Systematic review and meta-analysis of the clinical efficacy and adverse effects of Chinese herbal decoction for the treatment of gout.
BACKGROUND
In East Asia, numerous reports describe the utilization of traditional Chinese herbal decoctions to treat gout. However, the reported clinical effects vary.


OBJECTIVE
In this study, we reviewed and analyzed a large number of randomized controlled clinical trials to systematically assess the clinical efficacy and adverse reactions of Chinese herbal decoctions for treating gout.


METHODS
We performed a comprehensive search of databases, such as PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database, et al. In addition, we manually searched the relevant meeting information in the library of the Third Military Medical University.


RESULTS
Finally, 17 randomized controlled trials with a sample size of 1,402 cases met the criteria and were included in the study. The results of the meta-analysis showed that when gout had progressed to the stage of acute arthritis, there was no significant difference in clinical efficacy between Chinese herbal decoctions and traditional Western medicine, as indicated based on the following parameters: serum uric acid (standardized mean difference (SMD):0.35, 95% confidence interval (CI): 0.03 to 0.67), C reactive protein (SMD: 0.25, 95% CI: -0.18 to 0.69), erythrocyte sedimentation rate (SMD: 0.21, 95% CI: -0.02 to 0.45) and overall clinical response (relative risk (RR): 1.05, 95% CI: 1.01 to 1.10). However, the Chinese herbal decoction was significantly better than traditional Western medicine in controlling adverse drug reactions (RR: 0.06, 95% CI: 0.03 to 0.13).


CONCLUSIONS
Through a systematic review of the clinical efficacy and safety of Chinese herbal decoctions and traditional Western medicine for the treatment of gout, we found that Chinese herbal decoction and traditional Western medicine led to similar clinical efficacy, but the Chinese herbal decoctions were superior to Western medicine in terms of controlling adverse drug reactions.
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Liang
L
Zhou
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China ; P. E. Department of Physical Education of Chongqing University of Arts and Sciences, Chongqing, China.
Ling
L
Liu
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Xiaoyu
X
Liu
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Pinyi
P
Chen
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Ling
L
Liu
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Yanqi
Y
Zhang
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Yazhou
Y
Wu
University of Washington, School of Arts and Sciences, Department of Biological Sciences and Department of Asian Language and Literature, Seattle, Washington, United States of America.
Julia Christine
JC
Pettigrew
School of Software Engineering, Chongqing University of Posts and Telecommunications, Chongqing, China.
Dixiang
D
Cheng
Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing, China.
Dong
D
Yi
D000328:Adult; D000368:Aged; D016206:Databases, Bibliographic; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage* / Q000009:adverse effects; D006073:Gout / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006074:Gout Suppressants / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
D004365:Drugs, Chinese Herbal; D006074:Gout Suppressants; D014527:Uric Acid