Guide
Six-flavor five-spirit tablets are composed of schisandra, female virgin, forsythia, curcuma, lettuce, and reishi spore powder.
Function and indications: nourish the kidneys and nourish the liver, activate blood and detoxify. It is used to treat chronic hepatitis B with elevated aminotransferase, and the chinese medicine dialectic belongs to the liver and kidney deficiency, evil poison and heat interlocking. Symptoms: pain in the flanks, sore waist and knees, dry mouth and throat, fatigue and fatigue, poor tolerance, swelling, yellow or no yellowing of the body, yellowish urine, dizziness, dry eyes, hot hands and feet, insomnia and dreams, dark red tongue or ecchymosis, little or no moss, fine pulse strings.
This consensus stipulates the indications, dosage, course of treatment, adverse reactions and contraindications for the treatment of chronic hepatitis B with six flavors and five spirit tablets. It is suitable for clinicians in tertiary and secondary hospitals engaged in the diagnosis and treatment of liver disease to use Liuwei Wuling tablets to treat chronic hepatitis B.
Consensus recommendations
1. Liuwei Wuling tablets are used for the treatment of chronic hepatitis B and have hepatoprotective and enzyme-lowering effects. (Evidence level: B; recommended intensity: strong recommendation)
2. Liuwei Wuling tablets are used for the treatment of chronic hepatitis B and have a yellowing effect. (Evidence level: B; recommended intensity: weak recommendation)
3. Liuwei Wuling tablets combined with nucleosides (acids) or α-interferons can synergistically inhibit HBV virus replication when treating chronic hepatitis B. (Evidence level: C; recommended intensity: weak recommendation)
4. When used in the treatment of chronic hepatitis B, Liuwei Wuling tablets can improve the overall clinical efficacy [including improvement of clinical symptoms, improvement of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and other liver function indicators and decrease of hepatitis B virus levels]. (Evidence level: C; recommended intensity: strong recommendation)
5. Liuwei Wuling tablets are used for the treatment of hepatitis B fibrosis with elevated aminotransferase, which has the effect of hepatoprotective enzymes. (Evidence level: C; recommended intensity: strong recommendation)
6. Liuwei Wuling tablets combined with nucleoside (acid) antiviral drugs or thymic pentapeptides can significantly reduce the serum hepatic fibrosis of hepatitis B patients with four items of liver fiber [type III precollection (PCIII), type IV collagen (IV-C), laminin (LN), hyaluronidase (HA)] levels. (Evidence level: C; recommended intensity: weak recommendation)
7. Liuwei Wuling tablets are used for the treatment of patients with hepatitis B cirrhosis with elevated aminotransferase, and have a hepatoprotective and enzyme-lowering effect. (Evidence level: C; recommended intensity: strong recommendation)
8. Liuwei Wuling tablets combined with nucleoside (acid) antiviral drugs or thymus pentapeptides can significantly reduce the serum liver fiber four items [type III precollection (PCI-II), type IV collagen (IV-C), laminin (LN), hyaluronidase (HA)] levels in patients with hepatitis B cirrhosis. (Evidence level: D; recommended intensity: weak recommendation)
9. When Liuwei Wuling tablets combined with antiviral therapy are used for the treatment of hepatitis B cirrhosis, the overall clinical efficacy can be improved (clinical symptom improvement, ALT, AST, TBIL and other liver function indicators improve, or fibrosis indicators improve). (Evidence level: C; recommended intensity: weak recommendation)
10. Combing through the relevant clinical studies of Liuwei Wuling tablets before and after marketing and the adverse reaction information of Liuwei Wuling tablets on the website of the State Food and Drug Administration shows that Liuwei Wuling tablets have good safety. (Evidence level: C; recommended intensity: weak recommendation)
Consensus recommendations
1. The medication regimen of Liuwei Wuling tablets is 1.5g/time, 3 times/day. It can be administered continuously for 1 to 2 months when it is used for the treatment of hepatitis, and for no less than 6 months in the treatment of liver fibrosis and cirrhosis. (Evidentiary level: no evidence; recommended intensity: recommended)
This article is excerpted from: Hepatobiliary Disease Branch of Chinese Association of Traditional Chinese Medicine, Branch of Chinese Proprietary Chinese Medicine, Clinical Pharmacy Professional Committee of Chinese Pharmaceutical Association. Expert consensus on the clinical application of Liuwei Wuling tablets in the treatment of chronic hepatitis B[J]. Journal of Integrated Traditional Chinese and Western Medicine in Liver Disease, 2020, 30(05):482-485.