Comparison of the efficacy of dispensing granules with traditional decoction: a systematic review and meta-analysis

Abstract

as effective as the traditional decoction kept unclear. This systematic review and meta-analysis was made to assess the efficacy of dispensing granules compared with traditional decoction. Methods:We searched four databases since their inception to 9th September in 2016. Two authors independently identified trials, extracted data and assessed risk of bias with Cochrane Reviewer's Handbook 5.0. We conducted meta-analysis with RevMan 5.1.0 software for eligible and appropriate trials.Results: In the end, 7,035 participants from 51 randomized controlled trials (RCTs) which compared dispensing granules with traditional decoction were included in this systematic review. There were 33 different kinds of diseases for investigation, of which 8 RCTs observed common cold, 4 RCTs observed migraine. For rheumatoid arthritis, insomnia and hypertension, there were 3 RCTs reported respectively.The last RCTs reported different kinds of diseases in one or two trials. The majority of trials were in low methodological quality. Thirty-eight (74.5%) RCTs showed that the efficacy of dispensing granules were similar with traditional decoction, 6 (11.8%) RCTs reported that the therapeutic efficacy of dispensing granules were significantly better than traditional decoction. We conducted meta-analysis for 4 trials investigating patients with migraine. The results showed that dispensing granules reduced headache frequency by about 1.03 attacks per month as compared to traditional decoction. No evidence was found in terms of migraine intensity and duration. Conclusions:The low quality of RCTs and conflicting results made it difficult to draw a definite conclusion. In the future, it needs much more evidence to explore the efficacy and safety of dispensing granules. N-of-1 trials and fuzzy comprehensive evaluation methods may be better choices for assessing the efficacy of them than RCTs.

A sensitive UPLC–MS/MS method for simultaneous determination of polyphenols in rat plasma: Application to a pharmacokinetic study of dispensing granules and standard decoction of Cinnamomum cassia twigs

“…The equivalence between dispensing granules and standard decoction remains unknown. Recent meta-analysis, which reviewed the efficacy of dispensing granules and traditional decoctions, revealed that the clinical evidence for dispensing granules is controversial (Qiu, Zhang, Zhao, Li, & Shang, 2017).…”

Patients’ and clinicians’ expectations on integrative medicine Services for Diabetes: a focus group study

“…Integrated clinics are increasingly common globally and provide a platform for physicians from different streams to design and evaluate IM protocols [48]. High quality decoctingfree herbal granules provide patients more standardised and user-friendly administration for long-term use [49].…”

Traditional Chinese Medicine: From Aqueous Extracts to Therapeutic Formulae

“…With the increasing development of TCM granules, international research has focused on whether decoction can be replaced by granules with similar effectiveness and safety [15]. During the procedure of granule preparation, the difference of water extraction, concentration, desiccation and granulation may influence the dissolution and chemical profiles of active ingredients [85]. Thus, this may result in different clinical efficacy between granules and decoction.…”