Traditional East Asian Herbal Medicine for Amyotrophic Lateral Sclerosis: A Scoping Review

Abstract

This study aimed to analyze and summarize the existing evidence regarding herbal medicine treatments for amyotrophic lateral sclerosis (ALS). Studies on herbal medicine treatment in patients with ALS were searched within English, Chinese, Japanese, and Korean databases up to July 31, 2021. In the selected studies, we collected the following information: the first author, year of publication, country, language, study methodology, sample size, demographic characteristics of the study participants, disease duration, diagnostic criteria, treatment method, treatment periods, evaluation tools, results, and side effects. The organized data were classified and analyzed narratively. This study included 59 studies. The first clinical study on the effect of herbal medicine was published in 1995; moreover, most studies were conducted in China. Among the 59 selected studies, 47.5% were observational studies, including case reports and case series. Moreover, there was one meta-analysis. The El Escorial criteria were the most commonly used diagnostic criterion for ALS; moreover, the ALS functional rating scale was the most common evaluation tool. Buzhongyiqitang, Sijunzitangjiawei, and Jianpiyifeitang were the most commonly used herbal medicines, with anti-inflammatory, protein aggregation, and anti-oxidant effects. There remain evidence of gaps in the effectiveness of herbal medicine for ALS. To allow effective treatment of patients with ALS using herbal medicine, large-scale and rigorously designed high-quality clinical studies should be performed.

"A Suggestion for Treating Amyotrophic Lateral Sclerosis (ALS)"

“…One good study I was able to find [36] examined and summarized 59 studies that focused on the effect of herbal medicine on the treatment of ALS. Most of those studies were conducted in China; some were conducted in Korea.…”

The efficacy and safety of Chinese herbal medicine as an add-on therapy for amyotrophic lateral sclerosis: An updated systematic review and meta-analysis of randomized controlled trials

“…The cause of ALS has yet to be elucidated; however, ∼5-10% of patients with ALS are thought to suffer from a familial form of ALS that exerts familial genetic characteristics and feature mutations in several genes including C9orf72, SOD1, FUS, and TARDBP. The remaining 90% of patients are considered as sporadic cases of ALS associated with abnormalities of the immune system, toxic exposure, mitochondrial dysfunction, oxidative stress, neuroinflammation, or glutamate poisoning (2)(3)(4)(5).…”

“…This condition progresses rapidly, and the median survival duration is around 3–5 years from primary symptoms to death ( 3 ). This disease has an incidence of 2.5 per 100,000 persons-years and is more prevalent in men than in women ( 4 ). The cause of ALS has yet to be elucidated; however, ~5–10% of patients with ALS are thought to suffer from a familial form of ALS that exerts familial genetic characteristics and feature mutations in several genes including C9orf72, SOD1, FUS , and TARDBP .…”

“…Riluzole, an anti-glutamate drug, is currently the only drug approved by the Food and Drug Administration (FDA) to prolong the life span of patients with ALS. However, this drug is expensive and is associated with several detrimental side effects including fatigue and diarrhea ( 4 ). Furthermore, an increasing body of evidence supports the fact that antioxidants may represent a potential treatment without serious clinical adverse effects although the efficacy of this treatment remains uncertain ( 6 ).…”

“…Chinese Herbal Medicine (CHM), a form of TCM therapy, has been used to treat a wilt disease for thousands of years ( 8 ). A recent scoping review analyzed the research trends for the use of traditional herbal medicine in the treatment of ALS and identified many case reports, clinical observation studies, and randomized controlled trials (RCTs) involving the use of traditional herbal medicine for the treatment of ALS in East Asia, thus indicating that CHM may represent a potentially unique and effective therapy for ALS ( 4 ). However, the mechanisms and targets of CHM in the treatment of ALS were not described in this previous scoping review.…”