OTHER CHINESE HERB THERAPIES FOR HEPATITIS C

Chinese medical treatment is often based on the model of treating hepatitis B.

Even though the viruses are quite different, the fact that the diseases are caused by viruses that ultimately damage the liver remains the same, and the herb therapies are thus similar in nature---at least until further diagnostic information is available. Hepatitis B is treated by herbs for the traditional categories of pathological disturbance labeled as damp-heat, qi and blood stasis, and for qi, blood, and yin deficiency.

Herbs are also given according to specific manifestation of the disease and underlying constitutional factors. Chinese tonic herbs have been shown to enhance interferon production and thus may substitute for interferon therapy (six months of alpha interferon injections is the standard procedure). Use of exogenous alpha interferon is often unsuccessful and, sometimes, there is a rebound of hepatitis C viremia after apparently successful treatment with this drug.

Herb therapy provides its effects through more mechanisms of antiviral action than simply increasing interferon, and it can be pursued for a longer time, due to absence of substantial side-effects. Cures for hepatitis B have been repeatedly reported in the Chinese literature and are accomplished by administering non-toxic herbs and vitamins.

ITM is currently involved in evaluating a formulation for treatment of hepatitis B in China.

A related protocol, being used in the U.S., is to consume 9 tablets of the Seven Forests Eclipta Tablets (or 4 of the larger tablets of White Tiger Baicalcumin) and 1 tablet of the White Tiger Quercenol each time, three times daily for 12 weeks; favorable responses for hepatitis B have been informally reported to ITM from both the American cases and the initial Chinese research (with 40 patients).

Other studies reported in the Chinese medical literature include these:

Chinese Journal of Integrated Traditional and Western Medicine for Liver Diseases 1994 4(1): 44-45.

The details of the treatment were not specified. Patients were given different formulas according to presentation of constitution and symptoms; typical herbs used included smilax, scute, dictamnus, salvia, epimedium, loranthus, and lycium fruit. Inosine and vitamins were also given orally. It was calimed that 20 of the 33 patients (60.6%) so-treated were cured.

Chinese Journal of Integrated Traditional and Western Medicine 1995 (15(4): 198-201).

The patients selected for treatment were suffering from aplastic anemia and had probably become infected by hepatitis C as the result of blood transfusions. The patients were treated according to differential diagnosis, with high-dosage herb combinations. As an example, for patients with symptoms such as pallor, lassitude, anorexia, nausea, abdominal fullness, and thin stools, the prescription included:

25 grams pseudostellaria,

25 grams astragalus,

10 grams citrus, 10 grams tang-kuei,

12 grams cardamon,

20 grams peony,

20 grams bupleurum,

25 grams polygonatum,

20 grams coix,

20 grams plantago seed.

Patients also received intravenous vitamins and other nutrient factors.

Among 21 patients with hepatitis C, 17 were reportedly improved by the treatment, but only 3 were said to be cured.

Chinese Journal of Integrated Traditional and Western Medicine 1995 (15(6): 371).

Patients who had a history of blood transfusion and who tested positive for hepatitis C were divided into two groups; the control group received alpha-interferon and the herb group received herbal decoctions (depending on presenting symptoms and signs). As an example, for those classified as presenting liver qi stagnation and spleen deficiency, the formula was:

15 grams bupleurum,

12 grams hoelen,

10 grams atractylodes,

10 grams codonopsis,

10 grams peony,

6 grams chih-ko,

6 grams gardenia,

6 grams curcuma,

5 grams licorice.

For those classified as having accumulated heat toxin, the formula was:

15 grams lithospermum,

15 grams hu-chang,

15 grams forsythia,

12 grams scrophularia,

12 grams gardenia,

10 grams raw rehmannia,

10 grams moutan,

10 grams red epony,

6 grams curcuma,

5 grams licorice.

Other herbs might be added to these base formulas for treating specific symptoms.

Among the 32 persons treated by herbs, 4 were cured and 25 others were improved. With the alpha interferon, 2 of 32 paitents were cured, and 19 others were improved.

HepC BC

CHINESE HERBAL MEDICINE IMPLICATED IN LIVER FAILURE

Another case of acute hepatitis and liver failure linked to consumption of the Chinese herbal medication, ma-huang, has been reported by clinicians at the University of California at San Francisco (UCSF).

A 63-year-old Chinese woman developed fulminant liver failure requiring transplantation following the use of the mixture of 12 plant species. She was one of three people who presented to UCSF with acute hepatitis associated with Chinese herbal medications during a two-month period.

"The patient transplanted did not have a history of chronic liver disease nor alcohol consumption," Eric M. Yoshida and colleagues from UCSF wrote ("Chinese Herbal Medicine, Fulminant Hepatitis, and Liver Transplantation," American Journal of Gastroenterology, December 1996;91(12):1647-1648). "Viral studies, however, revealed seropositivity for hepatitis B surface antigen and hepatitis B core antibody (HBcAb) IgG; serum hepatitis B virus DNA was 511."

Lake et al. noted that serology for HBcAb IgM was negative. Serologies for hepatitis C, hepatitis A IgM, and hepatitis D, likewise, were negative.

When first admitted to the hospital, the woman was notably jaundiced and encephalopathic with no stigmata of chronic liver disease, and initial clinical impression was of fulminant viral hepatitis. A history was taken and the woman acknowledged taking the Chinese herbal medication ma-huang for a one-week period four weeks before admission.

Coagulopathy, jaundice, and encephalopathy progressively worsened requiring endotracheal intubation. Liver transplantation was performed and gross inspection of the explanted liver revealed marked collapse and very small regenerative nodules. Histologic examination of the explant revealed massive centrilobular necrosis with periportal bile ductular proliferation and inflammation.

The UCSF cases are not the first to implicate ma-huang in the development of acute hepatitis and liver failure. In 1996, Nadir et al. also reported such a case (Am J Gastroenterol 1996;91:1436-1438).

"Our transplanted patient would have had a fatal outcome, which is infrequently reported, had an allograft not been available," Yoshida et al. wrote.

"The recent experience at UCSF demonstrates that liver injury from traditional Chinese medicines does not always resolve, and urgent transplantation may be required. It remains to be seen whether or not the recent cluster of cases at UCSF represents a trend that grows with the increasing use of 'alternative' medicines."

The corresponding author for this study is John R. Lake, Department of Medicine and Pathology, University of California at San Francisco..

HepC BC