Traditional Chinese medicines benefit to nonalcoholic fatty liver disease: a systematic review and meta-analysis

Abstract

Evidences from randomized controlled trials (RCTs) for the efficiency of traditional Chinese medicine (TCM) on the treatment of nonalcoholic fatty liver disease (NAFLD) are conflicting. Here we conducted a systematic review and meta-analysis of RCTs to evaluate the efficiency and safety of TCM in the treatment of NAFLD. Studies were searched on PubMed and China National Knowledge Infrastructure from January 1995 to June 2010. RCTs comparing either TCM formulations alone or in combination with placebo, ursodeoxycholic acid, insulin sensitizers, lipid-lowering drugs, or antioxidants were included. The category of most usually used herbs in the treatment of NAFLD was also calculated. Five thousand nine hundred and four patients from 62 RCTs were included for meta-analysis and 25,661 patients from 419 clinical studies were for TCM formulation analysis. Comparing with western medicines mentioned above, TCM had a better effect on the normalization of alanine aminotransferase and disappearance of radiological steatosis in the treatment of NAFLD. Furthermore, 246 kinds of Chinese herbs were included in our present study, with an average of 10 herbs (range 1–31) in each formulation. Hawthorn Fruit (321 times in 17,670 patients) was the most often used herb in the treatment of NAFLD. In conclusion, TCM is of modest benefit to the treatment of NAFLD.

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Abbreviations

ALT:

Alanine aminotransferase

CI:

Confidence interval

CONSORT:

Consolidated Standards of Reporting Trials

NAFLD:

Nonalcoholic fatty liver disease

OR:

Odds ratio

RCT:

Randomized controlled trial

TCM:

Traditional Chinese medicine

UDCA:

Ursodeoxycholic acid

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Acknowledgments

This work was supported by grants from National Science and Technology Major Project of China (2012ZX10002004), the Scientific Research Foundation of Wenzhou, Zhejiang Province, China (H20090014, Y20090269), Zhejiang Provincial Administration of Traditional Chinese Medicine (2011ZQ015), Health Bureau of Zhejiang Province (2010KYB070), Research Foundation of Education Bureau of Zhejiang Province (Y201009942) and Project of New Century 551 Talent Nurturing in Wenzhou, Natural Science Foundation of Shandong Province (ZR2010HQ040), Independent Innovation Foundation of Shandong University (IIFSDU, 2010TS013).

Conflict of Interest

All authors have no conflicts of interest.

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Corresponding author

Correspondence to Ming-Hua Zheng.

Additional information

K.-Q. Shi and Y.-C. Fan contribute equally to the study.

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Supplementary material 3 (JPG 234 kb)

Supplementary material 4 (JPG 111 kb)

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Supplementary material 11 (JPG 265 kb)

Supplementary Reference 1

. References associated with RCTs included in the study. (DOC 36 kb)

Supplementary Reference 2

. References associated with clinical trials summarizing the herbs in TCMs formulations. (DOC 140 kb)

Supplementary Table 1

. Characteristics of included RCTs of TCMs versus placebo for NAFLD (DOC 49 kb)

Supplementary Table 2

. Characteristics of included RCTs of TCMs versus UDCA for NAFLD (DOC 57 kb)

Supplementary Table 3

. Characteristics of included RCTs of TCMs versus insulin sensitizers for NAFLD (DOC 32 kb)

Supplementary Table 4

. Characteristics of included RCTs of TCMs versus fibrates for NAFLD (DOC 52 kb)

Supplementary Table 5

. Characteristics of included RCTs of TCMs versus statins for NAFLD (DOC 65 kb)

Supplementary Table 6

. Characteristics of included RCTs of TCMs versus antioxidants for NAFLD (DOC 62 kb)

Supplementary material 20 (PDF 61 kb)

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Shi, K., Fan, Y., Liu, W. et al. Traditional Chinese medicines benefit to nonalcoholic fatty liver disease: a systematic review and meta-analysis. Mol Biol Rep 39, 9715–9722 (2012). https://doi.org/10.1007/s11033-012-1836-0

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Keywords

  • Herb
  • Fatty liver
  • Therapy
  • Meta-analysis
  • Nonalcoholic fatty liver disease