Effects of Chinese herbal formula Erxian decoction for treating osteoporosis: a systematic review

Abstract

PurposeThe aim is to systematically assess the effectiveness and safety of Chinese herbal formula Erxian decoction (EXD) for treating osteoporosis.Materials and methodsSix databases were searched from inception through September 17, 2016, without language restriction. All randomized controlled trials of EXD for osteoporosis were included. One or more outcome measures including fracture, change in bone mineral density (BMD), pain symptom improvement, bone biochemical markers, quality of life, adverse event or adverse drug reaction were evaluated. Study selection, data extraction, quality assessment, and data analyses were conducted according to Cochrane standards.ResultsEight trials including 644 patients investigated the effects of EXD in the treatment of osteoporosis. The methodological quality of the included trials was generally low. The meta-analysis from two trials showed favorable effects of EXD in improving BMD of lumbar spine (mean difference [MD]: 0.05 [0.03, 0.06]; I2=0%; P<0.00001) and BMD of femoral great trochanter (MD: 0.06 [0.02, 0.10]; I2=59%; P=0.005) compared with caltrate tablets. The other meta-analysis from two trials showed beneficial effects of EXD plus caltrate tablets and calcitriol in improving BMD of femoral neck (MD: 0.04 [0.00, 0.09]; I2=56%; P=0.04), the level of calcium (MD: 0.20 [0.15, 0.24]; I2=0%; P<0.00001), and phosphorus (MD: −0.28 [−0.39, −0.17]; I2=68%; P<0.00001) compared with caltrate tablets and calcitriol alone. The adverse drug reactions of EXD were mainly slight gastrointestinal symptoms.ConclusionThe study provides suggestive evidence of the superiority of EXD monotherapy or combination therapy over basic supplements for treating osteoporosis. However, the evidence remains weak. More rigorously designed and measured, randomized double-blind, placebo-controlled trials with larger sample size are needed to verify the current conclusions.

An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula

“…Accordingly, there is a clear requirement for newer therapeutic options or agents. In recent years, the increasing use of complementary and alternative medicine, including Chinese herbal medicine, for treating osteoporosis has attracted widespread attention (Li et al, 2017; Wang et al, 2018; Zhang et al, 2016).…”

Efficacy and Safety of Duhuo Jisheng Decoction for Postmenopausal Osteoporosis: A Systematic Review and Meta‐Analysis

“…Traditional herbal medicines have been used as complementary and alternative treatment options for osteoporosis patients for a long time. Some reviews have assessed the efficacy and safety of different Chinese multiherb prescriptions in treating osteoporosis, such as Liuwei Dihuang decoction and Erxian decoction [ 19 , 20 ]. But considering the diversity of Chinese herbal medicine, we have reason to believe that there is still huge part of diverse herbs compound recipes which remains unexplored.…”

Small molecules for mesenchymal stem cell fate determination

“…The gene expression profiles showed that the common genes that were upregulated during EXD extract treatment were related to the MAPK signaling pathway, indicating that EXD exerted its effect by regulating the MAPK signaling pathway. A clinical trial showed that EXD improved bone mineral density at both the lumbar spine and the femoral head in postmenopausal women, demonstrating an osteoprotective effect[95]. However, no study has demonstrated its effect on the incidence rate of fracture.…”