title: Efficacy and safety of herbal medicines for idiopathic Parkinson's disease: a systematic review.
abstract: The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted.
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
authors.forename: Vincent
authors.initials: V
authors.lastname: Chung
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Bian
authors.forename: Zhongzhen
authors.initials: Z
authors.lastname: Zhao
authors.forename: Wai
authors.initials: W
authors.lastname: Leuk Fong
authors.forename: Wan Fung
authors.initials: WF
authors.lastname: Kum
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.forename: Min
authors.initials: M
authors.lastname: Li
mesh_terms: D000978:Antiparkinson Agents / Q000008:administration & dosage*; D000529:Complementary Therapies; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage; D010300:Parkinson Disease / Q000188:drug therapy*; D008517:Phytotherapy; D010936:Plant Extracts / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D004365:Drugs, Chinese Herbal; D010936:Plant Extracts; D007980:Levodopa