Complementary and alternative medicine for treating epilepsy in China: A systematic review

Abstract

There are about 10 million people with epilepsy (PWE) in China. In addition to therapies approved by the National Medical Products Administration, the use of complementary and alternative medicine (CAM) is prevalent in Chines PWE. These CAM therapies mainly comprise traditional Chinese medicine herbs (TCMHs), acupuncture, and music. A retrospective literature search was performed to summarize the updates of CAM in China in the past ten years, and sixty‐two papers were finally included. In this following review, we listed the animal and clinical studies to summarize the antiepileptic mechanisms and clinical efficacy of CAM in Chines PWE. The main mechanisms of TCMHs and acupuncture included regulation of neurotransmitters and receptors, voltage‐gated ion channels modulation, expression of apoptosis‐related genes, antioxidant response, and anti‐inflammation. Although there were enormous clinical studies on them, the current available clinical trials were small, short‐term, heterogeneous, and had a high risk of bias. With regard to music, a few studies conducted by Chinese scholars suggested that it was beneficial for PWE as an add‐on therapy, which was consistent with the results of foreign studies. Further randomized clinical trials in large populations are required to prove the effectiveness and safety of CAM.

Efficacy and safety of herbal medicine combined with acupuncture in pediatric epilepsy treatment: A meta-analysis of randomized controlled trials

“…The robustness of the results of this study is further supported by TSA findings. This aligns with the results of previous studies that reported favorable outcomes from the combined use of herbal medicine and acupuncture for epilepsy in both children and adults [ 19 , 39 – 41 ]. Notably, an updated meta-analysis demonstrated the use of herbal medicine as a promising clinical strategy for epilepsy across age groups [ 19 ].…”

“…Another comprehensive review of 17 RCTs that included participants aged between 1 and 66 years highlighted the potential of herbal medicine to improve seizure control and normalize EEG patterns [ 38 ]. Furthermore, a specific review delved into the molecular mechanisms of herbal medicine in pediatric epilepsy treatment, demonstrating its multifaceted approach in regulating neurotransmitters, ion channels, inflammation, apoptosis-related genes, and oxidative stress [ 39 ]. Despite this array of evidence, a gap exists in research specifically focused on pediatric patients with unique pharmacokinetic and pharmacodynamic profiles compared with adults [ 42 ].…”

“…The Ping Gan formula, traditionally used to "calm the liver yang" and alleviate spasms and convulsions, was the most frequently prescribed herbal medicine in our patient sample [23][24][25]29]. Ding Xian Tang is known to be "the most extensively studied antiepileptic herbal medicine formula" [39,43]. It demonstrated antiseizure and convulsant mitigation properties, particularly in combination with valproic acid, in animal models of pentylenetetrazol-induced chronic epilepsy [44,45].…”

Effectiveness of acupuncture as auxiliary combined with Western medicine for epilepsy: a systematic review and meta-analysis

“…There were no systematic reviews and meta-analyses that addressed the treatment effectiveness of acupuncture combined with Western medicine in patients with epilepsy. At present, acupuncture for epilepsy is widely used in clinical practice, and most of them report reliable efficacy, indicating that acupuncture for epilepsy has certain advantages and development potential ( Zhong, 2014 ; Zhao et al, 2022 ). Throughout the papers published in recent years on the treatment of epilepsy with acupuncture, it can be found that a variety of acupuncture therapies, including acupoint embedding and electroacupuncture, have obvious effects, and have the advantages of simple operation, economic and inexpensive and long duration of therapeutic effects, which have obvious advantages in the treatment of epilepsy.…”

Editorial

“…In addition, the use of complementary and alternative medicine (CAM) is prevalent in Chinese patients with epilepsy. In the review “Complementary and Alternative Medicine for treating epilepsy in China: A systematic review,” Zhao et al focused on three main CAM therapies including traditional Chinese medicine herbs (TCMHs), acupuncture, and music 10 . For the neuromodulation, Xue et al emphasized on three approved neuromodulation therapies: vagus nerve stimulation (VNS), deep brain stimulation of the anterior nucleus of the thalamus (ANT‐DBS), and closed‐loop responsive neurostimulation (RNS) in their review “Neuromodulation in drug‐resistant epilepsy: a review of current knowledge.” 11 Yan et al described the clinical evidence on the possible mechanism, anti‐epileptic effect, and safety of deep brain stimulation of the subthalamic nucleus (STN‐DBS) in their review “Deep brain stimulation of the subthalamic nucleus for epilepsy.” 12 For the management of neurologic critically ill patients, in the review “Non‐convulsive seizures and non‐convulsive status epilepticus in neuro‐intensive care unit,” Wang et al summarize the EEG, clinical, epidemiological, diagnostic, and therapeutic knowledge of NCS and NCSE in the neuro‐intensive care setting 13 …”