title: Chinese herbal medicine for cancer-related fatigue: a systematic review of randomized clinical trials.
abstract: OBJECTIVE
  To assess the effectiveness and safety of Chinese herbal medicine for the treatment of cancer-related fatigue.
  
  
  METHODS
  We systematically searched seven electronic databases and two trial registries for randomized clinical trials of Chinese herbal medicine for cancer-related fatigue. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data were synthesized using RevMan 5.2 software.
  
  
  RESULTS
  A total of 10 trials involving 751 participants with cancer-related fatigue were identified and the methodological quality of the included trials was generally poor. Chinese herbal medicine used alone or in combination with chemotherapy or supportive care showed significant relief in cancer-related fatigue compared to placebo, chemotherapy or supportive care based on single trials. Chinese herbal medicine plus chemotherapy or supportive care was superior to chemotherapy or supportive care in improving quality of life. Data from one trial demonstrated Chinese herbal medicine exerted a greater beneficial effect on relieving anxiety but no difference in alleviating depression. Seven trials reported adverse events and no severe adverse effects were found in Chinese herbal medicine groups.
  
  
  CONCLUSIONS
  The findings from limited number of trials suggest that Chinese herbal medicine seems to be effective and safe in the treatment of cancer-related fatigue. However, the current evidence is insufficient to draw a confirmative conclusion due to the poor methodological quality of included trials. Thus, conducting rigorously designed trials on potential Chinese herbal medicine is warranted.
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China; School of Nursing, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100102, China.
authors.forename: Chun-Xiang
authors.initials: CX
authors.lastname: Su
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China.
authors.forename: Li-Qiong
authors.initials: LQ
authors.lastname: Wang
authors.affiliation: National Institute of Complementary Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
authors.forename: Suzanne J
authors.initials: SJ
authors.lastname: Grant
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China. Electronic address: Jianping_l@hotmail.com.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005221:Fatigue / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D008517:Phytotherapy / Q000379:methods*
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Cancer-related fatigue; Chinese herbal medicine; Randomized clinical trial; Systematic review