Effectiveness, Medication Patterns, and Adverse Events of Traditional Chinese Herbal Patches for Osteoarthritis: A Systematic Review

Abstract

Objective. The aim of this study is to systematically evaluate the evidence whether traditional Chinese herbal patches (TCHPs) for osteoarthritis (OA) are effective and safe and analyze their medication patterns. Methods. A systematic literature search was performed using all the possible Medical Subject Headings (MeSH) and keywords from January 1979 to July 2013. Both randomized controlled trials (RCTs) and observational studies were included. Estimated effects were analyzed using mean difference (MD) or relative risk (RR) with 95% confidence intervals (CI) and meta-analysis. Results. 86 kinds of TCHPs were identified. RCTs and controlled clinical trials (CCTs) which were mostly of low quality favored TCHPs for local pain and dysfunction relief. TCHPs, compared with diclofenac ointment, had significant effects on global effectiveness rate (RR = 0.50; 95% CI (0.29, 0.87)). Components of formulae were mainly based on the compounds “Xiao Huo Luo Dan” (Minor collateral-freeing pill) and “Du Huo Ji Sheng Tang” (Angelicae Pubescentis and Loranthi decoction). Ten kinds of adverse events (AEs), mainly consisting of itching and/or local skin rashes, were identified after 3-4 weeks of follow-up. Conclusions. TCHPs have certain evidence in improving global effectiveness rate for OA; however, more rigorous studies are warranted to support their use.

Mori folium inhibits interleukin-1β-induced expression of matrix metalloproteinases and inflammatory mediators by suppressing the activation of NF-κB and p38 MAPK in SW1353 human chondrocytes

“…For thousands of years, herbal medicines have been used safely and effectively for alleviating and treating various diseases in many countries; there is increasing interest in the pharmacological activity of traditional herbs that are widely used in traditional medicine, and numerous studies support their potential clinical benefits for diseases that are difficult to treat (15,16). Among them, Morus alba L., or white mulberry, a deciduous tree that belongs to the Moraceae family, is widely distributed in Asia (16).…”

“…For thousands of years, herbal medicines have been used safely and effectively for alleviating and treating various diseases in many countries; there is increasing interest in the pharmacological activity of traditional herbs that are widely used in traditional medicine, and numerous studies support their potential clinical benefits for diseases that are difficult to treat (15,16). Among them, Morus alba L., or white mulberry, a deciduous tree that belongs to the Moraceae family, is widely distributed in Asia (16). In particular, Mori folium, the leaves of Morus alba L., is one of the most widely consumed medicinal herbs in Asia, including Korea, and medications made from Mori folium have been found to be useful in the treatment of metabolic disorders, such as diabetes, hyperlipidemia, and high blood pressure (17)(18)(19).…”

Shikonin inhibits inflammation and chondrocyte apoptosis by regulation of the PI3K/Akt signaling pathway in a rat model of osteoarthritis

“…Osteoarthritis is a cause of long-term disability second only to cardiovascular disease in China (2). On the basis of a review, osteoarthritis giving rise to damage affects 2-6% of the population (3). Osteoarthritis has a greater influence on elderly patients than other diseases, affecting, for example, the ability to go up and down the stairs and other lower limb functions (4).…”

Duhuo Jisheng decoction inhibits endoplasmic reticulum stress in chondrocytes induced by tunicamycin through the downregulation of miR-34a

“…Natural products have been proved effective in treating OA by decreasing joint pain and dysfunction, and preventing and delaying the cartilage degeneration (25,26). DHJSD contains a number of natural products with numerous chemical compounds that have been deemed to have multi-target agents and multi-components exerting their therapeutic function.…”