A hospital clinic-based survey on traditional Chinese medicine usage among chronic hepatitis B patients

Wong, Vincent Wai‐Sun; Law, M. P. M.; Hui, Alex; Lo, Angeline Oi–Shan; Li, Cheuk-Yin; Soo, Man-Tak; Leung, Hor-Yee; Chan, Henry Lik‐Yuen

doi:10.1016/j.ctim.2005.04.006

Cited by 29 publications

(21 citation statements)

References 26 publications

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“…We screened 2879 abstracts from electronic search, and 39 full texts were retrieved for further assessment. With the application of exclusion criteria, 14 papers were considered ineligible . Finally, 25 studies from electronic searches were included.…”

Section: Resultsmentioning

confidence: 99%

Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies

Chung

Lau

et al. 2012

Health Expectations

112

102

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Section: Resultsmentioning

confidence: 99%

Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies

Chung

Lau

et al. 2012

Health Expectations

112

102

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“…With a retrospective study of reviewing HBV-infected cases with liver injury, Yuen et al found 45 cases with suspected CHP-associated liver injury. [26] A hospital-based questionnaire survey found 10 of 116 patients who had taken CHPs experienced side effects [15]. But they did not explore the detailed active ingredients in the exposed CHPs.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, Xiao-Chai-Hu-Tang is often prescribed to treat HBV infection and the usual posology for Radix bupleuri is doses of 3–9 g/day. [8], [13], [14] However, another study undertaken in Hong Kong found that 32% of the patients with HBV infection had used CHPs, and 9% of them experienced moderate to severe side effects [15]…”

Section: Introductionmentioning

confidence: 99%

Risk of Liver Injury Associated with Chinese Herbal Products Containing Radix bupleuri in 639,779 Patients with Hepatitis B Virus Infection

2011

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BackgroundChinese herbal products (CHPs) containing Radix bupleuri are often prescribed for chronic hepatitis. There have been no epidemiological studies in populations with hepatitis B virus (HBV) infection. Our study was conducted to determine the association between the use of CHPs containing Radix bupleuri and the risk of hospitalisation related to liver injury among HBV-infected patients in Taiwan.MethodsFrom a total of 639,779 patients with diagnoses related to HBV infection, we included hospitalised adult cases with a primary diagnosis of liver injury in the database of Taiwan's national health insurance during the period 1997–2004. Case-control and case-crossover designs were used to assess the risk of hospitalisation with conditional logistic regression models constructed and adjusted for 270 conventionally hepatotoxic drugs. Cumulative doses of these CHPs and Radix bupleuri were assessed for any dose-response relationship.FindingsIn total, we collected 1,080 cases fulfilled the inclusion criteria. In the case-control design, the adjusted odds ratio was 1.90 (95% confidence interval [CI]: 1.30 to 2.77). The risks from prescribing the CHPs Xiao-Chai-Hu-Tang and Long-Dan-Xie-Gan-Tang were significantly high, and dose-response relationships were found. The risk of adding each 19 gm dose of Radix bupleuri was 2.19 (95% CI: 1.66 to 2.89). The results using the case-crossover design remained similar.ConclusionsPrescribing Xiao-Chai-Hu-Tang, Long-Dan-Xie-Gan-Tang, or CHPs containing more than 19 gram of Radix bupleuri in HBV-infected patients might increase their risks of liver injury. Further studies are indicated to corroborate the above findings.

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“…The widely prescribed Chinese herbal product, Xiao-Chai-Hu-Tang , a famous multi-herbal remedy containing RB, is renowned for its possible healing effects on chronic hepatitis B and its beneficial effects on preventing the development of hepatocellular carcinoma in patients with liver cirrhosis [4–6]. A study performed in Hong Kong has shown that 39% patients with chronic liver diseases prefer to use Chinese herbal products and 21% and 13% patients have taken Traditional Chinese Medicine (TCM) previously or are currently using TCM to improve their liver conditions, respectively [7]. According to the Chinese pharmacopoeia, the clinical safe dosage of RB prescriptions ranged from 3 g/day to 10 g/day, based on 70 kg body weight.…”

Section: Introductionmentioning

confidence: 99%

Saikosaponins induced hepatotoxicity in mice via lipid metabolism dysregulation and oxidative stress: a proteomic study

et al. 2017

BMC Complement Altern Med

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BackgroundRadix Bupleuri (RB) has been popularly used for treating many liver diseases such as chronic hepatic inflammation and viral Hepatitis in China. Increasing clinical and experimental evidence indicates the potential hepatotoxicity of RB or prescriptions containing RB. Recently, Saikosaponins (SS) have been identified as major bioactive compounds isolated from RB, which may be also responsible for RB-induced liver injury.MethodsSerum AST, ALT and LDH levels were determined to evaluate SS-induced liver injury in mice. Serum and liver total triglyceride and cholesterol were used to indicate lipid metabolism homeostasis. Liver ROS, GSH, MDA and iNOS were used to examine the oxidative stress level after SS administration. Western blot was used to detect CYP2E1 expression. A 8-Plex iTRAQ Labeling Coupled with 2D LC - MS/MS technique was applied to analyze the protein expression profiles in livers of mice administered with different doses of SS for different time periods. Gene ontology analysis, cluster and enrichment analysis were employed to elucidate potential mechanism involved. HepG2 cells were used to identify our findings in vitro.ResultsSS dose- and time-dependently induced liver injury in mice, indicated by increased serum AST, ALT and LDH levels. According to proteomic analysis, 487 differentially expressed proteins were identified in mice administrated with different dose of SS for different time periods. Altered proteins were enriched in pathways such as lipid metabolism, protein metabolism, macro molecular transportation, cytoskeleton structure and response to stress. SS enhanced CYP2E1 expression in a time and dose dependent manner, and induced oxidative stress both in vivo and in vitro.ConclusionOur results identified hepatotoxicity and established dose-time course-liver toxicity relationship in mice model of SS administration and suggested potential mechanisms, including impaired lipid and protein metabolism and oxidative stress. The current study provides experimental evidence for clinical safe use of RB, and also new insights into understanding the mechanism by which SS and RB induced liver injury.

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A hospital clinic-based survey on traditional Chinese medicine usage among chronic hepatitis B patients

Cited by 29 publications

References 26 publications

Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies

Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies

Risk of Liver Injury Associated with Chinese Herbal Products Containing Radix bupleuri in 639,779 Patients with Hepatitis B Virus Infection

Saikosaponins induced hepatotoxicity in mice via lipid metabolism dysregulation and oxidative stress: a proteomic study

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