Efficacy and Safety of Mucopolysaccharide Polysulfate Cream for Non-Exudative Eczema: A Systematic Review and Meta-Analysis

Background: Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. However, there is no further research to collect and analyze these studies.Objective: This meta-analysis aimed to assess the efficacy and safety of MPS cream as monotherapy or add-on therapy for non-exudative eczema.Methods: Ten databases were searched to identify the eligible randomized controlled trials (RCTs) from their inception to July 31, 2021. Revman 5.3 software was used for the meta-analysis.Results: A total of eligible 20 studies were included. Among the 20 studies, 2 studies compared MPS cream with other moisturizers, 14 compared MPS cream plus topical corticosteroids (TCS) with TCS alone, and 4 compared with MPS cream plus tacrolimus ointment with tacrolimus ointment alone. The pooled results demonstrated that MPS cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% CI: 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment. Moreover, in comparison with TCS or tacrolimus ointment alone, the combination treatment performed better in terms of total efficacy rate, total symptom score, recurrence rate, and pruritus score. For safety, the skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events.Conclusions: MPS cream as monotherapy or add-on therapy could provide a good effect for treating non-exudative eczema with mild and tolerable skin adverse events. However, due to the suboptimal quality of the included studies, high-quality and large-sample RCTs are needed in the future for update or validation.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/PROSPERO/), identifier: CRD42021265735.

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Inhaled Levodopa (CVT-301) for the Treatment of Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Neurology Clinical Practice ◽

10.1212/cpj.0000000000001143 ◽

2021 ◽

pp. 10.1212/CPJ.0000000000001143

Author(s):

Glenardi Glenardi ◽

Tutwuri Handayani ◽

Jimmy Barus ◽

Ghea Mangkuliguna

Keyword(s):

Systematic Review ◽

Placebo Group ◽

Adverse Events ◽

Respiratory Symptoms ◽

Meta Analysis ◽

Motor Fluctuation ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Improve Motor Function

ABSTRACTPurposeof Review: To investigate the efficacy and safety of CVT-301 for motor fluctuation in Parkinson’s disease (PD).Recent Findings:This study demonstrated that the CVT-301 group had a higher proportion of patients achieving an ON state than the placebo group (OR=2.68; 95% CI: 1.86-3.86; p<0.00001). Moreover, CVT-301 had also shown to improve motor function by UPDRS-III score (SMD=3.83; 95% CI: 2.44-5.23; p<0.00001) and promote an overall improvement of PD by PGIC self-rating (OR=2.95; 95% CI: 1.78-4.9; p<0.00001). The most common adverse events encountered were respiratory symptoms (OR=12.18; 95% CI: 5.01-29.62; p<0.00001) and nausea (OR=3.95; 95% CI: 1.01-15.41; p=0.05).Summary:CVT-301 had the potential to be an alternative or even a preferred treatment for motor fluctuation in PD patients.

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Acupuncture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2019-030713 ◽

2019 ◽

Vol 9 (8) ◽

pp. e030713 ◽

Cited By ~ 1

Author(s):

Dacheng Li ◽

Li Zhu ◽

Daming Liu

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Adverse Events ◽

Reflux Disease ◽

Meta Analysis ◽

Oesophageal Reflux ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Oesophageal Reflux Disease

IntroductionRefractory gastro-oesophageal reflux disease (rGORD) is a common disease, affecting patients’ quality of life. Since conventional medicines have limitations, like low effective rates and adverse events, acupuncture may be a promising therapy for rGORD. While no related systematic review has been published, the present study is designed to evaluate the efficacy and safety of acupuncture for rGORD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from establishment of the database to 31 August 2019. There will be no limitations on language, and all articles will be screened and collected by two reviewers independently. RevMan V.5.3.5 software will be used for meta-analysis, and the conduction of study will refer to the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. The efficacy and safety of acupuncture for rGORD will be evaluated based on outcomes, including global symptom improvement, oesophageal sphincter function test measured by high-resolution manometry, quality of life, recurrence rate and adverse events.Ethics and disseminationThere is no necessity for this study to acquire an ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42018111912.

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Comparative Efficacy and Safety of Dopamine Agonists in Advanced Parkinson's Disease With Motor Fluctuations: A Systematic Review and Network Meta-Analysis of Double-Blind Randomized Controlled Trials

Frontiers in Neuroscience ◽

10.3389/fnins.2021.728083 ◽

2021 ◽

Vol 15 ◽

Author(s):

Xinglin Ruan ◽

Fabin Lin ◽

Dihang Wu ◽

Lina Chen ◽

Huidan Weng ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Dopamine Agonists ◽

Meta Analysis ◽

Risk Of Bias ◽

Motor Fluctuations ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Troublesome Dyskinesia

Background: Movement fluctuations are the main complication of Parkinson's disease (PD) patients receiving long-term levodopa (L-dopa) treatment. We compared and ranked the efficacy and safety of dopamine agonists (DAs) with regard to motor fluctuations by using a Bayesian network meta-analysis (NMA) to quantify information from randomized controlled trials (RCTs).Methods and Findings: We carried out a systematic review and meta-analysis, and only RCTs comparing DAs for advanced PD were included. Electronic databases (PubMed, Embase, and Cochrane Library) were systematically searched for relevant studies published until January 2021. Two reviewers independently extracted individual study data and evaluated studies for risk of bias using the Cochrane Risk of Bias tool. Network meta-analyses using a Bayesian framework were used to calculate the related parameters. The pre-specified primary and secondary outcomes were efficacy (“ON” time without troublesome dyskinesia, “OFF” time, “ON” time, “UPDRS-III,” and “UPDRS-II”) and safety [treatment-emergent adverse events (TEAE) and other adverse events] of DAs. The results are presented as the surface under the cumulative ranking (SUCRA) curve. A total of 20 RCTs assessing 6,560 patients were included. The general DA effects were ranked from high to low with respect to the amount of “ON” time without troublesome dyskinesia as follows: apomorphine (SUCRA = 97.08%), pramipexole_IR (probability = 79.00%), and ropinirole_PR (SUCRA = 63.92%). The general safety of DAs was ranked from high to low with respect to TEAE as follows: placebo (SUCRA = 74.49%), pramipexole_ER (SUCRA = 63.6%), sumanirole (SUCRA = 54.07%), and rotigotine (SUCRA = 53.84%).Conclusions: This network meta-analysis shows that apomorphine increased “ON” time without troublesome dyskinesia and decreased “OF” time for advanced PD patients. The addition of pramipexole, ropinirole, or rotigotine to levodopa treatment in advanced PD patients with motor fluctuations increased “ON” time without troublesome dyskinesia, improved the UPDRS III scores, and ultimately ameliorated the UPDRS II scores, thereby maximizing its benefit. This NMA of pramipexole, ropinirole, and rotigotine represents an effective treatment option and has an acceptable safety profile in patients with advanced PD.

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Efficacy and Safety of Moxibustion for Postherpetic Neuralgia: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.676525 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qiqi Wu ◽

Hantong Hu ◽

Dexiong Han ◽

Hong Gao

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Adverse Events ◽

Postherpetic Neuralgia ◽

Outcome Measure ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Efficacy Rate ◽

Efficacy And Safety

Background: Postherpetic neuralgia (PHN) is one of the most common complications of herpes zoster (HZ), and there is still a lack of effective therapies. An increasing number of studies have found that compared to traditional therapy, moxibustion treatment is beneficial for the treatment of PHN, although current evidence remains inconclusive. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of moxibustion for PHN.Methods: We conducted a broad literature review of a range of databases from inception to December 2020, including the Cochrane Library, PubMed, EMBASE, Web of Science, Clinical Trails, China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), China Biomedical Network Information, and Wanfang databases. We included RCTs that compared moxibustion to pharmacological therapies, herbal medicine, or no treatment for treating PHN. The main outcome measure was efficacy rate and Visual Analog Scale (VAS); the secondary outcome measure was adverse events. Data accumulation and synthesis included meta-analysis, publication bias, sensitivity analysis, risk-of-bias assessment, and adverse events.Results: We included 13 RCTs involving 798 patients. Compared with the controls (pharmacological therapies, herbal medicine, or no treatment), moxibustion achieved a significantly higher efficacy rate (odds ratio [OR]: 3.65; 95% [confidence interval]: [2.32, 5.72]; P < 0.00001). Subgroup analysis of the distinct moxibustion modalities showed that both Zhuang medicine medicated thread and thunder-fire moxibustions obtained higher clinical efficacy than the control group. Compared with the controls, moxibustion resulted in significantly lower scores on the VAS (Weighted Mean Difference (MD) = −1.79; 95% CI: [−2.26, −1.33]; P < 0.00001). However, there was no significant difference in terms of safety between moxibustion and the controls (OR = 0.33; 95% CI [0.06, 1.77]; P = 0.19).Conclusion: Due to the lack of methodological quality as well as the significant heterogeneity of the included studies, it remains difficult to draw a firm conclusion on the efficacy and safety of moxibustion for the treatment of PHN. Future high-quality studies are urgently needed.

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Efficacy and Safety of Tripterygium Glycoside in the Treatment of Diabetic Nephropathy: A Systematic Review and Meta-Analysis Based on the Duration of Medication

Frontiers in Endocrinology ◽

10.3389/fendo.2021.656621 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yizhen Li ◽

Runpei Miao ◽

Yixing Liu ◽

Jiawei Zhang ◽

Zhili Dou ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Diabetic Nephropathy ◽

Adverse Events ◽

Treatment Duration ◽

Meta Analysis ◽

Efficacy And Safety ◽

Severe Adverse Events ◽

Blood Creatinine

AimThe aim of this study was to assess the clinical efficacy and safety of Tripterygium-derived glycosides (TG) after 3-month and 6-month of treatments of diabetic nephropathy (DN) and to resolve the conflict between medicine guidance and clinical practice for TG application.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials involving TG application in treating DN. We extensively searched PubMed, Cochrane Library, CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Trial Registry, and WHO International Clinical Trial Registration Platform till November 2020, along with grey literature for diabetes and all other relevant publications to gather eligible studies. Based on the preset inclusion and exclusion criteria, document screening, quality assessment of methodology, and data extraction was conducted by two researchers independently. The methodological quality was assessed by the Cochrane risk test from the Cochrane Handbook 5.2, and then analyses were performed by Review Manager 5.3 (Rev Man 5.3). The quality of output evidence was classified by GRADE.ResultsThirty-one eligible studies (2764 patients) were included for this meta-analysis. Our study results showed a comparable significant decrease in the 24 h-UTP and blood creatinine levels in DN patients from both 3-month and 6-month TG treatment groups, compared with the routine symptomatic treatment alone. To the contrary of the findings from the included studies, our results showed that the occurrence of serious adverse reaction events was significantly higher in the TG treated group with 6 months of treatment duration compared to that of 3 months of the treatment course. However, the total AR ratio was slightly varied while increasing the percent of severe adverse events. GRADE assessment indicated that the quality of evidence investigating TG-induced adverse reactions was moderate and that for 24 h-UTP and blood creatinine indicators were considerably low.ConclusionCombinatorial treatment regimen including TG can significantly decrease the pathological indicators for DN progression, while it can also simultaneously predispose the patient to a higher risk for developing severe adverse events, as the medicine guidance indicates. Notably, even in 3-month of course duration smaller percent of severe adverse events can get to a fatal high percent and is likely to increase proportionally as the TG treatment continues. This suggests that TG-mediated DN treatment duration should be optimized to even less than 3 continuous months to avoid adverse event onset-associated further medical complications in DN patients. In clinical practice, serious attention should be paid to these severe side-effects even in a course normally considered safe, and importantly more high-quality studies are urgently warranted to obtain detailed insights into the balance between the efficacy and safety profiles of TG application in treating DN.

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A Systematic Review and Meta-Analysis of the Effects of Herbal Medicine Buyang Huanwu Tang in Patients with Poststroke Fatigue

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/4835488 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Chul Jin ◽

Seungwon Kwon ◽

Seung-Yeon Cho ◽

Seong-Uk Park ◽

Woo-Sang Jung ◽

...

Keyword(s):

Adverse Events ◽

Meta Analysis ◽

Herbal Medicines ◽

Efficacy Rate ◽

Asian Countries ◽

Severity Scale ◽

Serious Adverse Events ◽

Randomized Controlled ◽

Fatigue Severity

Poststroke fatigue (PSF) is reported to occur in 30%–72% of all patients with stroke. PSF not only is a symptom of stroke but has also been reported to adversely affect the prognosis of patients with stroke. However, no treatment has had a significant effect on PSF. In East Asian countries, several herbal medicines have been used to treat stroke, with Buyang Huanwu Tang (BHT) being the most common. This review aimed to evaluate the efficacy and safety of BHT for PSF. A literature search was conducted on MEDLINE, CENTRAL, Scopus, CiNii, CNKI, OASIS, NDSL, and KTKP databases for randomized controlled trials that evaluated the effects and safety of BHT on PSF. Six studies (n = 427) were included. The overall methodological quality of these studies was relatively low. In the adjunctive BHT group, the meta-analysis indicated statistically significant improvements in the Fatigue Severity Scale score (mean difference −1.49, 95% CI [−2.25, −0.73]) and total clinical efficacy rate (risk ratio 0.11, 95% CI [0.03, 0.41]) compared to those in the nonherbal group. Adverse events were only reported in one study, and no serious adverse events occurred. BHT administration might be effective in the treatment of PSF. We were unable to draw definitive conclusions owing to the limitations of the included studies. The trial is registered with CRD42019130178 in PROSPERO.

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Xiao Chai Hu Tang for Peptic Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6693677 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Min Li ◽

Wenchao Dan ◽

Hui Zhang ◽

Yong’en Yun ◽

Qingyong He

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Recurrence Rate ◽

Clinical Efficacy ◽

Meta Analysis ◽

Controlled Trials ◽

Efficacy Rate ◽

Peptic Ulcers ◽

Randomized Controlled ◽

Stomach Pain

A peptic ulcer (PU) is a digestive disorder most commonly found in clinical practice. An oriental herbal formula, Xiao Chai Hu Tang (XCHT), has been used to treat PU for an extended period in China. The effectiveness and safety of XCHT in treating peptic ulcers was evaluated using a systematic review of randomized controlled trials (RCTs). Studies were systematically retrieved from CNKI, Embase, Medline, PubMed, SinoMed, VIP, Wanfang, and Web of Science. The following information was extracted from the relevant RCTs: the clinical efficacy rate, recurrence rate, clinical efficacy of traditional Chinese medicine, and the adverse effects. 13 RCTs, including 1334 patients, were included in this review. The meta-analysis showed that treatment with XCHT was superior to conventional pharmacotherapy (CPT) in improving the clinical efficacy rate (RR: 1.20, 95% confidence intervals (CIs): 1.08–1.34, P = 0.0007 ), poor appetite (RR: 0.30, 95% CI: 0.15–0.61, P = 0.0009 ), abdominal distension (RR: 0.61, 95% CI: 0.39–0.96, P = 0.03 ), vomiting (RR: 0.33, 95% CI: 0.19–0.55, P < 0.0001 ), and stomach pain (RR: 0.36, 95% CI: 0.19–0.68, P = 0.002 ) and reducing adverse events (RR: 0.23, 95% CI: 0.07–0.69, P = 0.009 ). XCHT considerably increased the total clinical efficacy rate (RR: 1.22, 95% CI: 1.15–1.30, P < 0.00001 ) as both monotherapy and adjunctive therapy. The recurrence rate (RR = 0.29; 95% CI: 0.16–0.52, P < 0.0001 ) was remarkably decreased in the XCHT plus CPT group. The meta-analysis did not show a significant beneficial effect of XCHT compared with CPT in reducing the recurrence rate (RR = 0.45; 95% CI: 0.07–3.10, P = 0.42 ) and acid reflux (RR: 0.76, 95% CI: 0.47–1.23, P = 0.26 ). Our findings show that XCHT can treat peptic ulcers as part of an alternative medicine approach.

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P451 Efficacy and safety of tofacitinib in the treatment of patients with active, moderate to severe, Ulcerative Colitis: a systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.575 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S446-S447

Author(s):

M Khorshid Fasge ◽

D Dorgham ◽

A Sharobim ◽

M Attia ◽

M Hussein ◽

...

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Adverse Events ◽

Cohort Studies ◽

Clinical Response ◽

Meta Analysis ◽

Drug Discontinuation ◽

Efficacy And Safety ◽

Severe Ulcerative Colitis

Abstract Background To perform a systematic review and meta-analysis to discuss the efficacy and safety of tofacitinib in patients with moderate to severe ulcerative colitis (UC). Methods We searched PubMed, Scopus, Web of Science, in addition to Cochrane Central, until May 2020 using relevant keywords. We included randomized controlled trials (RCTs) in addition to cohort studies that compared tofacitinib oral treatment versus placebo in patients with active UC, with a moderate to severe degree. Quality of included RCTs was assessed by the Cochrane risk of bias assessment tool, whereas the Newcastle-Ottawa scale was applied to assess for bias sources in included cohort studies. Data were pooled, after being extracted, from eligible articles in the review manager software, or the open meta-analyst software. Dichotomous outcomes were pooled as risk ratios (RR) under the fixed effect model, while continuous outcomes were pooled as standardized mean difference (SMD) under the random-effects model. Results pooling data from seven RCTs and four cohort studies, 2728 patients, showed that tofacitinib therapy was superior to placebo in inducing a clinical response in UC patients after eight weeks (p = 0.0001) and 26 weeks, in a proportion 0.4 of patients who took tofacitinib 10 mg BID. Additionally, tofacitinib treatment was associated with significantly higher events of clinical remission of UC, after eight weeks (RR= 3.12, 95% CI [2.34, 4.16], p < 0.0001). Likewise, endoscopic, deep, in addition to symptomatic remission rates were higher in the tofacitinib group, compared to the group of placebo (p ≤ 0.008). Most of the drug-related adverse events were comparable between tofacitinib and placebo groups. However, tofacitinib treatment was associated with fewer serious adverse events (RR= 0.68, 95% CI [0.48, 0.98], p = 0.04); adverse events that led to drug discontinuation (RR= 0.53, 95% CI [0.39, 0.73], p< 0.0001); and worsening of UC (RR= 0.48, 95% CI [0.38, 0.61], p < 0.00001). On the other hand, the placebo group had fewer overall infections (p = 0.002); and elevation in laboratory parameters, including LDL cholesterol, total cholesterol, and triglycerides. Conclusion Our systematic review and meta-analysis showed that, in patients with active moderate to severe UC, tofacitinib treatment was superior to placebo in inducing clinical response and remission, with less adverse reactions. Additionally, treatment with tofacitinib showed beneficial quality of life and survival benefits for UC patients. Future clinical trials should study the effect of higher doses of tofacitinib in larger RCTs, with longer follow up periods.

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Efficacy and safety of Sihogayonggolmoryeo-tang (Saikokaryukotsuboreito, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for post-stroke depression: A systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-019-51055-6 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Chan-Young Kwon ◽

Boram Lee ◽

Sun-Yong Chung ◽

Jong Woo Kim ◽

Aesook Shin ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Subgroup Analysis ◽

Meta Analysis ◽

Risk Of Bias ◽

Efficacy And Safety ◽

Quality Of Evidence ◽

Post Stroke Depression ◽

Grade Approach

Abstract This systematic review and meta-analysis aimed to analyze the efficacy and safety of Sihogayonggolmoryeo-tang (SGYMT), a classical herbal medicine consisting of 11 herbs, for treatment of post-stroke depression (PSD). Thirteen databases were comprehensively searched from their inception dates until July 2019. Only randomized controlled trials (RCTs) using SGYMT as a monotherapy or adjunctive therapy for PSD patients were included. Where appropriate data were available, meta-analysis was performed and presented as risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CIs). We assessed the quality of RCTs using the Cochrane risk of bias tool and the Jadad scale. The quality of evidence for each main outcome was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Twenty-one RCTs with 1,644 participants were included. In the comparison between the SGYMT and antidepressants groups, the SGYMT group scored significantly lower on both the Hamilton Depression Scale (HAMD) (8 studies; MD −2.08, 95% CI −2.62 to −1.53, I2 = 34%) and the National Institutes of Health Stroke Scale (NIHSS) (2 studies; MD −0.84, 95% CI −1.40 to −0.29, I2 = 19%), and significantly higher on the Barthel index (3 studies; MD 4.30, 95% CI 2.04 to 6.57, I2 = 66%). Moreover, the SGYMT group was associated with significantly fewer adverse events (6 studies; RR 0.13, 95% CI 0.05 to 0.37, I2 = 0%) than the antidepressants group. In the subgroup analysis, SGYMT treatment consistently reduced HAMD scores within the first 8 weeks of treatment, but thereafter this difference between groups disappeared. Comparisons between SGYMT combined with antidepressants, and antidepressants alone, showed significantly lower scores in the combination group for both HAMD (7 studies; MD = −6.72, 95% CI = −11.42 to −2.01, I2 = 98%) and NIHSS scores (4 studies; MD −3.03, 95% CI −3.60 to −2.45, I2 = 87%). In the subgroup analysis, the reductions of HAMD scores in the SGYMT combined with antidepressants group were consistent within 4 weeks of treatment, but disappeared thereafter. The quality of RCTs was generally low and the quality of evidence evaluated by the GRADE approach was rated mostly “Very low” to “Moderate.” The main causes of low quality ratings were the high risk of bias and imprecision of results. Current evidence suggests that SGYMT, used either as a monotherapy or an adjuvant therapy to antidepressants, might have potential benefits for the treatment of PSD, including short-term reduction of depressive symptoms, improvement of neurological symptoms, and few adverse events. However, since the methodological quality of the included studies was generally low and there were no large placebo trials to ensure reliability, it remains difficult to draw definitive conclusions on this topic. Further well-designed RCTs addressing these shortcomings are needed to confirm our results.

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Therapeutic Efficacy of Kangfuxin Liquid Combined with PPIs in Gastric Ulcer

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/1324969 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Jun-Bo Zou ◽

Xiao-Fei Zhang ◽

Ya-Jun Shi ◽

Jia Tai ◽

Yu Wang ◽

...

Keyword(s):

Gastric Ulcer ◽

Adverse Events ◽

Recurrence Rate ◽

T Lymphocyte ◽

Lymphocyte Subsets ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy Rate ◽

Efficacy And Safety ◽

T Lymphocyte Subsets

Objective. To evaluate the clinical efficacy and safety of Kangfuxin liquid (KFX) combined with proton pump inhibitors (PPIs) in the treatment of gastric ulcer (GU). Materials and Methods. Electronic databases including PubMed, Wanfang, CNKI, VIP, Embase, Cochrane Library, and CBM were examined for appropriate articles without language limitations on key words before March 10, 2019. RevMan 5.3 software was applied to execute outcome assessment and finish the meta-analysis. Results. 22 articles involving 2,024 patients with a gastric ulcer were selected. Total efficacy rate and efficacy rate of gastroscopy were significantly enhanced for the combination of KFX with PPIs compared to those of PPI treatment alone (OR = 6.95, 95% CI: 4.87, 9.91, P<0.00001; OR = 2.96, 95% CI: 1.98, 4.42, P<0.00001, respectively). Same results were found for different PPIs in combination on total efficacy rate, respectively. The combination also significantly reduced the adverse events (OR = 0.39, 95% CI: 0.22, 0.70, P=0.002). In addition, KFX combined with PPI could suppress the inflammation (MD = −6.11, 95% CI: −7.45, −4.77, P<0.00001), reduce the recurrence rate (OR = 0.31, 95% CI: 0.14, 0.70, P=0.005), and enhance the clearance rate of Helicobacter pylori (HP, OR = 3.76, 95% CI: 1.80, 7.87, P=0.0004). It seemed like the combination would influence immune function by increasing levels of T-lymphocyte subsets CD4 and CD8 but not CD3 (MD = 2.40, 95% CI: 1.25, 3.55, P<0.0001); MD = 25.72, 95% CI: 14.55, 36.90, P<0.00001; MD = 0.72, 95% CI: −0.66, 2.09, P=0.31, respectively). Conclusion. KFX combined with PPIs in treatment of patients with GU could improve the total efficacy rate and efficacy rate of gastroscopy and reduce adverse events and the recurrence rate. However, the results of this study should be handled with care due to the limitations. Several rigorous RCTs are in need to confirm these findings.

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