ABSTRACT
BACKGROUND: In East Asia, numerous reports describe the utilization of traditional Chinese herbal decoctions to treat gout. However, the reported clinical effects vary. OBJECTIVES: In this study, we reviewed and analyzed a large number of randomized controlled clinical trials to systematically assess the clinical efficacy and adverse reactions of Chinese herbal decoctions for treating gout. METHODS: We performed a comprehensive search of databases, such as PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database, et al. In addition, we manually searched the relevant meeting information in the library of the Third Military Medical University. RESULTS: Finally, 17 randomized controlled trials with a sample size of 1,402 cases met the criteria and were included in the study. The results of the meta-analysis showed that when gout had progressed to the stage of acute arthritis, there was no significant difference in clinical efficacy between Chinese herbal decoctions and traditional Western medicine, as indicated based on the following parameters: serum uric acid (standardized mean difference (SMD):0.35, 95% confidence interval (CI): 0.03 to 0.67), C reactive protein (SMD: 0.25, 95% CI: -0.18 to 0.69), erythrocyte sedimentation rate (SMD: 0.21, 95% CI: -0.02 to 0.45) and overall clinical response (relative risk (RR): 1.05, 95% CI: 1.01 to 1.10). However, the Chinese herbal decoction was significantly better than traditional Western medicine in controlling adverse drug reactions (RR: 0.06, 95% CI: 0.03 to 0.13). CONCLUSIONS: Through a systematic review of the clinical efficacy and safety of Chinese herbal decoctions and traditional Western medicine for the treatment of gout, we found that Chinese herbal decoction and traditional Western medicine led to similar clinical efficacy, but the Chinese herbal decoctions were superior to Western medicine in terms of controlling adverse drug reactions.
Subject(s)
Drugs, Chinese Herbal/administration & dosage , Gout Suppressants/adverse effects , Gout/drug therapy , Medicine, Chinese Traditional/methods , Phytotherapy/methods , Adult , Aged , Databases, Bibliographic , Drugs, Chinese Herbal/adverse effects , Gout/blood , Gout/pathology , Gout Suppressants/administration & dosage , Humans , Middle Aged , Randomized Controlled Trials as Topic , Severity of Illness Index , Treatment Outcome , Uric Acid/bloodABSTRACT
Migraine is a chronic disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous system symptoms. It is a common disease and incidence has increased yearly. Chinese medical treatments are popularly used in Asian countries, although they vary in effectiveness. In this study, we applied a systematic review method and combined meta-regression with meta-subgroup analysis to explore heterogeneity of clinical therapeutic efficacy upon meta-analysis of randomized controlled Chinese medical treatments for migraine. We also aimed to provide a more effective Chinese prescription and to advance the knowledge in evaluating validity of preventing or alleviating migraine symptoms with Chinese medical treatments. Twenty randomized migraine control trails, including 2246 patients, were collected from online databases: PubMed, MEDLINE, EMBASE, CENTRAL of Cochrane Library, CBM, integrated version of CMCI/CMCC, TCM online, CDFD, and CMFD from January 2000 to December 2011. The results showed that the major factors influencing therapeutic efficacy were either the specific medicine form of or its prescription type (p < 0.05). The use of TCM decoctions, especially those that condition the viscera, treat from the perspective of "wind", and target the Shaoyang gateway, could be the best migraine treatment in clinical TCM practice (RR > 1.30).