Herbal medicines for fatty liver diseases

Area of Science:

• Hepatology
• Integrative Medicine
• Pharmacology

Background:

• Fatty liver disease is a reversible condition that can progress to end-stage liver disease.
• Increasing use of herbal medicines like Crataegus pinnatifida and Salvia miltiorrhiza necessitates a review of their efficacy.
• A systematic review is needed to evaluate herbal medicine's role in managing fatty liver disease.

Purpose of the Study:

• To assess the beneficial and harmful effects of herbal medicines.
• To evaluate herbal medicine interventions for alcoholic and non-alcoholic fatty liver disease.

Main Methods:

• Systematic review of randomized clinical trials (RCTs) up to March 2012.
• Searched multiple databases including Cochrane, MEDLINE, EMBASE, and Chinese medical databases.
• Included RCTs comparing herbal medicines against placebo, no treatment, or other interventions.

Main Results:

• 77 RCTs with 6753 participants were included, testing 75 different herbal products.
• High risk of bias was noted in all trials, potentially overestimating benefits and underestimating harms.
• Herbal medicines showed statistically significant improvements in liver enzymes (AST, ALT, GGT) and imaging (ultrasound, CT) in many trials, with no significant difference in reported adverse effects.

Conclusions:

• Some herbal medicines demonstrated positive effects on surrogate markers like liver enzymes and imaging findings.
• No significant differences in adverse effects were found between herbal medicine and control groups.
• Findings are inconclusive due to high risk of bias and limited trials on individual herbal medicines, indicating a high risk of random errors.