Viral Hepatitis
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2005; 11(26): 4013-4017
Published online Jul 14, 2005. doi: 10.3748/wjg.v11.i26.4013
Herbal medicine Ninjinyoeito ameliorates ribavirin-induced anemia in chronic hepatitis C: A randomized controlled trial
Yoshiharu Motoo, Hisatsugu Mouri, Koushiro Ohtsubo, Yasushi Yamaguchi, Hiroyuki Watanabe, Norio Sawabu
Yoshiharu Motoo, Hisatsugu Mouri, Koushiro Ohtsubo, Yasushi Yamaguchi, Hiroyuki Watanabe, Norio Sawabu, Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
Author contributions: All authors contributed equally to the work.
Supported by the research grant from the Institute of Kampo Medicine, Japan
Correspondence to: Yoshiharu Motoo, MD, Department of Medical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan. motoo@kanazawa-med.ac.jp
Telephone: +81-76-218-8284 Fax: +81-76-218-8283
Received: October 27, 2004
Revised: December 15, 2004
Accepted: December 20, 2004
Published online: July 14, 2005
Abstract

AIM: Ribavirin (RBV) shows a strong antiviral effect on hepatitis C virus when used in combination with interferon. However, RBV-induced anemia is a major problem in this therapy. It would be of great clinical importance to ameliorate the anemia without reducing the RBV dose. We report here that, Ninjinyoeito (NYT), a herbal medicine can reduce the RBV-induced anemia.

METHODS: Twenty-three patients with chronic hepatitis C were treated with interferon alpha 2b plus RBV with (NYT group) or without (control group) NYT by a randomized selection. Eighteen patients completed the treatment schedule, and hemato-biochemical and virological effects were evaluated.

RESULTS: There was no significant difference in biochemical and virological responses between the two groups. However, anemia was significantly reduced in the NYT group compared with the control group. The maximal decrease of Hb in the NYT group (2.59 ± 1.10 g/dL) was significantly (P = 0.026) smaller than that in the control group (3.71 ± 0.97 g/dL). There was no significant difference in serum glutathione peroxidase activity, serum RBV concentration, and Th1/Th2 balance between the two groups. There was no specific adverse effect in NYT administration.

CONCLUSION: These results suggest that NYT could be used as a supportive remedy to reduce the RBV-induced anemia in the treatment of chronic hepatitis C.

Keywords: Chronic hepatitis C; Ribavirin; Interferon; Herbal medicine; Anemia