Bojungikgi-tang for Chemotherapy-induced Leukopenia: A Systematic Review and Meta-Analysis.

Chemotherapy-induced leukopenia is a common side effect of cytotoxic anticancer drugs. It can deprive patients of treatment opportunities, resulting in the delay, reduction, or discontinuation of chemotherapy or other anticancer drug administration. Two researchers searched English, Chinese, Japanese, and Korean electronic databases, without limiting the time period and language, using search terms such as "Bojungikgi," "WBC," "leuko," and "neutrop." Among the human randomized controlled studies in which Bojungikgi-tang was administered to patients who underwent chemotherapy, studies reporting leukopenia-related outcomes were selected, and data extraction, bias risk assessment, and meta-analysis were performed on the selected papers. Ten studies were selected, and a systematic review with meta-analysis was conducted. Nine papers were published in China and the total number of participants was 715. As a result of administering Bojungikgi-tang to these patients, the number of patients with chemotherapy-induced leukopenia significantly decreased (OR: 0.41, 95% CI: 0.27-0.61, P = .0001, I2 = 35%). Further, white blood cell counts were compared with that of the control group, and it showed an effect on prevention (MD: 0.64, 95% CI: 0.46-0.83, P < .00001, I2 = 90%). A pronounced effect was observed, especially when administered after a diagnosis based on the pattern identification, such as Qi deficiency. (OR: 0.32, 95% CI: 0.18-0.58, P = .0002, I2 = 0%). However, all studies had a high risk of bias due to non-blinding, and most studies had a high or uncertain risk of bias in creating random assignment orders and concealing them. Bojungikgi-tang has an effect on the prevention and treatment of chemotherapy-induced leukopenia. The effect rate can be increased when administered after proper diagnosis, and the possibility of adverse reactions and side effects is lower than that of Granulocyte-Colony Stimulating Factor (G-CSF) injection. Bojungikgi-tang appears to be useful in the treatment and prevention of leukopenia caused by cytotoxic anticancer drugs. However, it is necessary to conduct high-quality clinical studies in the future, considering the possibility of local and language bias, heterogeneity of carcinoma and intervention, and the risk of bias.Registration: PROSPERO CRD4202341054.

Acupuncture for Regulating Blood Pressure of Stroke Patients: A Systematic Review and Meta-Analysis.

Background: Blood pressure (BP) after a stroke is affected by autonomic regulation, the Cushing reaction, and basal history of hypertensive, arteriosclerotic conditions. To prevent recurrent stroke attack and its complications, BP must be regulated to within the normal range through monitoring, rest, and medication. Previous studies have reported that acupuncture may be effective in lowering BP in patients with hypertension. Objectives: This study was aimed at evaluating the efficacy of acupuncture in regulating BP in stroke patients, including both cerebral infarction and hemorrhage. Methods: A review was conducted of articles published in English, Korean, Chinese, and Japanese across 16 electronic databases (Pubmed, EMBASE, Cochrane Central Resister of Controlled Trials, AMED, CINAHL, CNKI, Wanfang, VIP, CiNii, and seven Korean databases) up to April 2020. Only randomized controlled trials that evaluated the efficacy of acupuncture for stroke patients were included and meta-analyzed, and BP data and risk of bias were extracted by scanning the full texts. Data analysis was performed by using RevMan 5.3. Results: From the 16 electronic databases, 7623 relevant articles were identified, and 847 stroke patients of 10 trials met the inclusion criteria. Two trials reported that BP was lowered more in the group who had received acupuncture treatment than the group who were treated with conventional medication. Two trials reported that BP was lowered after auricular acupuncture treatment more than those observed in the group receiving conventional medical treatment. Six trials reported that BP in cerebral infarction patients was lower than in the control group. None of the trials reported any adverse events. Conclusions: It was concluded that acupuncture may be a suitable treatment option for regulating BP after stroke. However, the trials are not free from bias. Further reviews would yield positive results if well-designed trials are conducted.