Qingkailing injection for the treatment of acute stroke： a systematic review and Meta-analysis

OBJECTIVE: To evaluate systematically the clinical efficacy and safety of Qingkailing(QKL) injection in the treatment of acute stroke.METHODS: Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database,Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software.RESULTS: A total of 13 studies with 1110participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk(RR) in the acute cerebral hemorrhage(ACH) sub-group was 1.17 [95%confidence interval(CI)(1.08, 1.26), P=0.0001]. In the acute cerebral infarction(ACI) sub-group, RR was 1.27 [95% CI(1.14, 1.42), P0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI(1.20,1.50),P0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference(MD)=﹣3.73, 95%CI(﹣4.48, ﹣2.98), P0.000 01],decreased neurological damage in ACI [MD=﹣5.60, 95% CI(﹣8.50, ﹣2.70), P=0.0002] and ACH[MD= ﹣ 4.08, 95% CI( ﹣ 8.00, ﹣ 0.16), P=0.04],promoted the recovery of awareness [RR=1.56, 95%CI(1.09, 2.21), P=0.01] and reduced the whole blood viscosity coefficient [MD=﹣ 0.75, 95% CI( ﹣1.47, ﹣0.03), P=0.04]. There were no adverse drug reactions reported in the included studies.CONCLUSION: Based on this systematic review,QKL combined with conventional therapy was effective compared with control treatment.However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.     

Traditional Chinese Herbal Medicine for Perimenopausal Depression of Chinese Women: A Meta‑analysis

Objective: The objective of this study is to evaluate the effectiveness and safety of traditional Chinese herbal medicine (TCHM) in treatment of perimenopausal depression (PD) in China. Methods: To identify randomized controlled trials, an electronic search has been conducted through databases as follows: PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese Biological Medicine Database, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, and WanFang Digital Periodicals Database. Methodological quality was evaluated by Cochrane Collaboration’s tool which is able to assess the risk of bias in Review Manager Software. What’s more, meta?analysis was performed by using Cochrane Collaboration’s RevMan 5.2 software, (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, and Denmark). Dichotomous data were analyzed by using relative risk (RR) and 95% confidence interval (CI). Continuous variables were analyzed using weighted mean differences (WMDs) and 95% CI. Subgroup analysis was performed by the type of medicine which was used in the experimental group. Results: This meta?analysis includes 11 randomized control trials with 818 patients. Compared to the control group (RR: 1.14, 95% CI: [1.03, 1.26], P = 0.009 and WMD: ?2.09, 95% CI: [ ?3.58, ?0.18]), the experimental group had a significant higher clinical efficacy rate and relatively lower Hamilton Depression Rating Scale (HAM?D) score. For clinical efficacy rate, the results varied depending on the detail treatment measures of the experimental group. In the experimental group with TCHM, no significant difference was observed (RR: 1.14, 95% CI: [0.97, 1.33]), while in the experimental group combined with western medicine, a significant difference in the clinical efficacy rate between the experimental group and control group showed up (RR: 1.15, 95% CI: [1.01, 1.32], P = 0.04). For the HAM?D score, subgroup analyses revealed that the pure TCHM therapy was not associated with significant HAM?D score reduction compared to the control group (WMD: ?2.48, 95% CI: [?6.00, 1.03], P = 0.17). However, in the experimental group where western medicine was added to, the HAM?D score decreased statistically compared to the control group (WMD: ?1.88, 95% CI: [?3.58, ?0.18], P = 0.03). There is no serious adverse event in both groups. Conclusions: Combination therapy of TCHM and western medicine is more effective in treating PD in terms of clinical efficacy rate. However, the results should be interpreted with caution due to the mediocre methodological quality of the included trials.     

Efficacy and safety of Traditional Chinese Medicine for the treatment of acquired immunodeficiency syndrome：a systematic review

OBJECTIVE： To systematically review the efficacy and safety ofTraditional Chinese Medicine（TCM） in- terventions, compared with control interventions（placebo or conventional Western medical thera- py）, in the treatment of acquired immunodeficien- cy syndrome（AIDS）. METHODS： Electronic databases including PubMed, the Cochrane Library, China National Knowledge Infrastructure（CNKI）, and Wanfang Da- ta were searched to identify relevant randomized controlled trials（RCTs） published as of May 2012. Studies were selected according to the specified in- clusion and exclusion criteria and then subjected to methodological quality assessment, data extrac- tion, and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.RESULTS： Twelve RCTs involving 881 patients with AIDS were included. Methodological quality assess- ment showed that two were high-quality, two were moderate-quality, and eight were low-quality. Me- ta-analysis showed that TCM interventions were as- sociated with significantly reduced plasma viral load compared with placebo [odds ratio OR=2.46, 95% confidence interval CI（1.02, 5.94）; P=0.04]. However, the reductions in plasma viral load signifi- cantly favored conventional Western medical thera- py alone over integrated traditional Chinese and Western medical therapy [OR=0.16, 95% CI（0.05, 0.55）; P=0.004]. Patients receiving TCM interven- tions had significantly higher CD4＋ T lymphocyte counts compared with those on placebo [OR=2.54, 95% CI（1.40, 4.60）; P=0.002]. In addition, TCM inter- ventions were significantly more likely to have im- proved clinical symptoms [OR=2.82, 95% CI（1.85, 4.31）; P0.00001]. TCM interventions conferred a similar risk of adverse events（AEs） compared with control interventions [OR=1.87, 95%CI（0.58, 6.01）; P=0.29]. CONCLUSION： Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and in- creasing CD4＋ T lymphocyte count in patients with AIDS. When compared with conventional Western medical therapy, TCM interventions were signifi- cantly less effective in reducing plasma viral load, although they were associated with a higher per- centage of patients with improved symptoms. Pa- tients receiving TCM interventions did not seem to be at an increased risk of AEs.     

Safety and efficacy of Danqipiantan capsule for treatment of stroke： a systematic review

OBJECTIVE： To evaluate the efficacy and safety of Danqipiantan capsule （DPC） for the treatment of stroke. METHODS： PubMed, China Science And Technolo- gy Journal Database, Wanfang Database, Chinese periodicals in the China National Knowledge Infra- structure, and the General Hospital of Tianjin Medi- cal University＇s Library were searched until July 2012. Randomized controlled trials （RCTs） and ob- servational studies that reported the use of DPC for treatment of stroke were selected. RESULTS： Eleven articles that included 12 RCTs, and 2 articles that included 3 observational studies were identified. A total of 2590 patients participat- ed in the studies. We found that there was a signifi-cant statistical difference between DPC treatment groups and the control groups in terms of the effec- tive rate [risk ratio （RR）, 1.14; 95% confidence inter- vals （CI）, 1.04, 1.25; P=0.01], FugI-Meyer Assessment Scale [weighted mean difference （WMD）, 9.77; 95% CI （4.84, 14.70）; P=0.00], Barthel Index [WMD=6.40; 95% CI （3.15, 9.65）], and mean flow velocity [WMD= 5.79; 95% CI （1.64, 9.94）]. There were no significant differences for The National Institutes of Health Stroke Scale [WMD=0.60; 95% CI （ - 1.09, 2.29）], vi- sual field defects [left visual field： WMD= - 203.10; 95% CI （ - 424.41, 18.21）; right visual field： WMD= - 172.60; 95% CI （ - 409.29, 64.09）] or the functional independence measure [WMD= - 7.90; 95% CI （ - 16.64, 0.84）]. Seven articles that included eight RCTs reported the safety of DPC treatment. Two ar- ticles that included three observational studies also reported beneficial effects for DPC. Because the Chinese studies were of poor methodological quali- ty, and most of the sample sizes were small, our analysis was likely affected by bias. CONCLUSION： DPC has a beneficial effect and is relatively safe when used for the treatment of stroke.     

Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke： a systematic review and meta-analy- sis

OBJECTIVE： To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke. METHODS： Randomized controlled trials （RCTs） testing ligustrazine in the treatment of acute isch- emic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medi- cal Journal Database, Chinese Biomedical Data- base, China National Knowledge Infrastructure Da- tabase, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Co- chrane Handbook 5.1, a risk of bias assessment toot. RevMan 5.1 was used for meta-analysis.RESULTS： Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR=0.42, 95% CI （0.18, 0.94）, P〈 0.05] or 3-years observation [RR=0.48, 95% C/（0.27, 0.83）, P〈0.05]. The ligustrazine group also showed higher survival rate [RR=1.67, 95% CI （1.02, 0.2.71）, P〈0.05] and significantly better effective rate [RR= 1.28, 95% CI（1.10, 1.50）, P〈0.05] than that of the control group at the end of 1 year visit. Only one tri- al conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor. CONCLUSION： The findings provided evidence that the combination of ligustrazine and conven- tional medication was medium- and long-term ben- eficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.     

Xuefuzhuyu decoction for hyperlipidemia： a systematic review and Meta-analysis of randomized clinical trails

OBJECTIVE：To evaluate the efficacy and safety of Xuefuzhuyu decoction for hyperlipidemia.METHODS：Randomized clinical trials on hyperlipidemia treated by Xuefuzhuyu decoction,either alone or with Western Medicine,were searched in electronic databases.Databases searched were：MEDLINE,Allied and Complementary Medicine Database,EMBASE,The Cochrane Library 2013（Issue4）,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,and Wanfang Database up to 2 May,2013.Study selection,data extraction,quality assessment,and data analysis were conducted according to the Cochranestandards.RESULTS：Six randomized clinical trials involving748 patients（373 patients in the treatment group,375 patients in the control group）were included in the analysis.The studies were of low methodological quality.Meta-analysis indicated that the effect of Xuefuzhuyu decoction on hyperlipidemia was better than that in the control group[n=748,OR=5.07,95%CI（3.40,7.58）,P〈0.01].Weighted mean differencesin total cholesterol,low-densitylipoprotein cholesterol,triglycerides,and high-density lipoprotein cholesterol were﹣0.79,﹣0.74,﹣0.44,0.16,respectively,and Meta-analysis revealed that the treatment group was better than the control group with 95%CI（﹣1.21,﹣0.36）,（﹣0.94,﹣0.55）,（﹣0.77,﹣0.11）,（0.04,0.27）,respectively（all P〈0.05）.Some adverse events in evaluated studies wererecorded.CONCLUSION：Xuefuzhuyu decoction may be effective for treating hyperlipidemia.The studies we analyzed were of low methodological quality,which indicates that the above findings should be considered cautiously.Therefore,more strictly designed large-scale randomized clinical trials are needed to evaluate the efficacy of Xuefuzhuyu decoction in hyperlipidemia.     

Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma：a Meta-analysis of randomized control trials

OBJECTIVE： To systematically evaluate the effectiveness and safety of heat-sensitive moxibustion（HSM）onasthma.METHODS： Large databases in China and overseas were searched by electronic and manual means to collect information on randomized controlled trials（RCTs）.Two evaluators independently extracted data and evaluated the quality of RCTs according to Cochrane Review Handbook v5.0. RevMan v5.0.20 was used for statisticalanalyses.RESULTS： Fourteen RCTs involving 637 patients were collected.Thirteen RCTs compared the effects of HSM and Western Medicine. After 3-month treatment and after 6-month follow-up, there was no significant difference in effective rate [relative risk（RR）=1.01, 95% CI（0.92, 1.12）, and 1.12,（0.93, 1.36）,respectively], in the asthma control test score of asthma symptoms [weighted mean difference（WMD）=﹣1.54, 95% CI（﹣3.54, 0.47）, and 1.41,（﹣0.48, 3.29）, respectively] and in the forced expiratory volumein 1 second（FEV1）and peak expiratory flow（PEF）. One RCT compared the effect of HSM with warm-suspended moxibustion. After 6-month follow-up, there was a significant difference in FEV1 and PEF [WMD=0.51, 95% CI（0.10, 0.92）, and 1.78,（1.06, 2.50）, respectively]. After 3-month treatment,there was no significant difference between the two groups. One RCT compared the effect of HSM with acupoint application. After 3-month treatment, there was no significant difference in the effectiverate[RR=0.68,95%CI（0.42,1.12）].CONCLUSION： HSM did not show superiority to conventional Western Medicine and acupoint application in terms of curative effects, and may be superior to warm-suspended moxibustion with regard to long-term curative effects. Because of low quality of the included RCTs, this conclusion must be bolstered with higher-quality RCTs.     

火针对比西药治疗痛风性关节炎血尿酸及关节功能影响Meta分析及试验序贯分析

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.     

Effect of Banxiaxiexin Tang on treatment of functional dyspepsia： a Meta-analysis of randomized controlled trials

OBJECTIVE： To evaluate the efficacy of Banxiaxiex- in Tang compared with Western Medicine in the treatment of functional dyspepsia （FD） through Meta-analysis. METHODS： Literature was searched in the following databases： MEDLINE, Excerpta Medica Database, Chinese Medical Current Contents, China Science and Technology Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Randomized controlled trials evaluating the efficacy of Banxiaxiexin Tang for the treatment of FD were selected according to certain standards including clear general situation of pa- tients, specific diagnostic criteria, definite clinical outcomes, etc. Articles were evaluated with quality assessment standards in the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was conducted with RevMan 5.0.23 software. RESULTS： Ten articles with a total of 972 patients were included. The comparison of efficacy between Banxiaxiexin Tang and Western Medicine showed a combined effect size [OR=2.75, 95% CI （1.86-4.07）] and combined effect of value ofZ=5.07 （P〈0.000 01 ）, suggesting a significant difference between the groups. CONCLUSION： Banxiaxiexin Tang was more effec- tive than Western Medicine in treating FD.     

Clinical Effect of Tripterygium Glycosides Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome Patients: A Systematic Review and Meta‑Analysis

The objective of this study is to evaluate the effectiveness and safety of Tripterygium glycosides combined with glucocorticoids for the treatment of refractory nephrotic syndrome (NS). Computer search of Chinese and English databases, including CNKI, VIP, Wan Fang Database, PubMed, Cochrane Library, Embase, and Sinomed, for randomized controlled trials (RCTs) of Tripterygium glycosides combined with glucocorticoids for refractory NS (RNS) was conducted. Meta?analysis was performed using RevMan5.3. Thirteen RCTs comprising 994 patients were included in the study. Tripterygium glycosides combined with glucocorticoids had a statistical significance on the effective rate (odds ratio [OR] =4.69, 95% confidence interval [CI] 3.29, 6.67, P < 0.00001), 24?h urine protein ( Weighted mean difference (MD) = ?0.57, 95% CI [?0.62, ?0.51], P < 0.00001), serum albumin (MD = 4.77,95% CI [4.30, 5.24], P < 0.00001), total serum protein (MD = 9.45, 95% CI [8.73, 10.17], P < 0.00001), urea nitrogen (MD = ?0.53, 95% CI [?0.90, ?0.17], P = 0.005), and serum creatinine (MD = ?8.45, 95% CI [?15.32, ?1.57], P = 0.02). There was no statisticalsignificance on adverse reactions(OR = 0.68, 95% CI [0.41, 1.12], P = 0.13). Tripterygium glycosides combined with glucocorticoids could improve clinical effective rate, reduce 24?h urine protein, improve serum albumin and total serum protein, and reduce urea nitrogen and serum creatinine levels in patients with RNS. However, the quality of the included literature is poor, and conclusion still needs further verification using larger samples and high?quality randomized, double?blind controlled trials.     

Traditional Chinese medicine for acute mountain sickness prevention:A systematic review and meta-analysis of randomized controlled trialsOA

Objective: To evaluate the efficacy of traditional Chinese medicine(TCM) for preventing acute mountain sickness(AMS).Methods: We included randomized controlled trials(RCTs) which evalueded the effect of TCM for preventing AMS, compared with a placebo, no treatment or acetazolamide. The literature was searched in 6major databases. RevMan 5.4 software was used for the meta-analysis. The relative risk for discrete variables and the mean difference for continuous variables with 95% confidence interv...     

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Treating Ulcerative Colitis by the Integration Method of Heat-Clearing, Damp-Excreting, Spleen-Strengthening, and Stasis-Removing of Traditional Chinese Medicine with Western Medicine

Objective:The objective ofthisstudywasto systematically evaluate the clinical efficacy ofthe integrationmethod of heat?clearing, dampness?excreting, spleen-strengthening, and stasis-removing from traditional Chinese medicine (TCM) combined with Western medicine for the treatment of ulcerative colitis (UC). Materials and Methods: The databases China National Knowledge Infrastructure, China Biology Medicine disc (CBMdisc), WANFANG, VIP, and PubMed were searched for randomized controlled trials investigating the integration of the TCM methods of clearing heat, draining dampness, invigorating the spleen, and removing stasis, combined with Western medicine to treat UC from January 2009 to March 2019. Two reviewers independently conducted literature searches, screenings, data extractions, and literature bias evaluations. A meta-analysis was conducted using RevMan 5.3 and Stata 13.0 software. Results: In total, 15 studies involving 1289 patients were included. The results of the meta-analysis showed that the total effective rate of treatment in the experimental groups was higher than that of the control groups(relative risk [RR] = 1.27, 95% confidence interval [CI]: 1.21, 1.35, Z = 8.74, P < 0.00001). In the subgroup analysis, the total effective rate of oral TCM combined with Western medicine was higher than that of the control groups (RR = 1.24, 95% CI: 1.15, 1.33, Z = 5.88, P < 0.00001). The total effective rate of oral TCM with enemas combined with Western medicine was higher than that of the control group (RR = 1.30, 95% CI: 1.12, 1.50, Z = 3.52, P = 0.0004). The comparison between Western medicine alone and oral TCM combined with enteroscopy and Western medicine showed that the effective rate of enteroscopy (RR = 1.18, 95% CI: 1.05, 1.33, Z = 2.86, P = 0.004) and the symptom scores before and after treatment all improved more in the combined treatment groupsthan in those of the Western medicine group alone, with statistically significant differences(RR = ?4.23, 95% CI: ?4.93, ?3.53, Z = 11.84, P < 0.00001). Conclusion: The integration of the TCM methods of heat clearing, dampness excreting, spleen strengthening, and stasis removing combined with Western medicine can significantly improve the cure rate of UC, and is an effective method to treat UC.     

Meta‑analysis of Clinical Efficacy of Traditional Chinese Medicine in the Treatment of Aplastic Anemia

Background: The “Diagnosis and Treatment Guidelines for Chinese Medicine Internal Common Diseases” issued by the Chinese Institute of traditional Chinese medicine (TCM) offers many methods for the treatment of aplastic anemia (AA). However, there is a lack of corresponding evidence. Objective: The study aimed to evaluate the clinical efficacy of TCM in the treatment of AA, and provide evidence for the development of guidelines for the diagnosis and treatment of AA using TCM. Methods: Data of randomized or semi?randomized control trials of AA treatments with TCM were retrieved, and the selected literature was scored using the Jadad scale. The data were extracted, and RevMan 5.2.6 software was used for the meta?analysis. Results: Two studies on the treatment of AA using Liuwei Dihuang pills combined with compound Zaofan pill were included. The results of the meta?analysis showed that there were no statistically significant differences in the efficacy between Liuwei Dihuang pills combined with compound Zaofan pill and androgen in the treatment of AA (P = 0.65). However, there were less adverse reactions, including liver damage and the hirsutism of women, with the former than the latter (P < 0.05). Other studies on the treatment of AA with TCM did not include reports from clinical trials. Conclusion: TCM had a certain curative effect when used to treat AA. However, the quality of the literature is generally low, and the sample size is small, which makes the validation of the results poor. Further high?quality studies are needed to provide high?level evidence.     

Xiaoke Decoction in treatment of type II diabetes: A Meta-analysis

Objective: To systematically evaluate the clinical effect of Xiaoke Decoction in the treatment of type 2 diabetes. Methods: Chinese databases such as CNKI, Wanfang, Weipu Chinese Biomedical Journal Database, and Chinese Medical Biological Literature Database, PubMed, Cochrane Library, Embase, and Web of Science were searched for english language literature from their inception until November 2019. A Meta-analysis was performed using RevMan 5.3 and Stata 12.0. Results: Thirty-eight studies were included in this study, with a total of 3757 patients. It was found that adding Xiaoke Decoction could improve total efficiency. The Xiaoke Decoction groups surpassed the western medicine groups regarding improvement in total efficiency (OR=3.49; 95% CI: 2.78–4.39, P < 0.00001). Adding Xiaoke Decoction could lower the fasting plasma glucose (FPG) level. The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in FPG levels (MD=-1.14; 95% CI: -1.36－-0.92, P < 0.00001). Adding Xiaoke Decoction could lower the 2h postprandial blood glucose (2hPG) level. The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in 2hPG (MD=-1.40; 95% CI: -1.61－-1.19, P < 0.00001). Adding Xiaoke Decoction could lower glycated hemoglobin (HbA1c). The Xiaoke Decoction groups surpassed the western medicine groups regarding reduction in HbA1c (MD=-0.77; 95% CI: -0.95－-0.58, P < 0.00001). It was found that adding Xiaoke Decoction could lower the traditional Chinese medicine (TCM) syndrome score. The TCM syndrome scores among patients in the Xiaoke Decoction group were lower than those among patients in the control group after treatment (MD=-4.90; 95% CI: -7.22－-2.57, P < 0.0001). At the same time, we conducted a subgroup and sensitivity analysis of age and intervention duration on the heterogeneity of total efficiency, FPG, 2hPG, HbAlc, and TCM syndrome score outcome indicators. For detecting publication bias, an egger test was conducted. Conclusion: Compared with western medicine alone, Xiaoke Decoction has more advantages for the treatment of type 2 diabetes with respect to total efficiency, FPG, 2hPG, HbAlc, and TCM syndrome score.     

Efficacy of Traditional Chinese Medicine in the Treatment of Rash Caused by Epidermal Growth Factor Receptor Inhibitors: A Frequency Statistics and Meta‑Analysis

Objective: The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine (TCM) in the treatment of rash caused by epidermal growth factor receptor inhibitors (EGFRIs). Materials and Methods: Foreign language database (such as PubMed, Web of Science, Cochrane Library, EMBASE) and Chinese language database (such as China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals [VIP], Wangfang, CBM disc) were searched for all trials of TCM in the treatment of rash caused by EGFRIs until January of 2019. We also looked through the references of relevant studies to supplement additional trials. The SPSS 25.0 was used for statistics of TCM with high frequency, and Review Manager 5.3 was used for meta-analysis. Results: A total of 22 studies were included in the study. We selected TCM whose frequency were >3.0%. They were Lonicera japonica（金银花）, Licorice Roots Northwest Origin（生甘草）, Cortex Dictamni（白鲜皮）, Radix Sophorae Flavescentis（苦参）, Schizonepeta（荆芥）, Saposhnikovia Divaricate（防风）. The meta?analysis revealed that the efficacy of TCM in treating EGFRIs?related rash was better than that of Western medicine or none. Conclusions: TCM could significantly relieve rash caused by EGFRIs, which is worth popularizing. Moreover, the mechanism deserves to be further explored.     

Effectiveness and safety of moxibustion in treatment of lumbar disc herniation: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness and safety of moxibustion therapy in the treatment of lumbar disc herniation(LDH).METHODS: Four Chinese databases and three English databases were searched from their inception to April 2018.Randomized controlled trials(RCTs)were included if moxibustion was used as the sole treatment or as a part of combination therapy with other treatments in patients with LDH.Two reviewers independently extracted the data and assessed the methodological quality using the Cochrane criteria for the risk of bias.The Meta-analysis was performed using Review Manager 5.3 software.RESULTS: In total, 16 RCTs including 1186 patients with LDH were analyzed.The Meta-analysis showed favorable effects of moxibustion in combination with massage therapy on the visual analog scale score compared with massage therapy alone[mean difference(MD) =-1.32, 95% confidence interval(CI)(-2.12,-0.51), P = 0.001].The subgroup Meta-analysis failed to show favorable effects of electro-acupuncture plus moxibustion on the efficacy rate compared with electro-acupuncture alone [relative risk(RR) = 1.06, 95% CI(0.98,1.14), P = 0.15].However, acupuncture or massage therapy plus moxibustion improved the efficacy rates compared with acupuncture or massage therapy alone [RR = 1.33, 95% CI(1.18, 1.49),P 0.000 01] [χ~2= 2.76, P = 0.25, I~2= 27%], [RR =1.15, 95% CI(1.06, 1.25), P = 0.001] [χ~2= 0.00, P =0.95, I~2= 0%].With respect to the Japanese Orthopaedic Association(JOA) scores, acupuncture or massage therapy in addition to moxibustion produced results different from those of acupuncture or massage therapy alone [MD = 5.58, 95% CI(4.15, 7.00), P 0.000 01] [χ~2= 0.58, P = 0.45, I~2=0%], [MD = 3.61, 95% CI(3.01, 4.21), P 0.000 01].There were no significant differences in the JOA score for subjective symptoms, objective symptoms, daily living ability, and other parameters.In six RCTs, no adverse reactions occurred during moxibustion.CONCLUSION: Whether moxibustion is an effective intervention for LDH is unclear because of the small sample size of qualified RCTs and the high risk of bias.More high-quality RCTs that overcome the methodological shortcomings of the existing evidence are needed.     

Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019

Background: Coronavirus disease 2019(COVID-19) has become a worldwide life-threatening pandemic.Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.Objective: To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.Search strategy: China National Knowledge Infrastructure, Wanfang Database, VIP Database, Pub Med,Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.Inclusion criteria:(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included.(2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment.(3) Research type: randomized controlled trials and retrospective study were included.Data extraction and analysis: Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio(OR) and 95% confidence interval(CI) were used as the effect value for count data, and mean difference(MD) and 95% CI were used as the effect value for measurement data.Results: Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction(OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction(OR = 3.39, 95% CI [1.85, 6.23],P < 0.0001), recovery from shortness of breath(OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue(OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate(OR = 2.51, 95% CI[1.73, 3.64], P < 0.00001), and shorter time to recovery from fever(MD = à1.00, 95% CI [à1.04, 0.96],P < 0.00001), and did not increase the adverse reaction rate(OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.Conclusion: The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind,controlled trials are still needed for verification.     

A comprehensive review of research progress in Chinese medicines for primary liver cancer treatment

Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of primary liver cancer.Clinical trials were conducted in recent years to evaluate the efficacy and safety of TCM.The mechanism of action of TCM in primary liver cancer treatment also received extensive attention.This study summarizes the common monomial Chinese herbal medicines and their components,formulae,and the proprietary Chinese medicines used to treat primary liver cancer.Common medicines include Chansu(Bufonis venenum),Kushen(Sophorae flavescentis radix),Renshen(Ginseng radix et rhizoma),and Jianghuang(Curcumae longae rhizoma).This study also reviewed the literature on liver cancer treatment using TCM.The results confirmed the safety and efficacy of TCM in liver cancer treatment.The possible mechanisms involved are also listed,including influencing the cell cycle,inducing cancer cell apoptosis and autophagy,inhibiting cancer cell angiogenesis and metastasis,regenerating the microenvironment and DNA methylation,and regulating the innate immune response.For primary liver cancer patients who often have a long disease course,Chinese herbal medicine often plays a role in protecting and conditioning the body.Research aimed at finding more traditional Chinese herbal medicines and their mechanisms of action should be promoted.This study aimed to provide a scientific reference for further research and the rational clinical application of TCM for primary liver cancer treatment.     

Chinese Herbal Medicine for the Treatment of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome‑Associated Diarrhea: A Protocol for the Systematic Review and Meta‑Analysis of Randomized Clinical Trials

Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome (AIDS) as a usual symptom in people with human immunodeficiency virus (HIV) infection. While it is usually not fatal, it can influence patients’ quality of life seriously. It has shown to be efficacious and improves people’simmune statusto a certain extent to treat HIV/AIDS?related diarrhea on the basis ofsyndrome differentiation and treatment or Chinese herbs plus conventional treatment. Therefore, it may have a good application potential. Here, we outline a protocol for the systematic review of this health?care intervention, with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine (TCM) for patients who suffer from HIV/AIDS?associated diarrhea. Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included, in spite of publication status or language. The primary outcomes include diarrhea frequency and fecal character. The databases we will search as follows: China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Wanfang Data, China National Knowledge Infrastructure, PubMed and the CENTRAL in Cochrane Library. Two authors will respectively conduct the screening of trials, data extraction, and use the Cochrane risk of bias tool to assess the methodological quality. We will analyze the data and perform a meta-analysis if possible. We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS?associated diarrhea.