Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis

Objective. To compare the efficacy and safety of kidney-tonifying and blood-activating medicinal herbs (KTBAMs) and nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of knee osteoarthritis (KOA). Methods. Randomized controlled trials (RCTs) from online databases that compared the efficacy of KTBAMs and NSAIDs in the treatment of KOA were retrieved. The main outcomes included the evaluation of functional outcomes, pain, and adverse effects. The Cochrane risk-of-bias (ROB) tool was used to assess methodological quality. Results. A total of 38 RCTs (3994 participants) were included in our meta-analysis. We found that KTBAMs had a significantly higher total effective rate (P<0.00001, risk ratio (RR) = 1.08, confidence interval (CI) = 1.05 to 1.11, I2 = 4%) and a lower gastrointestinal adverse reaction rate (P<0.00001, RR = 0.36, CI = 0.24 to 0.53, I2 = 33%) than NSAIDs. KTBAMs showed greater improvements in the Knee Society Scale (KSS) scores (mean difference (MD) = 7.17, 95% CI 0.71 to 13.64, P=0.03). Regarding the visual analog scale (VAS) scores, WOMAC scores, and Lequence scores, there were no significant differences between the KTBAM group and the NSAID group. The GRADE quality level of this systematic review indicated that the very low-quality evidence showed that KTBAMs had a higher total effective rate, while the moderate-quality evidence showed that the adverse reactions of KTBAMs were lower and the KSS scores were higher. Low-quality evidence showed no significant differences in improving VAS scores, WOMAC scores, or Lequence scores. Conclusion. KTBAMs were superior to NSAIDs in terms of a higher total effective rate, a lower adverse reaction rate, and a higher KSS score. There were no significant differences between KTBAMs and NSAIDs in improving VAS scores, WOMAC scores, and Lequence scores of patients with KOA. Therefore, KTBAMs may be an alternative effective method for treating KOA. However, high-quality, well-designed RCTs with long-term follow-up are still required.

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Effectiveness of Acupuncturing at the Sphenopalatine Ganglion Acupoint Alone for Treatment of Allergic Rhinitis: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/6478102 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Qinwei Fu ◽

Lanzhi Zhang ◽

Yang Liu ◽

Xinrong Li ◽

Yepeng Yang ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Disease Classification ◽

Sphenopalatine Ganglion ◽

Control Groups ◽

Vas Score

Aim(s). To evaluate the efficiency of acupuncturing at the sphenopalatine ganglion acupoint alone for treatment of allergic rhinitis. Design. A total of ten online databases were searched to find studies published up to Jan. 2018. Primary outcome measures include the TNSS, the RQLQ score, the VAS score, total effective rate, score for signs and symptoms, and the improvement of disease classification. Study quality of each included article was evaluated by the Cochrane Collaboration risk of bias tool. A meta-analysis was conducted based on the Cochrane systematic review method by using RevMan 5.3 software. Interventions. Acupuncturing SGA alone was the only therapy in experimental group. Interventions in control groups includes sham acupuncture, acupuncturing other regular acupoints, and western medicine. Specific techniques included manual acupuncture and electroacupuncture only. Primary Outcomes. They include TNSS, RQLQ, VAS score, total effective rate, the improvement of disease classification. Results. Ten studies of eight articles involving 1004 participants were included. Result of meta-analysis showed that acupuncturing sphenopalatine ganglion acupoints alone was more effective than control groups. However, several adverse effects were reported. Conclusion. These findings show that acupuncturing the sphenopalatine ganglion acupoint alone has a potential role in alleviating nasal symptoms, improving quality of life for patients, and the effectiveness of acupuncture in the treatment of allergic rhinitis, suggesting it as a considerable therapy for allergic rhinitis. However, more studies are needed to execute a subgroup analysis of various variables and to evaluate the publication bias of the study.

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Clinical Effect of Intravenous Vitamin C on Viral Myocarditis in Children: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/3082437 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Shuangdi Chen ◽

Wenli Zhao ◽

Binjie Zhang ◽

Yijun Jia ◽

Shihua Wu ◽

...

Keyword(s):

Systematic Review ◽

Vitamin C ◽

Conventional Therapy ◽

Total Effective Rate ◽

Meta Analysis ◽

Viral Myocarditis ◽

Effective Rate ◽

Cochrane Library ◽

Significant Difference ◽

Intravenous Vitamin

Objective. To comprehensively compare the effects of conventional therapy combined with intravenous vitamin C and conventional therapy on viral myocarditis in children through a meta-analysis. Methods. Relevant articles including clinical trials of normal treatment combined with intravenous vitamin C and conventional therapy for viral myocarditis in children that were published between January 2000 and February 2018 were selected from PubMed, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and WANFANG database. The quality of the included studies was assessed using the Cochrane systematic review method (version 5.1.0); data quality was evaluated by two independent researchers. The total effective rate; LDH, CK, and CK-MB levels; and other indicators were analyzed using Rev Man 5.3 software. Results. Eight studies were eligible for this meta-analysis, which included a total of 426 patients in the treatment group and 363 patients in the control group. The meta-analysis results of six studies showed that the total effective rate of intravenous vitamin C combined with conventional therapy was higher than that of conventional therapy alone [Z = 5.46, 95% confidence interval (CI): 1.21 (1.13 to 1.30), P < 0.00001]; that of five studies showed that LDH levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 3.70, 95% CI: −1.88 (−2.88 to −0.88), P = 0.0002]; that of three studies showed that CK levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 4.21, 95% CI: −0.55 (−0.81 to −0.30), P < 0.0001]; that of four studies showed that CK-MB levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 13.64, 95% CI: −1.44 (−1.65 to −1.24), P < 0.00001]; that of two studies showed that CD3 levels were higher in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 2.45, 95% CI: 0.41 (0.08–0.73), P = 0.01]; that of two studies showed no significant difference in changes in CD4 levels between children receiving intravenous vitamin C combined with conventional therapy and those receiving conventional therapy alone [Z = 0.28, 95% CI: −0.21 (−1.69 to 1.28), P = 0.78]; and that of two studies showed no significant difference in changes in CD4/CD8 between children receiving intravenous vitamin C combined with conventional therapy and those receiving conventional therapy alone [Z = 0.07, 95% CI: −0.03 (−0.73 to 0.67), P = 0.94]. Conclusion. The meta-analysis results showed that intravenous vitamin C combined with conventional therapy is better than the simple, conventional therapy for the treatment of viral myocarditis in children in terms of the total effective rate and LDH, CK, and CK-MB levels.

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Efficacy of Longdan Xiegan Decoction on the Treatment of Eczema: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8836117 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Ziteng Hu ◽

Lidong Gao ◽

Chengxian Li ◽

Alberto Cucco ◽

Shang Wang ◽

...

Keyword(s):

Clinical Efficacy ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Biomedical Literature ◽

Cure Rate ◽

Quality Of Evidence ◽

Moderate Quality ◽

Quality Evidence

Background. Longdan Xiegan decoction (LDXGD) has been widely used in the treatment of eczema. In recent years, randomized controlled trials (RCTs) of LDXGD for the treatment of eczema have gradually increased. Most of the results show that LDXGD is effective in treating eczema. However, whether these conclusions are reliable or not requires meta-analysis. Objective. This study aimed to systematically evaluate the clinical efficacy of LDXGD in the treatment of eczema. Materials and Methods. Seven electronic databases, including PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Chinese Biomedical Literature on Disc (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and Chinese Science and Technology Periodical Database (VIP) were systematically searched from their inception until January 2021. Risk of bias was assessed using criteria from the Cochrane Collaboration and meta-analysis was conducted on the screened literature data using Review Manage (RevMan 5.3). Then, to assess the quality of evidence, the GRADE criteria was adopted. Results. 14 RCTs with 1080 participants were identified. Meta-analysis indicated that compared with western medicine (WM), the cure rate and the total effective rate of LDXGD in treating eczema were higher. Meanwhile, the recurrence rate and the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α) after treatment were lower. The adverse reaction was reported in 5 out of 14 studies without significant statistical difference. According to GRADE criteria, the quality of evidence was low for all outcomes except for the cure rate (moderate-quality evidence) and the total effective rate (moderate-quality evidence). Conclusion. The clinical efficacy of LDXGD in the treatment of eczema was more effective compared with the one of conventional WM alone. However, due to the limitation of the quality of the included studies, additional studies are required to further confirm these results.

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Acupuncture for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Acupuncture in Medicine ◽

10.1136/acupmed-2016-011332 ◽

2018 ◽

Vol 36 (2) ◽

pp. 62-70 ◽

Cited By ~ 11

Author(s):

Shujie Tang ◽

Zhuomao Mo ◽

Renwen Zhang

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Total Effective Rate ◽

Lumbar Disc ◽

Meta Analysis ◽

Diclofenac Sodium ◽

Effective Rate ◽

Lumbar Traction ◽

Vas Scores ◽

Better Than

Objective To evaluate evidence for the effectiveness of acupuncture in the treatment of lumbar disc herniation (LDH). Methods Electronic databases were searched to identify randomised controlled trials (RCTs) of acupuncture for LDH. A meta-analysis was conducted using RevMan 5.3 and the evidence level was assessed using GRADE methodology. Results Thirty RCTs involving 3503 participants were included in the study. Meta-analysis showed that acupuncture had a higher total effective rate than lumbar traction (RR=1.1, 95% CI 1.05 to 1.15; p<0.001), ibuprofen (RR=1.24, 95% CI 1.03 to 1.48; p=0.02), diclofenac sodium (RR=1.44, 95% CI 1.24 to 1.67; p<0.001) and meloxicam (RR=1.16, 95% CI 1.03 to 1.31; p=0.01). Acupuncture was also better than lumbar traction (SMD −1.33, 95% CI −1.82 to −0.84; p<0.001) and diclofenac sodium (SMD −1.36, 95% CI −2.59 to −0.13; p=0.03) in terms of visual analogue scale (VAS) scores, and better than lumbar traction (SMD 0.96, 95% CI 0.48 to 1.45; p=0.0001) with respect to Japanese Orthopaedic Association (JOA) scores. In addition, the total effective rate in five individual trials was greater for acupuncture than for mannitol plus dexamethasone and mecobalamin, ibuprofen plus fugui gutong capsule, loxoprofen, mannitol plus dexamethasone and huoxue zhitong decoction, respectively. Additionally, two individual trials showed a superior effect of acupuncture in VAS scores comparedwith ibuprofen or mannitol plus dexamethasone, respectively. Conclusions Acupuncture showed a more favourable effect in the treatment of LDH than lumbar traction, ibuprofen, diclofenac sodium, meloxicam, mannitol plus dexamethasone and mecobalamin, fugui gutong capsule plus ibuprofen, mannitol plus dexamethasone, loxoprofen and huoxue zhitong decoction. However, further rigorously designed, large-scale RCTs are needed to confirm these findings.

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Knee extensor muscle weakness is a risk factor for the development of knee osteoarthritis: an updated systematic review and meta-analysis including 46 819 men and women

British Journal of Sports Medicine ◽

10.1136/bjsports-2021-104861 ◽

2021 ◽

pp. bjsports-2021-104861

Author(s):

Britt Elin Øiestad ◽

Carsten B Juhl ◽

Adam G Culvenor ◽

Bjørnar Berg ◽

Jonas Bloch Thorlund

Keyword(s):

Systematic Review ◽

Knee Osteoarthritis ◽

Muscle Weakness ◽

Meta Analysis ◽

Knee Extensor ◽

Extensor Muscle ◽

Knee Extensor Muscle Strength ◽

Quality Evidence ◽

Radiographic Knee Osteoarthritis

ObjectiveTo update a systematic review on the association between knee extensor muscle weakness and the risk of incident knee osteoarthritis in women and men.DesignSystematic review and meta-analysis.Data sourcesSystematic searches in PubMed, EMBASE, SPORTDiscus, CINAHL, AMED and CENTRAL in May 2021.Eligible criteria for selecting studiesLongitudinal studies with at least 2 years follow-up including baseline measure of knee extensor muscle strength, and follow-up measure of symptomatic or radiographic knee osteoarthritis. Studies including participants with known knee osteoarthritis at baseline were excluded. Risk of bias assessment was conducted using six criteria for study validity and bias. Grading of Recommendations Assessments, Development and Evaluation assessed overall quality of evidence. Meta-analysis estimated the OR for the association between knee extensor muscle weakness and incident knee osteoarthritis.ResultsWe included 11 studies with 46 819 participants. Low quality evidence indicated that knee extensor muscle weakness increased the odds of symptomatic knee osteoarthritis in women (OR 1.85, 95% CI 1.29 to 2.64) and in adult men (OR 1.43, 95% CI 1.14 to 1.78), and for radiographic knee osteoarthritis in women: OR 1.43 (95% CI 1.19 to 1.71) and in men: OR 1.39 (95% CI 1.07 to 1.82). No associations were identified for knee injured populations except for radiographic osteoarthritis in men.DiscussionThere is low quality evidence that knee extensor muscle weakness is associated with incident symptomatic and radiographic knee osteoarthritis in women and men. Optimising knee extensor muscle strength may help to prevent knee osteoarthritis.PROSPERO registration numberCRD42020214976.

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Chinese Medicinal Herbs for Childhood Pneumonia: A Systematic Review of Effectiveness and Safety

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/203845 ◽

2013 ◽

Vol 2013 ◽

pp. 1-25 ◽

Cited By ~ 1

Author(s):

Qianchun Yang ◽

Darong Wu ◽

Wei Mao ◽

Xusheng Liu ◽

Kun Bao ◽

...

Keyword(s):

Systematic Review ◽

Total Effective Rate ◽

Effective Rate ◽

Medicinal Herbs ◽

Chinese Herbs ◽

Controlled Trials ◽

Cochrane Central Register ◽

Chinese Medicinal Herbs ◽

Childhood Pneumonia ◽

Significant Difference

Objective. To assess the efficacy and safety of Chinese medicinal herbs for Childhood Pneumonia.Methods. We included randomized controlled trials (RCTs). The searched electronic databases included PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, CBM, CNKI, and VIP. All studies included were assessed for quality and risk bias. Review Manager 5.1.6 software was used for data analyses, and the GRADEprofiler software was applied to classify the systematic review results.Results. Fourteen studies were identified(n=1.824). Chinese herbs may increase total effective rate (risk ratio (RR) 1.18; 95% confidence interval (CI), 1.11–1.26) and improve cough (total mean difference (MD),−2.18; 95% CI,(−2.66)–(−1.71)), fever (total MD,−1.85; 95% CI,(−2.29)–(−1.40)), rales (total MD,−1.53; 95% CI,(−1.84)–(−1.23)), and chest films (total MD,−3.10; 95% CI,(−4.11)–(−2.08)) in Childhood Pneumonia. Chinese herbs may shorten the length of hospital stay (total MD,−3.00; 95% CI, (−3.52)–(−2.48)), but no significant difference for adverse effects (RR, 0.39; 95% CI, 0.09–1.72) was identified.Conclusion. Chinese herbs may increase total effective rate and improve symptoms and signs. However, large, properly randomized, placebo-controlled, double-blind studies are required.

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Warming Needle Moxibustion for Alzheimer’s Disease: A Systematic Review of Randomized Controlled Trials

10.22541/au.162746114.47553840/v1 ◽

2021 ◽

Author(s):

Xinming Chen ◽

Fang Liu ◽

Nan Lin ◽

Qian Lin ◽

Zecai Lv ◽

...

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Randomized Controlled Trials ◽

Daily Living ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Controlled Trials ◽

Randomized Controlled

Abstract Objective: To systematically research the impact of warming needle moxibustion (WNM) for Alzheimer’s Disease (AD). Methods: Four Chinese databases and six English databases were systematically searched. Randomized controlled trials (RCTs) involving the use of WNM to intervene in AD patients were included. Data were extracted from the included studies and methodological quality was evaluated according to the Cochrane Handbook for Systematic Reviews of Intervention 5.1.0. Meta-analysis was performed using RevMan 5.4 software. Results: 8 RCTs comprising 524 patients were included. The study showed that WNM was more effective in the treatment of AD than acupuncture or pharmacotherapy. The findings were as follows: MMSE (MD=1.01, 95%CI: 0.13, 1.90, P=0.03) and CDR (MD=-0.73, 95%CI: -0.84, -0.61, P<0.00001) for global cognitive function, ADL (MD=-1.84, 95%CI: -2.47, -1.22, P<0.00001) for activities of daily living, Syndrome Differentiation Scale of Dementia (SDSD) (MD=-2.67, 95%CI: -3.62, -1.72, P<0.00001), and the total effective rate of patients (OR=3.89, 95%CI: 2.49, 6.09, P<0.00001). The differences in all indicators were statistically significant. Conclusion: WNM has a significant effect on improving cognitive function and daily living ability, reducing the symptoms of AD, and increase the total effective rate. WNM is an effective non-pharmacological therapy for patients with AD. Keywords: Warming needle moxibustion, Alzheimer’s disease, Randomized Controlled Trials, systematic review and meta-analysis

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