Meta‐analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis

Wang, Shijun; Tang, Qiaofei; Qian, Wei; Fan, Yu

doi:10.1111/j.1398-9995.2012.02806.x

Cited by 45 publications

(35 citation statements)

References 28 publications

(57 reference statements)

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“…Compared to sham acupuncture, acupuncture showed a greater improvement on the symptoms of allergic rhinitis than sublingual immunotherapy . Also, acupuncture showed a larger effect than Chinese herbal medicine when compared to the waitlist group .…”

Section: Discussionmentioning

confidence: 85%

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

Choi

Park

et al. 2012

Allergy

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Background: The aim of this study was to evaluate the efficacy and safety of acupuncture in the treatment for allergic rhinitis. Methods: This study was a multicenter, randomized, parallel-controlled study. Participants were randomized to either the active acupuncture, sham acupuncture, or waitlist groups. The active and sham acupuncture groups received acupuncture treatment three times per week for 4 weeks. In the sham group, minimal acupuncture at nonacupuncture points was used. The waitlist group did not receive any acupuncture treatment. Results: Of the 238 participants, 97, 94, and 47 individuals were assigned to the active acupuncture, sham acupuncture, and waitlist group, respectively. After the treatment, the difference in the total nasal symptom score (TNSS) was significantly reduced in the active acupuncture group compared with the sham acupuncture (difference: À1.03, 95% confidence interval [CI]: À1.96, À0.09, P = 0.03) and waitlist (difference: À2.49, 95% CI: À3.68, À1.29, P < 0.0001). The active acupuncture group exhibited a significant change in the total non-nasal symptom score (TNNSS) compared with the waitlist (difference: À0.78, 95% CI: À1.22, À0.34, P = 0.0002), but not the sham acupuncture group (difference; 0.15, 95% CI: À0.21, 0.5, P = 0.56). Both active and sham acupuncture treatments resulted in significant improvements in TNSS and TNNSS compared to baseline. Conclusion: Active acupuncture showed a significantly greater effect on symptoms of allergic rhinitis than either sham acupuncture or no active treatment. The symptoms of allergic rhinitis decreased significantly after treatment in the both acupuncture and sham acupuncture groups. Acupuncture appears to be an effective and safe treatment for allergic rhinitis.

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Section: Discussionmentioning

confidence: 85%

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

Choi

Park

et al. 2012

Allergy

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“…Notably, the meta-analysis by Wang et al 10 assessing 7 RCTs suggested that CHM improved total nasal symptom scores as compared with placebo. This discordant finding between the study of Wang et al 10 and ours may be a consequence of significant heterogeneity observed in both studies and differences in the backgrounds of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, several clinical studies have evaluated the effects of CHM, such as Yu-ping-feng San (YS), Cure-allergic-rhinitis syrup (CS), fermented red ginseng, or Biminne capsules. 8 9 Wang et al 10 have suggested that CHM therapy is useful for the treatment of nasal symptoms in AR patients, based on the effect of decreased nasal symptoms in patients enrolled in seven randomized controlled trials (RCTs). However, some clinical trials have subsequently provided conflicting data for the potential benefit of CHM for AR, 11 12 Itching and sneezing represent two of the main bothersome symptoms of AR, and activation of the central and peripheral nervous systems plays an important role in the 2 processes.…”

Section: Introductionmentioning

confidence: 99%

Chinese Herbal Medicine to Treat Allergic Rhinitis: Evidence From a Meta-Analysis

Zhang

Feng

Zhang

et al. 2018

Allergy Asthma Immunol Res

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PurposeChinese herbal medicine (CHM) has been widely used in China to treat allergic rhinitis (AR). However, several studies have produced conflicting data with regard to the efficacy of the medicine. Our aim was to perform a meta-analysis of randomized clinical trials (RCTs) to evaluate the relative efficacy of CHM.MethodsWe systematically searched the PubMed, Medline, and Springer electronic databases up to March 2017 for RCTs comparing the efficacy of CHM versus placebo for the treatment of patients with AR. Total nasal symptoms and quality of life were assessed through pooling mean difference (MD) with its 95% confidence interval (CI). Moreover, sensitivity and subgroup analyses according to control design and quality of life assessment were performed to evaluate the source of heterogeneity.ResultsEleven RCTs were enrolled in the meta-analysis. Assessment of overall heterogeneity indicated significant heterogeneity among the individual studies (I2=100%, P<0.00001), and thus ransomed effects model was used to pool data. CHM was found to significantly enhance quality of life compared with placebo (MD=-0.88, (95% CI: -1.55, -0.21); P=0.01). The symptom of itchy nose, sneezing or total nasal symptoms scores were not significantly improved after CHM treatment, although the improvement in itchy nose just failed to reach significance (MD=0.09, (95% CI: 0.00, 0.18); P=0.06).ConclusionsThis study suggests that CHM appears to improve the quality of life of AR patients. However, these findings, as well as the findings for the effect of CHM on sneezing, total nasal symptoms, and the symptom of itchy nose, need to be substantiated in larger cohorts of AR patients by further well-designed studies.

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“…This guideline also pointed out that Chinese herbal medicine (CHM) has often been utilized for managing AR in clinical practice, although the evidence supporting its efficacy and mechanism of action is uncertain [ 5 ]. As suggested by a systematic review published in 2012, CHM might be more effective than placebo for persistent allergic rhinitis, but a confirmed conclusion could not be drawn since all included studies suffered certain methodological limitations [ 8 ].One CHM formula, Yu ping feng san (YPFS), was recommended by Chinese medicine clinical practice guideline to manage AR despite its classification and severity, but the effective treatment duration is not clear [ 9 ]. YPFS formula contains three key herbs: Astragalus membranaceus ( huang qi ), Rhizoma Atractylodis Macrocephalae ( bai zhu ) and Radix Ledebouriellae Divaricatae ( fang feng ) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials

Luo

Zhang

Yang

et al. 2017

BMC Complement Altern Med

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BackgroundChinese herbal medicine formula Yu ping feng san (YPFS) is commonly used for allergic rhinitis (AR). Previous review had summarized the effectiveness and safety of YPFS, however without any subgroup analysis performed to provide detailed evidence for guiding clinical practice. YPFS was recommended for the management of AR by Chinese medicine clinical practice guideline, but the treatment duration of YPFS was also not specified. The aim of this study is to evaluate the effectiveness and safety of YPFS in treating adult AR with the most recent evidence, and attempt to specify the duration of utilisation through subgroup meta-analyses.MethodsSeven databases were searched from their inceptions to September 2017. Randomized controlled trials (RCTs) evaluating YPFS for adult AR were included. Methodological quality of studies was assessed using the Cochrane risk of bias tool. Meta-analysis and subgroup meta-analyses were conducted for evaluating the effectiveness of YPFS. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for rating the quality of evidence.ResultsTwenty-two RCTs involving 23 comparisons were included in this review. YPFS was compared to placebo, pharmacotherapy, and used as an add-on treatment compared to pharmacotherapy. Meta-analyses were feasible for the outcomes of four individual nasal symptom scores and “effective rate”. Four individual nasal symptom scores decreased after YPFS’ combination treatment: itchy nose (MD-0.46, 95% CI[−0.50, −0.42]), sneezing (MD-0.41, 95% CI[−0.47, −0.35]), blocked nose (MD-0.46, 95% CI[−0.54, −0.39]) and runny nose (MD-0.42, 95% CI[−0.58, −0.26]). Based on “effective rate”, meta-analysis showed that YPFS did not achieve better effect than pharmacotherapy (RR1.07, 95%CI [0.94, 1.22), but its combination with pharmacotherapy seemed more effective than pharmacotherapy alone (RR1.27, 95%CI [1.19, 1.34]) (low quality). Subgroup analysis suggested that YPFS was not superior to the second-generation antihistamine (RR1.04, 95%CI [0.90, 1.19]) (low quality). Further, YPFS’ combination treatment seemed more beneficial when it was used for more than three weeks (RR1.15, 95%CI [1.01, 1.32]). In addition, YPFS was well-tolerated for treating adult AR.ConclusionChinese herbal medicine formula YPFS seems beneficial for adult AR. This potential benefit need to be further evaluated by more rigorous RCTs.Electronic supplementary materialThe online version of this article (10.1186/s12906-017-1988-5) contains supplementary material, which is available to authorized users.

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Meta‐analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis

Cited by 45 publications

References 28 publications

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

Chinese Herbal Medicine to Treat Allergic Rhinitis: Evidence From a Meta-Analysis

Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials

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