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Effectiveness and Safety of Manufactured Chinese Herbal Formula for Knee Osteoarthritis: Insights from a Systematic Review.

Zhu L, Yang S, Wang S, Gong H, Li L, Wei X - Evid Based Complement Alternat Med (2015)

Bottom Line: Additionally, MCHF plus routine treatments significantly decreased the scores of WOMAC and Lequesne index.No significant differences were found in Lysholm scores.Our results indicated that MCHF showed some potential benefits for KOA.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China.

ABSTRACT
Objective. To assess the current clinical evidence of manufactured Chinese herbal formulae (MCHF) for knee osteoarthritis (KOA). Methods. Seven databases were searched from inception to May 2015. Eligible randomized controlled trials investigating the effectiveness of MCHF for KOA were included. Data extraction, methodological assessment, and meta-analyses were conducted according to the Cochrane standards. Results. A total of 17 kinds of MCHF were identified from the twenty-six included trials. Meta-analyses showed that MCHF significantly relieved the global pain of knee joints, either used alone or combined with routine treatments. Additionally, MCHF plus routine treatments significantly decreased the scores of WOMAC and Lequesne index. However, there were no statistical differences between MCHF group and routine treatment group in walk-related pain and WOMAC scores. No significant differences were found in Lysholm scores. There were twenty-one trials that mentioned adverse events. A pooled analysis showed that adverse events occurred more frequently in control group compared with MCHF group. Conclusions. Our results indicated that MCHF showed some potential benefits for KOA. However, we still cannot draw firm conclusions due to the poor methodological quality of included trials. More high-quality RCTs would help to confirm the evidence.

No MeSH data available.


Related in: MedlinePlus

Forest plot of comparison: MCHF individually versus routine treatment for KOA, outcome: WOMAC score.
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fig5: Forest plot of comparison: MCHF individually versus routine treatment for KOA, outcome: WOMAC score.

Mentions: Five trials [29, 38, 40, 41, 47] with 6 comparisons including 662 participants reported the effect of MCHF individually versus routine treatments. A random effects model was used for meta-analysis (χ2 = 38.72, P < 0.00001; I2 = 87%). No significant differences were found between the two groups on WOMAC scores (SMD: 0.06 [−0.39, 0.51]; P = 0.80). Subgroup analysis revealed a better therapeutic effect in experimental group compared with oral NSAIDs group (SMD: 0.44 [0.05, 0.82]; P = 0.03). No statistically significant differences were found when compared with oral glucosamine (SMD: 0.09 [−0.41, 0.60]; P = 0.71) or ozone injection (SMD: −0.34 [−0.73, 0.06]; P = 0.09). The therapeutic effect of MCHF fell short of sodium hyaluronate injection in WOMAC scores (SMD: −0.75 [−1.24, −0.26]; P = 0.003) (as shown in Figure 5).


Effectiveness and Safety of Manufactured Chinese Herbal Formula for Knee Osteoarthritis: Insights from a Systematic Review.

Zhu L, Yang S, Wang S, Gong H, Li L, Wei X - Evid Based Complement Alternat Med (2015)

Forest plot of comparison: MCHF individually versus routine treatment for KOA, outcome: WOMAC score.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644564&req=5

fig5: Forest plot of comparison: MCHF individually versus routine treatment for KOA, outcome: WOMAC score.
Mentions: Five trials [29, 38, 40, 41, 47] with 6 comparisons including 662 participants reported the effect of MCHF individually versus routine treatments. A random effects model was used for meta-analysis (χ2 = 38.72, P < 0.00001; I2 = 87%). No significant differences were found between the two groups on WOMAC scores (SMD: 0.06 [−0.39, 0.51]; P = 0.80). Subgroup analysis revealed a better therapeutic effect in experimental group compared with oral NSAIDs group (SMD: 0.44 [0.05, 0.82]; P = 0.03). No statistically significant differences were found when compared with oral glucosamine (SMD: 0.09 [−0.41, 0.60]; P = 0.71) or ozone injection (SMD: −0.34 [−0.73, 0.06]; P = 0.09). The therapeutic effect of MCHF fell short of sodium hyaluronate injection in WOMAC scores (SMD: −0.75 [−1.24, −0.26]; P = 0.003) (as shown in Figure 5).

Bottom Line: Additionally, MCHF plus routine treatments significantly decreased the scores of WOMAC and Lequesne index.No significant differences were found in Lysholm scores.Our results indicated that MCHF showed some potential benefits for KOA.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China.

ABSTRACT
Objective. To assess the current clinical evidence of manufactured Chinese herbal formulae (MCHF) for knee osteoarthritis (KOA). Methods. Seven databases were searched from inception to May 2015. Eligible randomized controlled trials investigating the effectiveness of MCHF for KOA were included. Data extraction, methodological assessment, and meta-analyses were conducted according to the Cochrane standards. Results. A total of 17 kinds of MCHF were identified from the twenty-six included trials. Meta-analyses showed that MCHF significantly relieved the global pain of knee joints, either used alone or combined with routine treatments. Additionally, MCHF plus routine treatments significantly decreased the scores of WOMAC and Lequesne index. However, there were no statistical differences between MCHF group and routine treatment group in walk-related pain and WOMAC scores. No significant differences were found in Lysholm scores. There were twenty-one trials that mentioned adverse events. A pooled analysis showed that adverse events occurred more frequently in control group compared with MCHF group. Conclusions. Our results indicated that MCHF showed some potential benefits for KOA. However, we still cannot draw firm conclusions due to the poor methodological quality of included trials. More high-quality RCTs would help to confirm the evidence.

No MeSH data available.


Related in: MedlinePlus