What phytotherapy needs: Evidence‐based guidelines for better clinical practice

We performed a meta‐analysis to evaluate the efficacy of turmeric/curcumin supplementation on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in patients with nonalcoholic fatty liver disease (NAFLD). We searched PubMed, Scopus, Cochrane Library, ISI Web of Science, and Google Scholar up to November 20, 2018. Studies that examined the effect of turmeric/curcumin on serum concentrations of ALT and AST among patients with NAFLD were included. The mean difference and standard deviation (SD) of changes in ALT and AST between intervention and control groups were used as effect size for the meta‐analysis. A total of six randomized controlled trials (RCTs) were eligible for meta‐analysis. Results from pooled analysis revealed that turmeric/curcumin supplementation reduced ALT (MD: −7.31 UL/L, 95% CI [−13.16, −1.47], p = 0.014) and AST (MD: −4.68 UL/L, 95% CI [−8.75 −0.60], p = 0.026). When RCTs stratified on the basis of their treatment duration, the significant reduction in serum concentrations of ALT and AST was observed only in studies lasting less than 12 weeks. This review suggests that turmeric/curcumin might have a favorable effect on serum concentrations of ALT and AST in patients with NAFLD. However, further clinical trials are needed to confirm these findings.

Section: Discussionmentioning

confidence: 99%

Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? A systematic review and meta‐analysis of randomized controlled trials

Goodarzi

Sabzian

Shishehbor

et al. 2019

“…Over the past decade, many advances have been made in research conducted on herbs with weight‐loss properties, many of which have supported the effectiveness of medicinal plants in the treatment of obesity and metabolic syndrome factors. Regarding the fact that systematic review studies produce the highest level of evidence, this study aimed to investigate the efficacy, safety and mechanisms of effective herbal medicines in the management and treatment of obesity and metabolic syndrome in RCTs (Colalto, ; Izzo et al, ). All plants with therapeutic effects on obesity and components of the metabolic syndrome are summarized in Tables 3, 4, and 5 (Supplementary).…”

Section: Discussionmentioning

confidence: 99%

Effect of the herbal medicines in obesity and metabolic syndrome: A systematic review and meta‐analysis of clinical trials

Payab

Hasani‐Ranjbar

Shahbal

et al. 2019

100

Obesity is a medical situation in which excess body fat has gathered because of imbalance between energy intake and energy expenditure. In spite of the fact that the variety of studies are available for obesity treatment and management, its “globesity” still remains a big challenge all over the world. The current systematic review and meta‐analysis aimed to evaluate the efficacy, safety, and mechanisms of effective herbal medicines in the management and treatment of obesity and metabolic syndrome in human. We systematically searched all relevant clinical trials via Web of Science, Scopus, PubMed, and the Cochrane database to assess the effects of raw or refined products derived from plants or parts of plants on obesity and metabolic syndrome in overweight and obesity adult subjects. All studies conducted by the end of May 2019 were considered in the systematic review. Data were extracted independently by two experts. The quality assessment was assessed using Consolidated Standards of Reporting Trials checklist. The main outcomes were anthropometric indices and metabolic syndrome components. Pooled effect of herbal medicines on obesity and metabolic syndrome were presented as standardized mean difference (SMD) and 95% confidence interval (CI). A total of 279 relevant clinical trials were included. Herbals containing green tea, Phaseolus vulgaris, Garcinia cambogia, Nigella sativa, puerh tea, Irvingia gabonensis, and Caralluma fimbriata and their active ingredients were found to be effective in the management of obesity and metabolic syndrome. In addition, C. fimbriata, flaxseed, spinach, and fenugreek were able to reduce appetite. Meta‐analysis showed that intake of green tea resulted in a significant improvement in weight ([SMD]: −0.75 [−1.18, −0.319]), body mass index ([SMD]: −1.2 [−1.82, −0.57]), waist circumference ([SMD]: −1.71 [−2.66, −0.77]), hip circumference ([SMD]: −0.42 [−1.02, −0.19]), and total cholesterol, ([SMD]: −0.43 [−0.77, −0.09]). In addition, the intake of P. vulgaris and N. sativa resulted in a significant improvement in weight ([SMD]: −0.88, 95 % CI: [−1.13, −0.63]) and triglyceride ([SMD]: −1.67, 95 % CI: [−2.54, −0.79]), respectively. High quality trials are still needed to firmly establish the clinical efficacy of the plants in obesity and metabolic syndrome.

“…Systematic review and meta‐analysis, a widely acceptable research method, is at the top in the hierarchy of the evidence assessment (Colalto, ; Izzo, Hoon‐Kim, Radhakrishnan, & Williamson, ). However, to the best of our knowledge, there has been no evaluation of the clinical evidence regarding CSD as intervention for blood lipid in evidence‐based medicine.…”

Section: Discussionmentioning

confidence: 99%

Corn silk decoction for blood lipid in patients with angina pectoris: A systematic review and meta‐analysis

Shi

et al. 2019

The aims of this study were to evaluate the efficacy of corn silk decoction on lipid profile in patients with angina pectoris. PubMed, Cochrane, Embase, Google Scholar, Chongqing VIP Chinese Science and Technology Periodical Database, China National Knowledge Infrastructure, and Wanfang database were searched up to January 2019 for randomized controlled trials that assessed the impact of corn silk decoction on total cholesterol, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol in patients with angina pectoris. Study evaluation and synthesis methods were in accordance with the Cochrane Handbook, and data were analyzed using Review Manager (version 5.3) software. Random effects model was applied in this systematic review and meta‐analysis to compensate for potential heterogeneity among the included studies. A total of four randomized controlled trials were eligible for meta‐analysis. Pooled results of these studies indicated that corn silk decoction might improve high‐density lipoprotein cholesterol and reduce total cholesterol, triglycerides, and low‐density lipoprotein cholesterol in patients with angina pectoris. Subgroup analyses showed that corn silk decoction or modified corn silk decoction plus conventional pharmaceutical treatment could have favorable effects on blood lipids. However, the lack of blinding in most studies may have led to overestimation of these effects. Further studies with better design are needed to confirm these findings.