Soo-Yeon Chae , Seo-Hyun Park , Joo-Hee Kim , Eun-Jung Kim , Byung-Kwan Seo , Seong-Sik Park , Won-Suk Sung
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Primary outcomes for disease activity were effective rate (ER), joint pain score (JPS), joint swelling score (JSS), and morning stiffness (MS), and secondary outcome measures were laboratory inflammation markers and adverse events. The efficacy was presented as the risk ratio (RR) or mean difference (MD) with 95 % confidence interval (CI) using Review Manager. Risk of bias and the quality of evidence were assessed by using Cochrane “risk of bias” tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p></div><div><h3>Results</h3><p>A total of 16 RCTs involving 1,749 patients were included. Compared with conventional treatments, SXD monotherapy significantly improved the ER (RR = 1.34, 95 % CI [1.26, 1.43], 14 RCTs, <em>n</em> = 1,578), JPS (MD = -1.00, 95 % CI [–1.33, –0.68], 4 RCTs, <em>n</em> = 327), JSS (MD = -1.59, 95 % CI [–2.12, –1.05], 4 RCTs, <em>n</em> = 327), MS (MD = -0.39, 95 % CI [–0.59, –0.18], 6 RCTs, <em>n</em> = 525), and laboratory results, and SXD add-on therapy significantly improved the ER (RR = 1.22, 95 % CI [1.00, 1.49], 1 RCT, <em>n</em> = 70). Due to some concerns with risk of bias, small sample sizes, and/or inconsistency, the certainty of evidence for SXD monotherapy was moderate for ER, low for JPS and JSS, very low for MS, and very low for SXD add-on therapy. There were fewer cases of adverse events in the SXD group.</p></div><div><h3>Conclusion</h3><p>Our findings suggest that SXD can be a complementary treatment option. However, the methodological quality of the included RCTs was unsatisfactory, so further high-quality research is needed to confirm our results.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382023000987/pdfft?md5=92fcece4b08012fa089387c87e67442e&pid=1-s2.0-S1876382023000987-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The efficacy and safety of Simiao Xiaobi decoction on rheumatoid arthritis: A systematic review and meta‑analysis\",\"authors\":\"Soo-Yeon Chae , Seo-Hyun Park , Joo-Hee Kim , Eun-Jung Kim , Byung-Kwan Seo , Seong-Sik Park , Won-Suk Sung\",\"doi\":\"10.1016/j.eujim.2023.102322\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Simiao Xiaobi decoction (SXD) is a traditional Chinese medicine (TCM) formula that has been clinically applied for rheumatoid arthritis (RA). This meta-analysis aimed to systematically assess the therapeutic efficacy and safety of SXD compared to conventional therapy.</p></div><div><h3>Methods</h3><p>Twelve worldwide databases were searched for randomized controlled trials (RCTs) of treating RA with SXD and comparing non-operative conventional treatments (e.g., medication) from inception to August 2023. Primary outcomes for disease activity were effective rate (ER), joint pain score (JPS), joint swelling score (JSS), and morning stiffness (MS), and secondary outcome measures were laboratory inflammation markers and adverse events. The efficacy was presented as the risk ratio (RR) or mean difference (MD) with 95 % confidence interval (CI) using Review Manager. Risk of bias and the quality of evidence were assessed by using Cochrane “risk of bias” tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p></div><div><h3>Results</h3><p>A total of 16 RCTs involving 1,749 patients were included. Compared with conventional treatments, SXD monotherapy significantly improved the ER (RR = 1.34, 95 % CI [1.26, 1.43], 14 RCTs, <em>n</em> = 1,578), JPS (MD = -1.00, 95 % CI [–1.33, –0.68], 4 RCTs, <em>n</em> = 327), JSS (MD = -1.59, 95 % CI [–2.12, –1.05], 4 RCTs, <em>n</em> = 327), MS (MD = -0.39, 95 % CI [–0.59, –0.18], 6 RCTs, <em>n</em> = 525), and laboratory results, and SXD add-on therapy significantly improved the ER (RR = 1.22, 95 % CI [1.00, 1.49], 1 RCT, <em>n</em> = 70). Due to some concerns with risk of bias, small sample sizes, and/or inconsistency, the certainty of evidence for SXD monotherapy was moderate for ER, low for JPS and JSS, very low for MS, and very low for SXD add-on therapy. There were fewer cases of adverse events in the SXD group.</p></div><div><h3>Conclusion</h3><p>Our findings suggest that SXD can be a complementary treatment option. 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The efficacy and safety of Simiao Xiaobi decoction on rheumatoid arthritis: A systematic review and meta‑analysis
Introduction
Simiao Xiaobi decoction (SXD) is a traditional Chinese medicine (TCM) formula that has been clinically applied for rheumatoid arthritis (RA). This meta-analysis aimed to systematically assess the therapeutic efficacy and safety of SXD compared to conventional therapy.
Methods
Twelve worldwide databases were searched for randomized controlled trials (RCTs) of treating RA with SXD and comparing non-operative conventional treatments (e.g., medication) from inception to August 2023. Primary outcomes for disease activity were effective rate (ER), joint pain score (JPS), joint swelling score (JSS), and morning stiffness (MS), and secondary outcome measures were laboratory inflammation markers and adverse events. The efficacy was presented as the risk ratio (RR) or mean difference (MD) with 95 % confidence interval (CI) using Review Manager. Risk of bias and the quality of evidence were assessed by using Cochrane “risk of bias” tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Results
A total of 16 RCTs involving 1,749 patients were included. Compared with conventional treatments, SXD monotherapy significantly improved the ER (RR = 1.34, 95 % CI [1.26, 1.43], 14 RCTs, n = 1,578), JPS (MD = -1.00, 95 % CI [–1.33, –0.68], 4 RCTs, n = 327), JSS (MD = -1.59, 95 % CI [–2.12, –1.05], 4 RCTs, n = 327), MS (MD = -0.39, 95 % CI [–0.59, –0.18], 6 RCTs, n = 525), and laboratory results, and SXD add-on therapy significantly improved the ER (RR = 1.22, 95 % CI [1.00, 1.49], 1 RCT, n = 70). Due to some concerns with risk of bias, small sample sizes, and/or inconsistency, the certainty of evidence for SXD monotherapy was moderate for ER, low for JPS and JSS, very low for MS, and very low for SXD add-on therapy. There were fewer cases of adverse events in the SXD group.
Conclusion
Our findings suggest that SXD can be a complementary treatment option. However, the methodological quality of the included RCTs was unsatisfactory, so further high-quality research is needed to confirm our results.
期刊介绍：
The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education.
EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians.
The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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