title: Chinese Herbal Medicine for Symptom Management in Cancer Palliative Care: Systematic Review And Meta-analysis.
abstract: Use of Chinese herbal medicines (CHM) in symptom management for cancer palliative care is very common in Chinese populations but clinical evidence on their effectiveness is yet to be synthesized. To conduct a systematic review with meta-analysis to summarize results from CHM randomized controlled trials (RCTs) focusing on symptoms that are undertreated in conventional cancer palliative care.Five international and 3 Chinese databases were searched. RCTs evaluating CHM, either in combination with conventional treatments or used alone, in managing cancer-related symptoms were considered eligible. Effectiveness was quantified by using weighted mean difference (WMD) using random effect model meta-analysis. Fourteen RCTs were included. Compared with conventional intervention alone, meta-analysis showed that combined CHM and conventional treatment significantly reduced pain (3 studies, pooled WMD: -0.90, 95% CI: -1.69 to -0.11). Six trials comparing CHM with conventional medications demonstrated similar effect in reducing constipation. One RCT showed significant positive effect of CHM plus chemotherapy for managing fatigue, but not in the remaining 3 RCTs. The additional use of CHM to chemotherapy does not improve anorexia when compared to chemotherapy alone, but the result was concluded from 2 small trials only. Adverse events were infrequent and mild. CHM may be considered as an add-on to conventional care in the management of pain in cancer patients. CHM could also be considered as an alternative to conventional care for reducing constipation. Evidence on the use of CHM for treating anorexia and fatigue in cancer patients is uncertain, warranting further research.
authors.affiliation: From the Hong Kong Institute of Integrative Medicine (VCHC, XW, EPH, AYLL, SYSW, JCYW), The Chinese University of Hong Kong, Hong Kong, China; School of Public Health and Primary Care (VCHC, XW, PL, JZ, MF, SYSW), The Chinese University of Hong Kong, Hong Kong, China; Comprehensive Cancer Trials Unit (EPH), The Chinese University of Hong Kong, Hong Kong, China; Department of Family and Community Medicine (YZ), Texas Tech University, Lubbock; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health (YZ, ALZ), University of Technology Sydney, Sydney, Australia; Traditional & Complementary Medicine Research Program (ALZ), School of Health Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Australia; Department of Medicine and Therapeutics (AYLL, JCYW), The Chinese University of Hong Kong, Hong Kong, China; and Chinese Medicine Department (ETCZ, BFLN), Hong Kong Hospital Authority, Hong Kong, China.
authors.forename: Vincent C H
authors.initials: VCH
authors.lastname: Chung
authors.forename: Xinyin
authors.initials: X
authors.lastname: Wu
authors.forename: Ping
authors.initials: P
authors.lastname: Lu
authors.forename: Edwin P
authors.initials: EP
authors.lastname: Hui
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Zhang
authors.forename: Alexander Y L
authors.initials: AYL
authors.lastname: Lau
authors.forename: Junkai
authors.initials: J
authors.lastname: Zhao
authors.forename: Min
authors.initials: M
authors.lastname: Fan
authors.forename: Eric T C
authors.initials: ETC
authors.lastname: Ziea
authors.forename: Bacon F L
authors.initials: BFL
authors.lastname: Ng
authors.forename: Samuel Y S
authors.initials: SYS
authors.lastname: Wong
authors.forename: Justin C Y
authors.initials: JCY
authors.lastname: Wu
mesh_terms: D000855:Anorexia / Q000188:drug therapy / Q000209:etiology; D003248:Constipation / Q000188:drug therapy / Q000209:etiology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005221:Fatigue / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010166:Palliative Care; D008517:Phytotherapy; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal