title: Chinese herbal medicine for Henoch-Schönlein purpura in children without renal damage: a systematic review of randomized controlled trials.
abstract: BACKGROUND
  Henoch-Schönlein Purpura (HSP) is the most common necrotizing vasculitis affecting children. Traditional Chinese herbal medicine (CHM) was widely used. We aim to explore the evidence of effectiveness and safety of CHM for HSP in children without renal damage.
  
  
  METHODS
  Randomized controlled trials (RCTs) comparing CHM with conventional medications were searched from five databases. Eligible data were pooled using random-effects model using RevMan 5.2 Subgroup analysis for different co-interventions and sensitivity analysis for reducing heterogeneity were implemented. GRADE approach was adopted.
  
  
  RESULTS
  We included 15 trials with 1112HSP children (age 1-16 years old), disease duration one day to three months. The overall methodological quality of included trials is relatively low. Adjunctive oral CHM treatments reduced renal damage (6 trials, RR 0.47, 95%CI 0.31-0.72, I(2)=0%), and subsiding time (days) of purpura (5 trials, mean difference (MD) -3.60, 95%CI -4.21 to -2.99, I(2)=23%), joint pain (5 trials, MD -1.04, 95%CI -1.33 to -0.74, I(2)=1%) and abdomen pain (5 trials, MD -1.69, 95%CI -2.51 to -0.86, I(2)=74%). Subgroup and sensitivity analysis did not change the direction of results. No severe adverse events reported.
  
  
  CONCLUSIONS
  Orally taken adjunctive CHM treatments are effective for children suffering HSP in terms of reducing renal damage and subsiding time of purpura, and could possibly reduce subsiding pain of joint and abdomen. No reliable conclusion regarding safety is possible based on the safety data retrieved. Further rigorous trials are warranted.
authors.affiliation: Chinese Medicine Department, Children's Hospital of Zhengzhou, PR China; Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China.
authors.forename: Congcong
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Academic Exchange, World Federation of Chinese Medicine Societies, PR China.
authors.forename: Xinxue
authors.initials: X
authors.lastname: Li
authors.affiliation: Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China.
authors.forename: Qianyun
authors.initials: Q
authors.lastname: Chai
authors.affiliation: Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China. Electronic address: yutong_fei@163.com.
authors.forename: Yutong
authors.initials: Y
authors.lastname: Fei
authors.affiliation: Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China.
authors.forename: Ruyu
authors.initials: R
authors.lastname: Xia
authors.affiliation: Pediatric Department, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, PR China.
authors.forename: Rongqian
authors.initials: R
authors.lastname: Xu
authors.affiliation: Anyang Hospital of Traditional Chinese Medicine, Henan Province, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, PR China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy*; D008297:Male; D008516:Medicine, Chinese Traditional; D008517:Phytotherapy; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Children; Chinese herbal medicine; Henoch–Schönlein purpura; Renal damage; Systematic review