Efficacy and Safety of GuiZhi-ShaoYao-ZhiMu Decoction for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

The Traditional Chinese Medicine, GSZD, may have equal or superior effectiveness and safety for treating RA compared to Western RA drugs. It should be considered a viable alternative to Western medicine. However, more long-term research is needed in larger patient groups to better establish its safety and efficacy.

Adjunctive Chinese Herbal Products Therapy Reduces the Risk of Ischemic Stroke Among Patients With Rheumatoid Arthritis

“…Additionally, after 12 to 24 weeks of treatment with Tripterygium wilfordii Hook.f in combination with methotrexate, there was an improvement in the level of CRP (Lv et al, 2015). Furthermore, several randomized controlled trial about the efficacy of Gui-Zhi-Shao-Yao-Zhi-Mu-Tang with WM showed that after taking Gui-Zhi-Shao-Yao-Zhi-Mu-Tang with WM for 4-12 weeks, there was a significant decrease in ESR, RA factor, and CRP (Daily et al, 2017). The Pathological mechanisms of RA are characterized by chronic systemic inflammation, and patients using CHP for 30-180 days may achieve an improved antiinflammatory effect in terms of reducing their risk of IS.…”

“…We observed an association between using CHP in combination with WM and a lower risk of IS among patients with RA (aHR for IS: 0.67 vs. non-CHP group). A possible reason for this is that the commonly used CHP, such as Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, alleviate systemic inflammation by lowering the CRP, and erythrocyte sedimentation rate (ESR), which may decrease the progression of atherosclerosis, the main pathologic process of IS (Daily et al, 2017). Another commonly prescribed single herb, Spatholobus suberectus Dunn (Ji-Xie-Teng), has also been shown to suppress inflammation by decreasing TNF-a secretion .…”

“…(accounts for 6.5%), one of the single herb in the Du-Huo-Ji-Sheng-Tang, might lead to renal failure, tubulointerstitial fibrosis, and urothelial cancer owing to aconitine alkaloids. Although, the toxic compounds of the certain single herbs might result in harmful effects, Daily and Hsieh reported that no severe adverse events and drug reactions are observed after taking Gui-Zhi-Shao-Yao-Zhi-Mu-Tang and Du-Huo-Ji-Sheng-Tang 4 to 20 weeks (Hsieh et al, 2010;Daily et al, 2017).…”

“…Schischk., Glycyrrhiza uralensis Fisch. ex DC., Cinnamomum cassia (L.) J.Presl, Ephedra sinica Stapf, Aconitum carmichaelii Debx., Zingiber officinale Roscoe) and Boswellia neglecta S.Moore (Ru-Xiang) (Ammon, 2006;Daily et al, 2017). Additionally, Tripterygium wilfordii Hook.f, Stephania tetrandra S Moore, and Zingiber officinale Roscoe have also been reported to have potential to suppress inflammation (Kang et al, 1996;Liacini et al, 2005;Wang et al, 2013).…”

“…Additionally, Tripterygium wilfordii Hook.f, Stephania tetrandra S Moore, and Zingiber officinale Roscoe have also been reported to have potential to suppress inflammation (Kang et al, 1996;Liacini et al, 2005;Wang et al, 2013). To date, most studies have purposely analyzed the effects of Chinese herbal products (CHP) in terms of alleviating the clinical symptoms and managing the chronic inflammation of patients with rheumatoid arthritis (Soeken et al, 2003;Zhang et al, 2011;Daily et al, 2017). However, there is a lack of studies that investigated whether the use of CHP was associated with a reduced risk of IS, which is a leading cause of death, in patients with RA.…”