Oxymatrine, an alkaloid extracted from the root of the traditional Chinese herb Sophora flavescens, has been studied for its potential therapeutic effects in hepatitis, particularly hepatitis B and C. Several preclinical studies have demonstrated that oxymatrine possesses antiviral, anti-inflammatory, and antifibrotic properties. In vitro and animal studies suggest that oxymatrine can inhibit hepatitis B virus (HBV) DNA replication and reduce expression of HBV antigens. Clinical trials, primarily conducted in China, have reported that oxymatrine may improve liver function tests and reduce serum HBV DNA levels in patients with chronic hepatitis B, sometimes in combination with standard therapies. Meta-analyses of randomized controlled trials indicate that oxymatrine-treated patients may experience higher rates of HBV antigen seroconversion and hepatitis B e antigen (HBeAg) loss compared to controls, though the quality of these studies varies and many are at risk of bias due to limited blinding and small sample sizes.

The proposed mechanisms include inhibition of viral replication, suppression of inflammatory cytokines, and protection against liver fibrosis. Despite promising findings, oxymatrine is not approved as a standard treatment for hepatitis outside of China, and further well-designed, large-scale clinical trials are needed to confirm its efficacy and safety. In summary, while there is scientific evidence supporting oxymatrine’s use in hepatitis, the overall quality of the evidence is moderate, justifying a rating of 3 out of 5.