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Meta-analysis: silymarin and its combination therapy for the treatment of chronic hepatitis B

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Abstract

Silymarin is used by many patients with chronic hepatitis B, but its efficacy remains unknown. The aim of this investigation was to conduct a meta-analysis to determine the efficacy and safety of silymarin and its combination therapy for the treatment of chronic hepatitis B. We searched Chinese and English reports from January 1966 to December 2011, using 12 databases. Two reviewers independently screened all reports to identify randomized placebo-controlled trials that evaluated silymarin and its combination therapy for the treatment of chronic hepatitis B. Twelve trials satisfied the eligibility criteria for this meta-analysis. Silymarin was equivalent to antiviral drug or protection liver drugs in serum transaminases, viral load and hepatic fibrosis markers. But silymarin combined with antiviral drug or antiviral drug and protection liver drugs significantly reduced the level of serum transaminases, hepatic fibrosis markers and serum TGF-β1, TNF-α, IL-6 versus antiviral drug or protection liver drugs. Silymarin combined with protection liver drugs significantly reduced the level of serum transaminases, TBIL, hepatic fibrosis markers and was equivalent to protection liver drugs in the normalisation rates of serum transaminases, TBIL, but protection liver drugs significantly increased the improvement rates of hepatic fibrosis markers. Silymarin combined with antiviral drug or antiviral drug and protection liver drugs may have potential therapeutic value. Treatment with silymarin appears to be safe and well tolerated. The data are too limited to exclude a substantial benefit or harm of silymarin and its combination therapy on serum transaminases, and also to support recommending this herbal compound for the treatment of chronic hepatitis B.

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Conflict of interest

We have no financial relationship with the College of Pharmacy, Central South University, who sponsored the research. The authors declare that we have no conflict of interest.

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Authors and Affiliations

  1. Pharmaceutics Department, College of Pharmacy, Central South University, Changsha, Hunan, 410013, China

    F. Wei, S.-K. Liu & Z.-J. Li

  2. Department of Pharmacy, The Third Xiangya Hospital of Central South University, Tongzipo Road 172, Changsha, Hunan, 410013, China

    F. Wei, S.-K. Liu, Z.-J. Li, B. Li & Y.-L. Zhou

  3. Department of Pharmacy, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, 341000, China

    X.-Y. Liu

  4. Infectious Diseases Department, The Third Xiangya Hospital of Central South University, Changsha, Hunan, 410013, China

    H.-Y. Zhang

  5. Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, 410013, China

    Y.-W. Li

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  1. F. Wei
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  2. S.-K. Liu
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  3. X.-Y. Liu
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  4. Z.-J. Li
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  5. B. Li
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  6. Y.-L. Zhou
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  7. H.-Y. Zhang
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Correspondence to S.-K. Liu.

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Wei, F., Liu, SK., Liu, XY. et al. Meta-analysis: silymarin and its combination therapy for the treatment of chronic hepatitis B. Eur J Clin Microbiol Infect Dis 32, 657–669 (2013). https://doi.org/10.1007/s10096-012-1789-1

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  • DOI: https://doi.org/10.1007/s10096-012-1789-1

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