Assess the evidence of the efficacy of Lamivudine with Chinese herbal medicine in the treatment of chronic hepatitis B- A Review of Randomized Controlled Trials

o Background: Chronic hepatitis B is a serious worldwide public health problem. Among two billion people infected with hepatitis B, approximately 350 million people became chronic hepatitis. Chronic hepatitis B increases the risk of a progression to liver cirrhosis and hepatocellular carcinoma. Lamivudine, an anti-viral drug was one of the approved conventional treatments for HBeAg-positive chronic hepatitis B. Chinese herbal medicine has been widely used for treating chronic liver disease for thousand years. Some clinical trials on Lamivudine or Chinese medicine were conducted. However, a systemic review of the efficacy of the combined treatments was lacking. o Objectives: This review is to assess the current evidence on the efficacy of Lamiverdine combined with Chinese herbal medicine in the treatment of chronic hepatitis in the existing randomized control trials. o Methods: The electronic databases including MEDLINE (PUBMED), ALT HEALTH WATCH (EBSCO), CINAHL , VIP data (Chinese) from their inception through September 2011 were searched. Randomized controlled trials comparing Chinese herbal medicine combined with Lamivudine versus Lamivudine alone for chronic hepatitis B were included. Only the studies published in English and Chinese were considered. The quality of trials was assessed based on Jadad scale. o Results: Nine randomized controlled trials (n=873) were identified based on the inclusion and exclusion criteria. Among these RCTs, six trials (66.67%) showed that use of Lamiverdine combined with Chinese herbs significantly reduced the HBV DNA levels compared to use of Lamiverdine alone.