scholarly journals Clinical Effects and Safety of Zhi Sou San for Cough: A Meta-Analysis of Randomized Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Ningchang Cheng ◽  
Jia Zhu ◽  
Pinpin Ding

Introduction. Zhi Sou San (ZSS), a traditional Chinese prescription, has been widely applied in treating cough. The purpose of this meta-analysis was to evaluate the effectiveness and safety of ZSS for cough. Methods. We searched relevant articles up to 5 March 2017 in seven electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed, Chinese National Knowledge Infrastructure (CNKI), Cqvip Database (VIP), China Biology Medicine disc (CBM), and Wanfang Data. Randomized controlled trials (RCTs) were eligible, regardless of blinding. The primary outcome was the total effective rate. Results. Forty-six RCTs with a total of 4007 participants were identified. Compared with western medicine, ZSS significantly improved the total effective rate (OR: 4.45; 95% CI: 3.62–5.47) and the pulmonary function in terms of FEV1 (OR: 0.35; 95% CI: 0.24–0.46) and decreased the adverse reactions (OR: 0.05; 95% CI: 0.02–0.01) and the recurrence rate (OR: 0.30; 95% CI: 0.16–0.57). However, there was no significant improvement in the cough symptom score comparing ZSS with western medicine. Conclusions. This meta-analysis shows that ZSS has significant additional benefits and relative safety in treating cough. However, more rigorously designed investigations and studies, with large sample sizes, are needed because of the methodological flaws and low quality of the included trials in this meta-analysis.

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Jiao Xiao ◽  
Yunfeng Yang ◽  
Yuanrong Zhu ◽  
Yan Qin ◽  
Yifan Li ◽  
...  

Objectives. Traditional Chinese medicine (TCM) therapy for nonerosive reflux disease (NERD) remains controversial. The aim of this study was to evaluate the efficacy and safety of TCM regimens in NERD treatment. Methods. Randomized controlled trials (RCTs) of TCM treatment for NERD through September 31, 2017, were systematically identified in PubMed, Wanfang Data, CNKI, VIP, CBM, Ovid, Web of Science, and Cochrane Library databases. Quality assessment was performed by employing the Cochrane Risk of Bias assessment tool. Results. A total of 725 and 719 patients in 14 RCTs were randomly divided into TCM alone and conventional Western medicine groups, respectively. The clinical total effective rate of the TCM group was markedly higher than that of the single proton pump inhibitors (PPIs) or Prokinetics therapy group (RR = 1.19, 95% CI = 1.07–1.31, and P = 0.0008), while it was comparable to that of the combination of PPIs and Prokinetics therapy group (RR = 1.14, 95% CI = 1.00–1.29, and P = 0.05). Compared with Western medicine group, the TCM group showed improved symptom relief through a reduced RDQ score (SMD = −0.91; 95% CI = −1.68–−0.15; and P = 0.02). Additionally, TCM clearly decreased the recurrence rate (RR = 0.38, 95% CI = 0.28–0.52, and P < 0.00001). Adverse events, such as constipation, sickness, fever, abdominal distension, and stomach noise, were slight for both the TCM and Western medicine groups and disappeared after the easement of pharmacological intervention; in particular, TCM possessed fewer side effects. Conclusion. Compared with PPIs or Prokinetics therapy alone, TCM single therapy can better improve the clinical total effective rate and symptom relief and decrease the recurrence rate and adverse events in the treatment of NERD. Our results suggest that TCM will be a promising alternative therapy for NERD patients in the future.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Zhao ◽  
Chuantao Peng ◽  
Hafiz Arbab Sakandar ◽  
Lai-Yu Kwok ◽  
Wenyi Zhang

Lactobacillus (L.) plantarum strains, belong to lactic acid bacteria group, are considered indispensable probiotics. Here, we performed meta-analysis to evaluate the regulatory effects of L. plantarum on the immunity during clinical trials. This meta-analysis was conducted by searching across four most common literature databases, namely, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed. Clinical trial articles that met the inclusion and exclusion criteria were analyzed by Review Manager (version 5.3). p-value &lt; 0.05 of the total effect was considered statistically significant. Finally, total of 677 references were retrieved, among which six references and 18 randomized controlled trials were included in the meta-analysis. The mean differences observed at 95% confidence interval: interleukin (IL)-4, −0.48 pg/mL (−0.79 to −0.17; p &lt; 0.05); IL-10, 9.88 pg/mL (6.52 to 13.2; p &lt; 0.05); tumor necrosis factor (TNF)-α, −2.34 pg/mL (−3.5 to −1.19; p &lt; 0.05); interferon (IFN)-γ, −0.99 pg/mL (−1.56 to −0.41; p &lt; 0.05). Therefore, meta-analysis results suggested that L. plantarum could promote host immunity by regulating pro-inflammatory and anti-inflammatory cytokines.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yuanyuan Yue ◽  
Meng Gao ◽  
Yanru Deng ◽  
Jiemin Shao ◽  
Yingguang Sun

Background. Modified Yunu-Jian (mYJ), a Chinese medicine (CM) formula, is thought to clear heat and nourish yin. Clinically, it is often used to treat oral inflammation. However, its efficacy remains controversial. Methods. The study aims to evaluate the efficacy and safety of mYJ for treating patients with periodontitis. We searched electronic databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang database, VIP database, and CBM) from inception to December 2020. Only randomized controlled trials investigating modified Yunu-Jian, with or without other medications, against controlled intervention in the treatment of patients diagnosed with periodontitis were included. Both Review Manager 5.3 and Stata 15.0 software were used to analyze the data. The Cochrane Collaborations risk of bias tool was used to assess the quality of the methods. Results. Thirteen clinical trials, involving 1179 participants, were included in our investigation. The results showed that the combination of mYJ with western medicine improved the total effective rate compared with western medicine alone (RR = 1.17, 95% CI (1.12, 1.23), P  < 0.00001). The sensitivity analysis and Harbord’s test ( P  = 0.255) both showed that the results were statistically robust. Moreover, the periodontal indexes (GI, SBI, PLI, and PD; P  < 0.00001) of patients with periodontitis were also significantly improved after receiving the combined therapy. No serious adverse reactions were observed in the experimental groups. Conclusions. Evidence from the meta-analysis suggested that mYJ appeared to be effective and relatively safe for treating periodontitis. Because of the low quality of the methods used in the included RCTs, further studies with larger sample sizes and well-designed models are required to confirm our findings.


2020 ◽  
Author(s):  
Ping Li ◽  
Sheng-Wen Wu ◽  
Dong-Fang Ge ◽  
Zai-Rong Tang ◽  
Cong-Chao Ma ◽  
...  

Abstract Background: Restrictive fluid therapy is essential to enhanced recovery after surgery. A meta-analysis was conducted to explore the safety of restrictive fluid therapy for major abdominal surgery and compare it with liberal fluid therapy. Methodology : We searched MEDLINE, the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs), the WHO International Clinical Trials Registry Platform, and EMBASE in which restrictive and liberal fluid therapies were compared. Data on complications, anastomotic leaks, and wound infections were extracted. Results: Eleven RCTs comparing the two therapies were included. Compared with liberal fluid therapy, restrictive fluid therapy lowered the risk of complications and cardiopulmonary dysfunction and had similar rates of mortality, anastomotic leak, pneumonia and would infection. But increased kidney injury was also observed in restrictive fluid therapy. Conclusion: Restrictive fluid therapy is safe but may have potential dangers, so caution is warranted in its application.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Jinke Huang ◽  
Yao Shi ◽  
Xiaohui Qin ◽  
Min Shen ◽  
Manli Wu ◽  
...  

Objectives. Electroacupuncture (EA), an extension of acupuncture, which is based on traditional acupuncture combined with modern electrotherapy, is commonly used for poststroke dysphagia (PSD) in clinical treatment and research. However, there is still a lack of sufficient evidence to recommend the routine use of EA for PSD. The aim of this study was to assess the efficacy and safety of EA in the treatment of PSD. Methods. Randomized controlled trials (RCTs) evaluating the effects of EA on PSD were identified through a comprehensive literature search of the PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Database, and VIP databases from their inception to July 2020. The quality assessment of the included trials was performed based on the guidance of the Cochrane Reviewers’ Handbook, and meta-analysis (MA) was performed by using the RevMan 5.3 software. Results. Sixteen trials were identified, and these included 1,216 patients with PSD. The results demonstrated that EA in combination with swallowing rehabilitation training (SRT) was significantly superior to SRT alone with regard to effective rate (OR 5.40, 95% CI [3.78, 7.72], P < 0.00001 , water swallow test (WST) (MD −0.78, 95% CI [−1.07, −0.50], P < 0.00001 ), the video fluoroscopic swallowing study (VFSS) (MD 1.47, 95% CI [1.11, 1.84], P < 0.00001 ), the Ichiro Fujishima Rating Scale (IFRS) (MD 1.94, 95% CI [1.67, 2.22], P < 0.00001 ), and the incidence of aspiration pneumonia (IAP) (OR 0.20, 95% CI [0.06, 0.61], P = 0.005 ). Conclusions. The results showed that EA was better than the control treatment in terms of the effective rate, WST, VFSS, IFRS, and IAP of dysphagia after stroke. Strict evaluation standards and high-quality RCT designs are necessary for further exploration.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yue Wang ◽  
Ming Li ◽  
An-Sheng Zha

The objective of the meta-analysis was to evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of Crohn’s disease (CD). Pubmed, Embase, Medline, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature, Wanfang Database, and Cochrane Central Register of Controlled Trials were searched (through October 2018). The quality of randomized clinical trials meeting the inclusion criteria was assessed and the data were extracted according to the Cochrane Review Handbook v5.0 by two evaluators. A meta-analysis was performed using the software Stata 12.0. Twelve randomized controlled trials (RCTs) were selected. The studies were of low methodological quality. The meta-analysis indicated that treatment with TCM and Western Medicine (WM) was significantly superior compared to treatment with WM alone with regard to total effective rate, remission maintenance rate, reduction of C-reactive protein (CRP), reduction of erythrocyte sedimentation rate (ESR), clinical score reduction, and reduction of adverse events. Mucosal healing was improved in both the TCM-WM and WM groups; however, there were no significant differences between the two groups. There was a certain publication bias in the studies with regard to efficiency, adverse reactions, mucosal healing, and recurrence rate; however, there was no obvious publication bias with regard to other indicators. TCM, as an adjuvant therapy with WM, shows advantages in inducing remission in CD. The current evidence suggests that TCM-WM treatment might be more efficient in terms of total effective rate, remission maintenance rate, CRP reduction, ESR reduction, clinical score reduction, and reduction of adverse events than treatment with WM alone. Because of the low quality of the included RCTs, high quality confirmatory evidence is needed to assess the clinical value of TCM in the treatment of CD.


Gut ◽  
2019 ◽  
Vol 69 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Christopher J Black ◽  
Nicholas E Burr ◽  
Michael Camilleri ◽  
David L Earnest ◽  
Eamonn MM Quigley ◽  
...  

ObjectiveOver half of patients with IBS have either diarrhoea (IBS-D) or a mixed stool pattern (IBS-M). The relative efficacy of licenced pharmacological therapies is unclear in the absence of head-to-head trials. We conducted a network meta-analysis to resolve this uncertainty.DesignWe searched MEDLINE, Embase, Embase Classic, the Cochrane central register of controlled trials, and Clinicaltrials.gov through January 2019 to identify randomised controlled trials (RCTs) assessing the efficacy of licenced pharmacological therapies (alosetron, eluxadoline, ramosetron and rifaximin) in adults with IBS-D or IBS-M. Trials included in the analysis reported a dichotomous assessment of overall response to therapy, and data were pooled using a random effects model. Efficacy and safety of all pharmacological therapies were reported as a pooled relative risk with 95% CIs to summarise the effect of each comparison tested. Treatments were ranked according to their p score.ResultsWe identified 18 eligible RCTs (seven alosetron, five ramosetron, two rifaximin and four eluxadoline), containing 9844 patients. All were superior to placebo for the treatment of IBS-D or IBS-M at 12 weeks, according to the Food and Drug Administration (FDA)-recommended endpoint for trials in IBS. Alosetron 1 mg twice daily was ranked first for efficacy, based on the FDA-recommended composite endpoint of improvement in both abdominal pain and stool consistency, effect on global symptoms of IBS and effect on stool consistency. Ramosetron 2.5µg once daily was ranked first for effect on abdominal pain. Total numbers of adverse events were significantly greater with alosetron 1 mg twice daily and ramosetron 2.5µg once daily, compared with placebo. Rifaximin 550 mg three times daily ranked first for safety. Constipation was significantly more common with all drugs, except rifaximin 550 mg three times daily.ConclusionIn a network meta-analysis of RCTs of pharmacological therapies for IBS-D and IBS-M, we found all drugs to be superior to placebo, but alosetron and ramosetron appeared to be the most effective.


ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
O. M. Aboumarzouk ◽  
M. Z. Aslam ◽  
A. Wedderburn ◽  
K. Turner ◽  
O. Hughes ◽  
...  

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966–November 2011), EMBASE (1980–November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP.


2020 ◽  
pp. jrheum.200307
Author(s):  
Hao Deng ◽  
Bao Long Zhang ◽  
Jin Dong Tong ◽  
Xiu Hong Yang ◽  
Hui Min Jin

Objective To assess whether febuxostat use increases the risk of developing cardiovascular events, death from cardiac-cause and all-cause mortalities. Methods The relevant literature was searched in several databases including the MEDLINE (PubMed, 1 Jan. 1966–29 Feb. 2020), Web of science, EMBASE (1 Jan. 1974–29 Feb. 2020), ClinicalTrials.gov and Cochrane Central Register for Controlled Trials. Manual searches for references cited in the original studies and relevant review articles were also performed. All studies included in this metanalysis were published in English. Results In the end, 20 studies that met our inclusion criteria were included in this meta-analysis. Use of febuxostat was found not to be associated with an increased risk of all-cause mortality (RR = 0.87, 95% CI 0.57–1.32, P =0.507). Also, there was no association between febuxostat use and mortalities arising from cardiovascular diseases (CVD) (RR = 0.84, 95% CI 0.49–1.45, P=0.528). The RR also revealed that febuxostat use was not associated with CVD events (RR = 0.98, 95% CI 0.83–1.16, P =0.827). Furthermore, the likelihood of occurrence of CVD events was found not to be dependent on febuxostat dose (RR = 1.04, 95% CI 0.84–1.30, P =0.723). Conclusion Febuxostat use is not associated with increased risks of all-cause mortality, death from CVD or CVD events. Accordingly, it is a safe drug for the treatment of gout. Systematic review registration: PROSPERO CRD42019131872


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Congling Zhao ◽  
Chunyan Cai ◽  
Qiang Ding ◽  
Hongbin Dai

Abstract Background The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effectiveness of controlling the progression of myopia. Methods This work was done through the data searched from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of the included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than that in the control group, with MD = − 0.80, 95% CI (− 0.94, − 0.66) during the whole observation period. There was a statistical difference among 0.05, 0.5, and 1.0% atropine (P = 0.004). In addition, less axial elongation was shown, with MD = − 0.26, 95% CI (− 0.33, − 0.18) during the whole observation period. Conclusion The effectiveness of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.


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