1.
Paeoniae Radix-containing herbal medicine for patients with restless legs syndrome: A systematic review and meta-analysis.
Kwon, S, Jin, C, Cho, SY, Park, SU, Jung, WS, Moon, SK, Park, JM, Ko, CN, Cho, KH
Complementary therapies in clinical practice. 2019;:329-341
Abstract
BACKGROUND AND PURPOSE Paeoniae Radix has been used for legs discomfort such as restless legs syndrome. The aim of this review is to evaluate efficacy and safety of Paeoniae Radix-containing herbal medicine on restless legs syndrome. METHODS Literature search was conducted on PubMed, Scopus, CENTRAL, CiNii, KTKP, OASIS, and CNKI for randomized controlled trials that evaluated the effects of Paeoniae Radix-containing herbal medicines on restless legs syndrome. RESULTS Twelve studies (n = 639) were included. The overall methodological quality was low. In the herbal group, meta-analysis indicated statistically significant improvements in the total effective rate, the restless legs syndrome rating scale and the Pittsburgh Sleep Quality Index as compared with those in the non-herbal group. Herbal treatments were found to be relatively safe. CONCLUSION Paeoniae Radix-containing herbal medicines might promote improvements in restless legs syndrome. However, we are unable to draw concrete conclusions owing to limitations of the included studies.
2.
Herbal medicines for urinary stone treatment. A systematic review.
Monti, E, Trinchieri, A, Magri, V, Cleves, A, Perletti, G
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2016;(1):38-46
Abstract
OBJECTIVE To analyze the clinical evidence on the efficacy of phytotherapy in the treatment of calculi in the urinary tract. METHODS To be eligible, full-length articles should include the results of randomized controlled trials enrolling patients affected by urolithiasis, reporting any comparison between an experimental herbal agent versus placebo or any active comparator, aimed at preventing the formation or facilitating the dissolution of calculi in any portion of the urinary tract. Fifteen databases were searched for relevant references. The primary outcomes investigated were (i) the reduction of stone size and/or number and (ii) the urinary excretion rates of calcium, urate, or oxalate. The secondary outcome of the review was the adverse effects (AE) of treatment. Risk of bias (ROB) and quality of the evidence were assessed according to Cochrane and GRADE guidelines. We performed a random-effect meta-analysis. RESULTS 541 articles were retrieved and 16 studies were finally confirmed as eligible. Multiple Cochrane ROB tool items were rated as having high risk of bias in each analyzed trial report. Pooled analysis of continuous data could be performed for three different comparisons: (i) phytotherapy versus citrate as single agent (ii) phytotherapy versus placebo, (iii) preparation of Didymocarpus pedicellata (DP)--combined with other herbal agents--versus placebo. Results showed that citrate is superior to phytotherapy in significantly decreasing both the size of urinary stones (mean difference: phytotherapy, 0.42 mm higher; 95% CI: 0.23 to 0.6; Z = 4.42, P < 0.0001; I2 = 30%) and the urinary excretion rate of urate (mean difference: 42.32 mg/24h higher, 95% CI: 19.44 to 65.19; Z = 3.63, P = 0.0003; I2 = 96%), assessed after 3 months on-therapy. No significant differences in the excretion rates of urinary calcium or oxalate were found. The DP preparation was superior to placebo in inducing total clearance (risk ratio: 6.19, 95% CI: 2.60 to 14.74; Z = 4.12, P < 0.0001; I2 = 0%) and size reduction (mean difference: DP preparation, 4.93 mm lower; 95% CI: -9.18 to -0.67; Z = 2.27, P = 0.02; I2 = 99%) of renal and ureteral stones after 3 months of therapy. No significant differences in the inter-arm variation of excretion rates of urinary calcium or urate were found as result of the pooled phytotherapy-placebo comparison. Herbal remedies were in general devoid of side effects and in few cases citrate appeared to induce GI disturbances in a higher fraction of patients. Most reports did not provide inferential data concerning AE, and meta-analysis was not feasible. CONCLUSIONS Citrate is more effective than phytotherapy in decreasing the size of existing calculi in the urinary tract and in decreasing the urinary excretion rate of uric acid. A preparation containing Didymocarpus pedicellata combined with other herbal agents induces stone size reduction and clearance significantly better than placebo. Mayor limitations in the applicability of these results are the low quality of the evidence and the multiple sources of bias assessed in the studies included in the present review.
3.
FOLFOX 4 combined with herbal medicine for advanced colorectal cancer: a systematic review.
Chen, M, May, BH, Zhou, IW, Xue, CC, Zhang, AL
Phytotherapy research : PTR. 2014;(7):976-91
Abstract
This systematic review evaluates the clinical evidence for the addition of herbal medicines (HMs) to FOLFOX 4 for advanced colorectal cancer (ACRC) in terms of tumor response rate (tRR), survival, quality of life and reduction in adverse events (AEs). Seven electronic databases were searched for randomized controlled trials (RCTs) of FOLFOX4 combined with HMs compared to FOLFOX4 alone. Outcome data for 13 randomized controlled trials were analysed using Review Manager 5.1. Risk of bias for objective outcomes including tumor response and survival was judged as low. Publication bias was not evident. Meta-analyses found the addition of HMs improved tRR (RR 1.25, 95%CI 1.06-1.47, I(2) = 0%), one year survival (RR 1.51, 95%CI 1.19-1.90, I(2) = 0%) and quality of life in terms of Karnofsky Performance Status (KPS) gained (RR 1.84, 95%CI 1.54-2.19, I(2) = 0%); alleviated grade 3 and 4 chemotherapy-related AEs for neutropenia (RR 0.33, 95%CI 0.18-0.60, I(2) = 0%), nausea and vomiting (RR 0.34, 95%CI 0.17-0.67, I(2) = 0%) and neurotoxicity (RR 0.39, 95%CI 0.15-1.00, I(2) = 0%), compared to FOLFOX4 alone. The most frequently used herbs were Astragalus membranaceus, Panax ginseng, Atractylodes macrocephala, Poria cocos, Coix lachryma-jobi and Sophora flavescens. In experimental studies, each of these herbs has shown actions that could have contributed to improved tumor response.