Brief Report on Chinese Herbal Medicine Trial for Hepatitis C and a Chinese Herbal Formula

The John Hunter Hospital in Australia has been running a sponsored trial on the use of a chinese herbal formulation as a treatment for HCV.

A number of people have enquired about this and the following is a letter from Dr R Batey , Director of Garstoenterolgoy at the hospital. It is a guarded statement released as prior to a paper being presented last week (September 96) in Adelaide Australia.

A full copy of the paper may be obtained from the website "The Viral Staircase"

The following statement re: the trial was sent by Dr Batey.

Brief Report on Chinese Herbal Medicine Trial for Hepatitis C

The John Hunter hospital has now completed its trial of herbal medicine therapy for Hepatitis C. This was a placebo controlled trial of a tablet form of herbal extract for patients presenting with hepatitis C. There were 16 herbs in the tablet preparation and the proportions of the herbs used will not be made available until the results have been published in the scientific literature. Suffice it to say here, some of the herbs include Salvia, Paeonia and Ginseng root.

We took into the trial, patients who had not been treated with Interferon or patients who had relapsed following treament with Interferon. There were no other strict entry criteria apart from them having a definitive hepatitis C antibody and abnormal liver function test on at least 3 occasions.

Patients were treated with 5 tablets 3 times daily with either the active tablet or the placebo and a small number of patients who, at the end of six months of treatment on placebo, requested it, and they too received active tablets for a further 6 months. Our analyisis, therfore, includes all patients treated blind plus a small number who were treated, knowing that they were receiving the active tablet after their initial placebo treatment.

None of the patients had any severe adverse side-effects althought two patients withdrew from the trial because of side-effect symtoms, one of whom complained of palpitations which stopped on ceasing the tablets and one of whom had significant bowel symptomatology in the form of diarrhoea and bloating.

Overall, we found that compliance with the tablets was good.

Our results to date show show there were no effects of the medication on haematological parameters and that there was a fall in ALT in patients on active treatment. Six patients normalized their ALT during the treatment period but we have no evidence that any patient has been cured by the herbs.

At this stage of our analysis, it would appear that the medication has certainly done no harm and may well be offering some opportunity of minimising inflammation in the liver of patients with hepatitis C. We need to do more detailed analyisis or the results at this stage and I could certainly not recommend the present combination of herbs as the utltimate management for hepatitis C.

I look forward to publishing our completed results, once we have a full statistical analysis.

Thanks for your interest in the study

Yours Sincerely,

R.G. Batey

Director, GASTROENTEROLOGY

HepC BC

Chinese Herbal Formula

NOTE: Most of these herbals have some known anti-viral properties, but these are huge doses. Please research this and check with your Dr. and practitioner before trying this, as they may be harmful to some. Herbal doesn't mean non-toxic. Also, I believe 'cure' means the same thing as 'responder' with IFN, ie: there are normal lft's or pcr, but no decrease in disease progression. I have not seen one case or heard of one case of 'cure' but suspected long term remission has been achieved by some methods.

In a report in the Chinese Journal of Integrated Traditional and Western medicine (1994), a claimed rate of cure of 56%, with most other patients showing improvements, was obtained when the following formula was administered to treat hepatitis C:

astragalus: 30 grams

salvia: 30 grams

forsythia: 30 grams

red peony: 30 grams

ho-shou-wu: 15 grams

crataegus: 15 grams

moutan: 15 grams

gardenia: 15 grams

dandelion: 15 grams

bupleurum: 10 grams

The herbs are decocted and the amount indicated here is taken in two divided doses each day, for three months. The formula can be modified to address specific symptoms by adding additional herbs (e.g. for pain in the liver area, loss of appetite, or abdominal distention). As with treatments for hepatitis B, the formula contains herbs for treating damp-heat (forsythia, gardenia, dandelion, and bupleurum), blood stagnation (salvia, red peony, crataegus, moutan), and deficiency of qi and blood (astragalus and ho-shou-wu).

Due to the long course of therapy, one may wish to substitute dried extracts: a dose of three teaspoons (9grams), three times daily of this formulation should produce similar response [about 27 grams per day of dried extracts is roughly equivalent to a decoction of 160 grams of crude herbs, somewhat less than is recommended in the above clinical trial; the patient cost of this treatment is about $500 per three month course]. some patients may experience loose stool or diarrhea in response to this therapy (e.g. ho shou wu, gardenia, and dandelion can act as laxatives), thus one may need to adjust the formulation somewhat if this reaction occurs andpersists. It is not known if good results can be obtained by substituting powdered herbs for the extracts. If one wished to substitute tablets (which are comprised mainly of powdered crude herbs), Salvia Shgou Wu contains the salvia (extract), astragalus, crataegus, ho-shou-wu and red peony, while Nuphar 14 contains the moutan, bupleurum, and gardenia, as well as additional salvia, and Red Peony Tablets contains the dandelion and forsythia, as well as some additional red peony (extract). The use of these tablets will result in less relative dosage of the herbs than in the decoction formula, but there are additional herbs that would be expected to support thier actions. One might consume three tablets of each formula each time, three times daily [total: 27 tablets per day; patient cost is about $300 per three month course]. Using the tablets, one would expect to need a somewhat longer therapy than the higher dose decoctions or granules.

The dose of one or more of the formulas could be increased (e.g. to four tablets each time), if desired.

Until clinical work with hepC and Chinese herbs is carried out in the United States with available materials that are in a form suitable for administration, it may be difficult to convince medical practitioners and patients to try this method. Because the herbs are non-toxic, some patients may wish to utilize this therapy in place of, or in addition to, treatment by interferon. It is reasonable to begin collecting information from such patients to provide case histories in an effort to eventually develop a clinical trial.

HepC BC