Oral Administration of East Asian Herbal Medicine for Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Association Rule Analysis to Identify Core Herb Combinations

This review aimed to comprehensively assess the efficacy and safety of oral East Asian herbal medicine (EAHM) for overall peripheral neuropathy (PN). In addition, an Apriori algorithm-based association rule analysis was performed to identify the core herb combination, thereby further generating useful hypotheses for subsequent drug discovery. A total of 10 databases were searched electronically from inception to July 2021. Randomized clinical trials (RCTs) comparing EAHM with conventional analgesic medication or usual care for managing PN were included. The RCT quality was appraised using RoB 2.0, and the random effects model was used to calculate the effect sizes of the included RCTs. The overall quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation. By analyzing the constituent herb data, the potential association rules of core herb combinations were explored. A total of 67 RCTs involving 5753 patients were included in this systematic review. In a meta-analysis, EAHM monotherapy and combined EAHM and western medicine therapy demonstrated substantially improved sensory nerve conduction velocity, motor nerve conduction velocity, and response rate. Moreover, EAHM significantly improved the incidence rate, pain intensity, Toronto clinical scoring system, and Michigan diabetic neuropathy score. The evidence grade was moderate to low due to the substantial heterogeneity among the studies. Nine association rules were identified by performing the association rule analysis on the extraction data of 156 EAHM herbs. Therefore, the constituents of the herb combinations with consistent association rules were Astragali Radix, Cinnamomi Ramulus, and Spatholobi Calulis. This meta-analysis supports the hypothesis that EAHM monotherapy and combined therapy may be beneficial for PN patients, and follow-up research should be conducted to confirm the precise action target of the core herb.

Download Full-text

The Method of Activating Blood and Dredging Collaterals for Reducing Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/1029626 ◽

2019 ◽

Vol 2019 ◽

pp. 1-18

Author(s):

Zhaoyi Li ◽

Huimin Jin ◽

Qingying Yan ◽

Leitao Sun ◽

Harpreet S. Wasan ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Neuropathy ◽

Conduction Velocity ◽

Nerve Conduction ◽

Large Scale ◽

Nerve Conduction Velocity ◽

Meta Analysis ◽

Intervention Group ◽

Sensory Nerve ◽

Chinese Herbs

Background. Chemotherapy-induced peripheral neuropathy (CIPN) remains as a big unsolved challenge for cancer patients and oncologists. However, there is no effective treatment to prevent and cure it. This systematic review and meta-analysis chiefly aimed to assess the effectiveness and safety on the method of activating blood and dredging collaterals in traditional Chinese medicine (TCM) for reducing CIPN. Methods. Two authors comprehensively searched all the randomized controlled trials (RCTs) via PubMed, Cochrane, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD). The Review Manager (RevMan) 5.0 was used to conduct the meta-analysis. Results. 20 trials including 1481 participants were analyzed. 15 trials tested the incidence of all-grade CIPN which was significantly lower in intervention arm and 16 trails presented that the result of high-grade CIPN was the same. The total effective rate of the use of Chinese herbs was 77.19% versus 45.79% in the comparator group. Besides, the use of Chinese herbs statistically promoted the sensory nerve conduction velocity (SNCV) and the motor nerve conduction velocity (MNCV). Besides, the quality of life (QoL) in the intervention group was better than the comparator one. Herbs-related adverse events were skin allergy, skin chap, and scald, which could be managed well. Conclusions. The work involving studies of the effectiveness and safety on TCM for reducing CIPN proves to be encouraging. Herbs with the function of activating blood and dredging collaterals were found to potentially promote the curative effects as well as making improvements of SNCV and MNCV. However, in the future, more double-blind, multicenter, large-scale RCTs and more comprehensive researches are still required.

Download Full-text

An Apriori Algorithm-Based Association Rule Analysis to Identify Herb Combinations for Treating Uremic Pruritus Using Chinese Herbal Bath Therapy

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8854772 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Ping-Hsun Lu ◽

Jui-Lin Keng ◽

Ko-Li Kuo ◽

Yu-Fang Wang ◽

Yu-Chih Tai ◽

...

Keyword(s):

Association Rules ◽

Association Rule ◽

Meta Analysis ◽

Apriori Algorithm ◽

Potential Core ◽

Uremic Pruritus ◽

Chinese Herbal ◽

Increased Risk ◽

Rule Analysis ◽

Bath Therapy

Uremic pruritus (UP) is prevalent among patients with end-stage renal disease (ESRD), which causes severe itching and affects their quality of life. Additionally, patients experience fatigue and depression, and an increased risk of mortality has also been reported. A meta-analysis of 17 randomized controlled trials (RCTs) has indicated that Chinese herbal bath therapy (CHBT) had adjuvant benefits in improving UP in ESRD patients, and previous studies have reported that herb combinations were more useful than treatment with a single herb. Association rule analysis has been used to evaluate potential correlations between herb combinations, and Apriori algorithms are one of the most powerful machine-learning algorithms available for identifying associations within databases. Therefore, we used the Apriori algorithm to analyze association rules of potential core herb combinations for use in CHBT for UP treatment using data from a meta-analysis of 17 RCTs that used CHBT for UP treatment. Data on 43 CHBT herbs were extracted from 17 RCTs included for analysis and we found 19 association rules. The results indicated that the following herb combinations {Chuanxiong, Baijili} ≥ {Dahuang} and {Dahuang, Baijili} ≥ {Chuanxiong} were most strongly associated, implying that these herb combinations represent potential CHBT treatments for UP.

Download Full-text