Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 5067-5082
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5067
Five commonly used traditional Chinese medicine formulas in the treatment of ulcerative colitis: A network meta-analysis
Zhi-Hui Zhao, Yi-Hang Dong, Xin-Qi Jiang, Jing Wang, Wan-Li Qin, Zhang-Yi Liu, Xiao-Qing Zhang, Yu-Jie Wei
Zhi-Hui Zhao, Yi-Hang Dong, Xin-Qi Jiang, Jing Wang, Wan-Li Qin, Zhang-Yi Liu, Xiao-Qing Zhang, School of Life Sciences, Beijing University of Chinese Medicine, Beijing 102488, China
Yu-Jie Wei, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102488, China
Co-first authors: Zhi-Hui Zhao and Yu-Jie Wei.
Author contributions: Zhao ZH and Wei YJ contributed equally as co-first authors. Zhao ZH and Jiang XQ designed the research; Zhao ZH, Wei YJ, and Jiang XQ contributed to analytical tools and performed the analysis; Zhao ZH, Wei YJ, and Wang J analyzed the data; Zhao ZH, Dong YH, and Qin WL wrote the paper; Zhang XQ revised the manuscript and provided financial support.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper.
PRISMA 2009 Checklist statement: We have revised and filled out the document in accordance with the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Qing Zhang, PhD, Professor, School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Beisanhuan Road, Chaoyang District, Beijing 102488, China. 202001003@bucm.edu.cn
Received: February 19, 2024
Revised: April 26, 2024
Accepted: June 3, 2024
Published online: August 6, 2024
Processing time: 133 Days and 22.6 Hours
Abstract
BACKGROUND

Currently, traditional Chinese medicine (TCM) formulas are commonly being used as adjunctive therapy for ulcerative colitis in China. Network meta-analysis, a quantitative and comprehensive analytical method, can systematically compare the effects of different adjunctive treatment options for ulcerative colitis, providing scientific evidence for clinical decision-making.

AIM

To evaluate the clinical efficacy and safety of commonly used TCM for the treatment of ulcerative colitis (UC) in clinical practice through a network meta-analysis.

METHODS

Clinical randomized controlled trials of these TCM formulas used for the adjuvant treatment of UC were searched from the establishment of the databases to July 1, 2022. Studies that met the inclusion criteria were screened and evaluated for literature quality and risk of bias according to the Cochrane 5.1 standard. The methodological quality of the studies was assessed using ReviewManager (RevMan) 5.4, and a funnel plot was constructed to test for publication bias. ADDIS 1.16 statistical software was used to perform statistical analysis of the treatment measures and derive the network relationship and ranking diagrams of the various intervention measures.

RESULTS

A total of 64 randomized controlled trials involving 5456 patients with UC were included in this study. The adjuvant treatment of UC using five TCM formulations was able to improve the clinical outcome of the patients. Adjuvant treatment with Baitouweng decoction (BTWT) showed a significant effect [mean difference = 36.22, 95% confidence interval (CI): 7.63 to 65.76]. For the reduction of tumor necrosis factor in patients with UC, adjunctive therapy with BTWT (mean difference = −9.55, 95%CI: −17.89 to −1.41), Shenlingbaizhu powder [SLBZS; odds ratio (OR) = 0.19, 95%CI: 0.08 to 0.39], and Shaoyao decoction (OR = −23.02, 95%CI: −33.64 to −13.14) was effective. Shaoyao decoction was more effective than BTWT (OR = 0.12, 95%CI: 0.03 to 0.39), SLBZS (OR = 0.19, 95%CI: 0.08 to 0. 39), and Xi Lei powder (OR = 0.34, 95%CI: 0.13 to 0.81) in reducing tumor necrosis factor and the recurrence rate of UC.

CONCLUSION

TCM combined with mesalazine is more effective than mesalazine alone in the treatment of UC.

Keywords: Network meta-analysis; Traditional Chinese medicine; Ulcerative colitis; Mesalazine; Treatment

Core Tip: This study aimed to evaluate the clinical efficacy and safety of commonly used traditional Chinese medicines (TCM) for the treatment of ulcerative colitis (UC), in clinical practice, through a network meta-analysis. A network meta-analysis of the five types of TCM formulas can provide a rational and personalized plan for the selection and use of TCM as clinical adjuvant therapy for UC. TCM formulas combined with mesalazine exhibit a better effect in treating UC compared to using mesalazine alone. The adjuvant treatment of UC with TCM formulas can improve clinical efficacy, repair the intestinal mucosa, improve the immunity of the body and the quality of life of patients, and reduce the probability of disease recurrence.