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image of Efficacy and Safety of Chinese Herbal Medicine Combined with Western Medicine in the Treatment of Icteric Hepatitis: A Systematic Review and Meta-Analysis

Abstract

Introduction

Icteric hepatitis remains a significant clinical challenge. The integration of Chinese Herbal Medicine (CHM) with conventional Western Medicine (WM) is becoming increasingly common; however, its overall efficacy and safety profile requires systematic evaluation. This study aims to conduct a meta-analysis to assess the safety and effectiveness of using CHM in conjunction with WM to treat icteric hepatitis.

Methods

We conducted a systematic search of PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and major Chinese databases (CNKI, Wanfang, VIP, CBM) from inception to December 2023 for Randomized Controlled Trials (RCTs) comparing CHM plus WM with WM alone for icteric hepatitis. Two reviewers independently performed study selection, data extraction, and quality assessment using the Cochrane Risk of Bias 2.0 tool. Meta-analysis was performed using RevMan 5.4 software.

Results

Eight RCTs involving 645 participants were included. The combined therapy group demonstrated a significantly higher clinical efficacy rate (RR = 1.22, 95% CI [1.11, 1.34], P < 0.0001) compared to the WM alone group. The combined therapy also resulted in greater improvements in liver function, with significant reductions in ALT (WMD = -58.33 U/L, 95% CI [-87.75, -28.91]), AST (WMD = -47.11 U/L, 95% CI [-69.83, -24.39]), TBIL (WMD = -48.27 μmol/L, 95% CI [-67.48, -29.06]), and DBIL (WMD = -31.30 μmol/L, 95% CI [-45.16, -17.44]). Furthermore, the integrated approach led to lower levels of inflammatory markers (IL-6, CRP, TNF-α) and faster symptom resolution. There was no significant difference in the incidence of adverse events between the two groups (RR = 0.83, 95% CI [0.44, 1.57], P = 0.56).

Discussion

The pooled evidence suggests that adding CHM to standard WM treatment can enhance therapeutic outcomes by improving liver function and reducing systemic inflammation. The synergistic effects may be attributed to the multi-target pharmacological properties of the herbs used. However, the findings are limited by the high risk of bias and significant heterogeneity across the included studies.

Conclusion

The adjunctive use of CHM with WM appears to be an effective and safe strategy for treating icteric hepatitis. Nonetheless, due to methodological weaknesses in the primary studies, these results should be interpreted cautiously. High-quality, rigorously designed RCTs are needed to confirm these findings.

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2026-01-09
2026-01-29

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Efficacy and Safety of Chinese Herbal Medicine Combined with Western Medicine in the Treatment of Icteric Hepatitis: A Systematic Review and Meta-Analysis
Bentham Science Publishers ; https://doi.org/10.2174/0113862073421260251113045022
/content/journals/cchts/10.2174/0113862073421260251113045022
/content/journals/cchts/10.2174/0113862073421260251113045022
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Supplementary material is available on the publisher’s website along with the published article. PRISMA checklist is available as supplementary material on the publisher’s website along with the published article.

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  • Article Type:     Research Article
Keywords: systematic review ; integrative medicine ; icteric hepatitis ; safety ; Western medicine treatment ; efficacy ; meta-analysis ; Chinese herbal medicine

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