Evidence of Chinese herbal medicine Duhuo Jisheng decoction for knee osteoarthritis: a systematic review of randomised clinical trials

Abstract

ObjectivesDuhuo Jisheng decoction (DJD) is considered beneficial for controlling knee osteoarthritis (KOA)-related symptoms in some Asian countries. This review compiles the evidence from randomised clinical trials and quantifies the effects of DJD on KOA.Designs7 online databases were investigated up to 12 October 2015. Randomised clinical trials investigating treatment of KOA for which DJD was used either as a monotherapy or in combination with conventional therapy compared to no intervention, placebo or conventional therapy, were included. The outcomes included the evaluation of functional activities, pain and adverse effect. The risk of bias was evaluated using the Cochrane Collaboration tool. The estimated mean difference (MD) and SMD was within a 95% CI with respect to interstudy heterogeneity.Results12 studies with 982 participants were identified. The quality presented a high risk of bias. Meta-analysis found that DJD combined with glucosamine (MD 4.20 (1.72 to 6.69); p<0.001) or DJD plus meloxicam and glucosamine (MD 3.48 (1.59 to 5.37); p<0.001) had a more significant effect in improving Western Ontario and McMaster Universities Arthritis Index (total WOMAC scores). Also, meta-analysis presented more remarkable pain improvement when DJD plus sodium hyaluronate injection (MD 0.89 (0.26 to 1.53); p=0.006) was used. These studies demonstrated that active treatment of DJD in combination should be practiced for at least 4 weeks. Information on the safety of DJD or comprehensive therapies was insufficient in few studies.ConclusionsDJD combined with Western medicine or sodium hyaluronate injection appears to have benefits for KOA. However, the effectiveness and safety of DJD is uncertain because of the limited number of trials and low methodological quality. Therefore, practitioners should be cautious when applying DJD in daily practice. Future clinical trials should be well designed; more research is needed.

Duhuo Jisheng Decoction inhibits SDF-1-induced inflammation and matrix degradation in human degenerative nucleus pulposus cells in vitro through the CXCR4/NF-κB pathway

“…Loganic acid decreased proinflammatory cytokines in hypercholesterolemic rabbits [62,63] . Paeoniflorin is able to suppress inflammation in experimental arthritis by inhibiting abnormal proliferation of lymphocytes and synoviocytes and the production of proinflammatory cytokines and chemokines, nitric oxide, vascular endothelial growth factor (VEGF), and GM-CSF by synoviocytes [19,[64][65][66] . Ferulic acid, isolated from chuanxiong and danggui [67] has antioxidative and anti-inflammatory effects [67,68] .…”

Achyranthes bidentate saponins protect rat articular chondrocytes against interleukin‐1β‐induced inflammation and apoptosis in vitro

“…A. bidentata can strengthen the waist and knee, by eliminating stagnation, removing blood stasis, and nourishing the liver and kidney. Chinese herbal medicine formulas containing A. bidentata have been used in clinical practice for thousands of years, such as Duhuo Jisheng decoction [27] and SiMiaoFang [28]. A. bidentata is used to eliminate inflammation or improve circulation of the knees.…”

LncRNA DNM3OS promotes proliferation and inhibits apoptosis through modulating IGF1 expression by sponging MiR-126 in CHON-001 cells

“…Patients with severe OA suffer from joint deformity and loss of joint function [1,2]. Epidemiological statistical results showed that the prevalence of OA in patients aged over 40 years old in China was about 30, and 60%-70% among patients aged above 65 years [3,4]. With the aging of Chinese population, the occurrence of OA is increasing and becomes a serious social and public health problem.…”