Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis

Abstract

Integrated Chinese and Western medicine can promote the recovery of liver function and coagulation function, and reduce the mortality rate of patients with chronic severe hepatitis. However, due to a lower quality of clinical trials published in Chinese journals, the evidence is insufficient to prove the superiority of integrative therapy. Further well-designed, multicenter, large-sample RCTs are still needed to evaluate the beneficial effects of CHM.

Re-evaluation for systematic reviews of traditional Chinese medicine in the treatment of chronic bronchitis

“…By reading the full text of the article, 1 article containing non-RCTs and 2 articles with incomplete data were excluded. Included in 15 [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] SRs/Mas are journal literature, involving a total of 224 studies, including 20,710 patients, with a time span of 2013 to 2023.…”

“…The ROBIS evaluation revealed that within Phase 2, in Domain 1, none of the 15 studies included provided a systematic reviews Zhang et al 2023 [30] RCT 10 716 1b, 1e, 2a, 5a, 6 TCM/TCM+WM WM Cochrane Li et al 2021 [31] RCT 5 535 1a, 2a , 4a TCM+WM WM Cochrane Liu et al 2021 [32] RCT 19 1517 1b, 2c, 2d, 2f, 3b, 3c, 3d, 3e TCM+WM WM Cochrane Mo et al 2021 [33] RCT 48 4356 1b, 3f, 6 TCM+WM WM Cochrane Liu et al 2020 [34] RCT 12 1088 1b, 1d, 4d, 3a, 5b, 6 TCM/TCM+WM WM Cochrane Ji et al 2016 [35] RCT 11 1169 1b, 2a, 1f, 6 TCM/TCM+WM WM Cochrane Sun et al 201 [36] RCT 13 1556 1b TCM WM Jadad Tian. 2019 [37] RCT 5 612 1b, 5b, 6 TCM/TCM+WM TCM/WM Jadad Zhu et al 2017 [38] RCT 19 1996 1b TCM+WM WM Jadad Dou et al 2022 [39] RCT 8 680 1b, 3f, 4a, 3d, 3e, 6 TCM+WM WM Cochrane Gao et al 2019 [40] RCT 23 1901 1a, 2c, 2d, 2h, 6 TCM+WM WM Cochrane Bai et al 2013 [41] RCT 14 1232 1b, 1c, 2h, 2c, 2e, 3f, 3h, 3j, 5b, 6…”

“…Comprehensive effect value of serum inflammatory factor levelsm, and evidence quality grading. Liu et al 2021 [32] Hs-crp Mo et al 2021 [33] Liu et al 2020 [34] Chu et al 2022 [40] Li et al 2021 [31] Lung ① most of the information is from studies with high risk of bias, with large flaws in randomization methods, allocation concealment or blinding or without risk of bias assessment;…”

“…In domain 3, a more detailed presentation of the original literature data is important in order to enhance the credibility of the quantitative synthetic effect values, and some studies were not described in detail; consistent with the AMSTAR 2 assessment, the assessment tool of risk of bias of the original study had deficiencies and should be assessed using a recognized tool such as the Cochrane assessment tool of Q2 the presence of a pre-design programmed; Q3 the presence of a rationale for the inclusion of study types; Q4 the comprehensiveness of the search strategy; Q5 whether the literature selection was double-repeat; Q6 whether the data extraction was double-repeat; Q7 the presence of a list of excluded literature and reasons for exclusion; Q8 whether the description of the included studies was detailed; Q9 whether the bias risk was taken with an appropriate tool; Q10 whether the funding source of individual studies was clear; Q11 whether the study results were combined using appropriate statistical methods; Q12 whether the impact of the bias risk of the included studies on the results was assessed; Q13 whether the bias risk of the included studies was considered; Q14 whether the heterogeneity of the study results was assessed; Q15 whether the possibility of publication bias was evaluated; Q16 whether relevant conflicts of interest were reported. Zhang et al 2023 [30] Low risk High risk Low risk Uncertain risk Low risk Li et al 2021 [31] Low risk Uncertain risk High risk High risk High risk Liu et al 2021 [32] Low risk Uncertain risk Low risk High risk High risk Mo et al 2021 [33] Low risk High risk Low risk Uncertain risk Low risk Liu et al 2020 [34] Low risk High risk Uncertain risk Uncertain risk Low risk Ji et al 2016 [35] Low risk High risk Low risk High risk High risk Sun et al 2014 [36] Low risk High risk High risk High risk High risk Tian. 2019 [37] High risk High risk High risk High risk High risk Zhu et al 2017 [38] High risk High risk High risk Uncertain risk Low risk Dou et al 2022 [39] Low risk High risk Low risk Uncertain risk Low risk Gao et al 2019 [40] Low risk Uncertain risk Low risk Uncertain risk Low risk Bai et al 2013 [41] Low risk High risk Low risk High risk High risk Zang et al 2021 [42] High risk Uncertain risk High risk High risk High risk Chu et al 2022 [43] Low risk Uncertain risk Low risk Uncertain risk Low risk Liu et al 2017 [44] High risk High risk High risk High risk High risk risk of bias.…”

Large Dosage of Chishao in Formulae for Cholestatic Hepatitis: A Systematic Review and Meta‐Analysis

“…Along with development of medical science, complementary and alternative medicine displays its unique role in hepatitis treatment [6–8]. Traditional Chinese medicine (TCM), known for its holistic concept and treatment based on syndrome differentiation, emphasizes formulae employment more than single drug use in treatment of diseases.…”