The Efficacy of Heat-Clearing (Qingre) and Detoxifying (Jiedu) Traditional Chinese Medicine Gargle for Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis

Abstract

Objective: Chemotherapy-induced oral mucositis (CIOM) is an extremely serious complication of cancer. In China, the heat-clearing (Qingre) and detoxifying (Jiedu) traditional Chinese medicine QRJD-TCM gargle has been widely used to treat CIOM. To date, no systematic evaluation has been conducted on the clinical efficacy of QRJD-TCM gargle in treating CIOM. The objective of this systematic review and meta-analysis was to evaluate the efficacy of QRJD-TCM gargle in the treatment of CIOM.Methods: Relevant randomized controlled trials (RCTs) comparing QRJD-TCM gargle with conventional Western medicine mouthwash (CWMM) for CIOM were confirmed by systematically searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, and Sinomed until October 20, 2020. Two researchers independently assessed the risk of bias according to the Cochrane risk-of-bias criteria. Excel 2010 was used in setting up a database of extracted information, and RevMan 5.3.0 was used in analyzing included trial data. The composition of the QRJD-TCM gargle was evaluated.Results: A total of 25 articles were included in this meta-analysis. Results showed that compared with CWMM, QRJD-TCM gargle can reduce the incidence of CIOM (OR = 0.23, 95% CI [0.18, 0.29], p < 0.00001) and severity of CIOM (grade I–II: OR = 0.36, 95%CI [0.28, 0.46], p < 0.00001; grade III–IV: OR = 0.15, 95%CI [0.09, 0.28], p < 0.00001). In addition, QRJD-TCM gargle improved the effective rate of CIOM (OR = 15.91, 95% CI [7.93, 31.89], p < 0.00001).Conclusion: QRJD-TCM gargle is effective in preventing and treating CIOM. However, more standard, double-blind, and multicenter randomized controlled studies are needed to further confirm the efficacy of QRJD-TCM gargle in the prevention and treatment of CIOM.

Efficacy and Safety of Chinese Patent Medicine for the Prevention and Treatment of Radiotherapy and Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis

“…According to the TCM theory, chemotherapy and radiotherapy belong to the “drug poison” and “evil poison” from the environment. The clinical feature of oral mucositis, including redness, swelling, ulceration, and pain, are the characteristics of TCM heat toxin syndrome (( Lin et al, 2021 )). Heat clearing and detoxicating are classic TCM treatments for heat toxin syndrome ( Jin et al, 2009 ).…”

“…According to the TCM theory, CPMs with heat-clearing and detoxicating effects have become ideal options in the prevention and treatment of heat toxin syndrome, including redness, swelling, ulceration, and pain, which are also the main features of oral mucositis. In addition, unlike synthetic medicines, naturally originated CPMs are generally perceived to have a wider range of sources, fewer side effects, and multiple pharmacological targets ( Lin et al, 2021 ). Therefore, CPMs are in wide clinical use to prevent or treat radiotherapy and chemotherapy-induced oral mucositis in China as important complementary alternative medicines ( Zheng et al, 2011 ).…”

Preventive effect and safety of Chinese herbal medicine for oral mucositis during radiotherapy in patients with head and neck cancer: Study protocol for a randomized trial

“…Each medication in the ZYLGS formula is described in the ancient TCM literature as relatively safe, and in previous meta-analyses, therapeutic doses have been found to cause no significant toxicity in cancer patients [ 31 , 32 ]. However, some serious adverse reactions have been reported from time to time in recent years.…”

Herbal Granules of Heat-Clearing and Detoxifying for Children with Mild Hand, Foot, and Mouth Disease: A Bayesian Network Meta-Analysis

“…As reported, the heat-clearing and detoxifying therapy has been proved to reduce the progressive rate of mild HFMD and healing time of rash or oral ulcer [ 18 , 19 ], and HGs-HD were superior to placebo in resolution of fever symptom [ 20 ]. They could relieve the clinical symptoms, such as fever, rash, vesicles, and ulcers, by regulating the human immune response, boosting the body's resistance to inflammation, and preventing infective pathogens from invasion [ 21 , 22 ].…”