treatment. Unlike the persistently elevated serum HBV DNA level, the serum ALT and AST levels have gradually decreased. Our case shows that clinical symptoms of polymyositis improved with steroid and immunoglobulin treatment without deterioration of the hepatitis B. To our knowledge, this is the first case of polymyositis associated with dilated cardiomyopathy after the administration of interferon in a patient with hepatitis B.
Adrenal Cortex Hormones/therapeutic use ; Adult ; Antigens, CD13/blood ; Antiviral Agents/*adverse effects/therapeutic use ; Aspartate Aminotransferases/blood ; Cardiomyopathy, Dilated/blood/*chemically induced/drug therapy/physiopathology ; Hepatitis B, Chronic/blood/complications/*drug therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Interferon-alpha/*adverse effects/therapeutic use ; Male ; Polymyositis/blood/*chemically induced/drug therapy/physiopathology ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy of combination therapy of lamivudine (LAM) and adefovir dipivoxyl (ADV) for patients with hepatitis B-induced decompensated cirrhosis. METHODS: A total of 81 patients were randomly divided into a combination group and an ADV group over 48 week treatment course. The combination group were treated with LAM (100 mg/d) plus ADV (10 mg/d), and the ADV group with ADV (10 mg/d ) for 48 weeks. All patients received hepatic function support and symptomatic treatment. The levels of HBV DNA, liver function, Child-Pugh scores and HBV DNA indicators were observed before and after the treatment. RESULTS: At week 4, the mean reduction of HBV DNA was 1.83 lgIU/mL, 17.9% of the patients achieved undetectable HBV DNA and 28.2% showed normal ALT in the combination group. The counterpart in the ADV group was 0.96 lgIU/mL, 5.3% and 10.5%. At week 4, 12, 24 and 48, the differences in the mean reduction of HBV DNA, undetectable HBV DNA and ALT normalization were statistically significant between the 2 groups. The difference in HBeAg negative conversion rates and HBeAg seroconversion at week 24 and 48 was not significant. CONCLUSION The combination therapy results in HBV suppression and improved liver function and Child-Pugh score. The combination treatment has an advantage over ADV due to low drug resistance rate and good tolerance.
Adenine ; administration & dosage ; analogs & derivatives ; Adult ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; End Stage Liver Disease ; drug therapy ; etiology ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Lamivudine ; administration & dosage ; Liver Cirrhosis ; drug therapy ; etiology ; physiopathology ; Male ; Middle Aged ; Organophosphonates ; administration & dosage