Chinese herbal medicine for the treatment of chronic fatigue syndrome: A systematic review and meta-analysis.

Objectives: This meta-analysis aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) in treating chronic fatigue syndrome (CFS). Methods: Nine electronic databases were searched from inception to May 2022. Two reviewers screened studies, extracted the data, and assessed the risk of bias independently. The meta-analysis was performed using the Stata 12.0 software. Results: Eighty-four RCTs that explored the efficacy of 69 kinds of Chinese herbal formulas with various dosage forms (decoction, granule, oral liquid, pill, ointment, capsule, and herbal porridge), involving 6,944 participants were identified. This meta-analysis showed that the application of CHM for CFS can decrease Fatigue Scale scores (WMD: -1.77; 95%CI: -1.96 to -1.57; p < 0.001), Fatigue Assessment Instrument scores (WMD: -15.75; 95%CI: -26.89 to -4.61; p < 0.01), Self-Rating Scale of mental state scores (WMD: -9.72; 95%CI:-12.26 to -7.18; p < 0.001), Self-Rating Anxiety Scale scores (WMD: -7.07; 95%CI: -9.96 to -4.19; p < 0.001), Self-Rating Depression Scale scores (WMD: -5.45; 95%CI: -6.82 to -4.08; p < 0.001), and clinical symptom scores (WMD: -5.37; 95%CI: -6.13 to -4.60; p < 0.001) and improve IGA (WMD: 0.30; 95%CI: 0.20-0.41; p < 0.001), IGG (WMD: 1.74; 95%CI: 0.87-2.62; p < 0.001), IGM (WMD: 0.21; 95%CI: 0.14-0.29; p < 0.001), and the effective rate (RR = 1.41; 95%CI: 1.33-1.49; p < 0.001). However, natural killer cell levels did not change significantly. The included studies did not report any serious adverse events. In addition, the methodology quality of the included RCTs was generally not high. Conclusion: Our study showed that CHM seems to be effective and safe in the treatment of CFS. However, given the poor quality of reports from these studies, the results should be interpreted cautiously. More international multi-centered, double-blinded, well-designed, randomized controlled trials are needed in future research. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319680], identifier [CRD42022319680].

Randomised clinical trial: Efficacy and safety of Qing-Chang-Hua-Shi granules in a multicenter, randomized, and double-blind clinical trial of patients with moderately active ulcerative colitis.

Qing-Chang-Hua-Shi (QCHS) is a Chinese herbal formula, which is composed of 11 herbs. Studies have also shown that QCHS granules can alleviate colitis in animal models by preventing inflammatory responses and suppressing apoptosis through the MEK/ERK signaling pathway. To determine the efficacy and safety of QCHS granules in patients with moderately active UC. We performed a multicenter, randomized, placebo-controlled, double-blind study of patients with moderately active UC who did not respond to 4 weeks of mesalazine therapy at the maximum dose. Patients were randomly assigned to groups and administered QCHS granules (125 g/day, n = 59) or an identical placebo, which was similar to the QCHS granules in color and taste (125 g/day, n = 60), with continued 5-ASA 4 g/d therapy for 12 weeks. The primary outcome was the rate of clinical response and clinical remission at week 12. The secondary outcomes were health-related quality of life, endoscopic response rate, and mucosal healing rate. Any changes in mucus/bloody stool and diarrhea were recorded. Out of the 119 enrolled patients at 10 different centers in China, 102 patients completed the trial. Clinical remission and clinical response were seen in 31.48% and 92.59% of QCHS-treated patients, and 12.50% and 72.92% of placebo-treated patients, respectively. There was a significant difference between the two treatment groups. More patients receiving QCHS granules vs. placebo achieved remission of mucus/bloody stool (70.37% vs. 47.92%, P = 0.0361). Adverse event rates were similar (QCHS granules 38.33%; placebo 25.42%). In conclusion, QCHS granules were superior to the placebo in introducing clinical remission and mucosal healing, as well as in relieving mucus/blood stool in patients with moderately active and 5-ASA-refractory UC.

[Effects of xinwei granule on STAT3 and p-STAT3 signal pathway in rats with precancerous lesion of gastric cancer].

OBJECTIVE: To study the effects of Xinwei Granule (XG) on signal transducers and activators of transcription (STATs) and tyrosine phosphorylation of signal transducers and activators of transcription 3 (p-STAT3) signal pathway in rats with precancerous lesions of gastric carcinoma (PLGC). METHODS: Totally 96 Wistar rats were randomly divided into the blank control group (abbreviated as the blank group, n = 16) and the model group (n = 80). The PLGC rat model was established by complex pathogenic factors, in which methyl-N'-nitro-N-nitrosoguanidine (MNNG) was mainly used. After successful modeling, 75 rats randomly selected were divided into the model group, the Vitacoenzyme group, the low dose XG group, the middle dose XG group, and the high dose XG group, 15 in each group. Fifteen rats were randomly selected from the blank group, and fed with ordinary standard forage and administered with 10 mL/kg 0.9% sodium chloride by gastrogavage. XG at 1.254 g/kg, 2.508 g/kg, and 5.016 g/kg was respectively administered to rats in the three XG groups by gastrogavage. Rats in the model group were administered with 10 mL/kg 0.9% sodium chloride by gastrogavage. Vitacoenzyme was administered to rats in the Vitacoenzyme group. Vitacoenzyme Tablet was pulverized to prepare 0.1 g/mL 0.9% sodium chloride suspension and administered by gastrogavage. All the medication was performed once daily and continued for 12 weeks. The general conditions (including rats' fur, activity, food and water, excrement, body weight, and survival), the pathological changes in the gastric mucosa, as well as the expressions of STAT3 and p-STAT3 were observed. RESULTS: Compared with the blank group,the expression levels of STAT3 and p-STAT3 increased in the model group (P < 0.05). The general conditions, such as the activity, food and water intake, and body weight were improved in each XG group. Compared with the model group, the expressions of STAT3 and p-STAT3 decreased in each XG group with statistical difference (P < 0.05). The occurrence of PLGC, i.e., intestinal metaplasia (IM) and dysplasia (DYS) significantly decreased with statistical difference (P < 0.05). Compared with the Vitacoenzyme group, the occurrence of IM and DYS significantly decreased in the middle and high dose XG groups, showing statistical difference (P < 0.05). The expressions of STAT3 and p-STAT3 decreased more significantly in the middle and high dose XG groups, showing statistical difference (P < 0.05). CONCLUSIONS: XG could obviously improve the pathological conditions of gastric mucosa in rats with PLGC. It could fight against the progress of PLGC by down-regulating the expressions of STAT3 mRNA and p-STAT3.