The Efficacy of Traditional Chinese Medicine for Crohn's Disease Treatment: A Systematic Review and Meta-Analysis.

Background and aims: Crohn's disease (CD) is an inflammatory bowel disease with limited treatment options for patients with mild to moderately active disease. There is a lack of consensus for using traditional Chinese medicine (TCM) for symptom relief. This review aimed to assess the efficacy of TCM compared to placebo for CD symptom severity relief in patients with mild to moderate CD.

Methods: We searched MEDLINE via PubMed, the Cochrane Library, Scopus, and CINAHL for articles and reviewed results from Web of Science, Google Scholar, clinicaltrials.gov, and reference lists of included studies. We included randomized control trials comparing TCM to placebo in patients with mild to moderate CD to evaluate change in objective symptom severity [Crohn's Disease Activity Index (CDAI) and Crohn's Disease Endoscopic Index of Severity (CDEIS)]. We imported selected articles for dual blinded review, used random-effects models to calculate the mean CDAI and CDEIS differences between TCM and placebo, and qualitatively analyzed differences in inflammatory biomarkers and quality of life.

Results: The search identified 232 relevant studies. We included five studies, totalling 292 participants utilizing acupuncture and herb-partitioned moxibustion. The studies demonstrated a more significant decrease in mean CDAI score due to TCM compared to placebo [-49.91 (95% CI: -64.97, -34.84; p<0.00001); (I2 = 61%, p=0.03)]. Two studies also demonstrated an overall difference in mean CDEIS between TCM and placebo [-2.96 (95% CI: -6.31, 0.40; p=0.08); (I2 = 53%, p=0.140)]. Improvements in quality of life scores were greater in TCM versus placebo groups. There were mixed results for changes in inflammatory biomarkers.

Conclusion: Our findings suggest that TCM may improve objective CD symptoms compared to placebo. Additional studies with more extensive and diverse populations are necessary to determine TCM's true effects on CD patients.