Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2022; 10(17): 5690-5701
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5690
Systematic review of Yougui pills combined with levothyroxine sodium in the treatment of hypothyroidism
Xiao-Pei Liu, Ya-Nan Zhou, Cong-E Tan
Xiao-Pei Liu, Ya-Nan Zhou, Cong-E Tan, School of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi Province, China
Author contributions: Tan CE and Liu XP conceptualized and designed the protocol, drafted the initial manuscript and reviewed the manuscript; Liu XP and Zhou YN defined the concepts and search items and performed the data extraction process as well as methodological appraisal of the studies; Zhou YN and Tan CE planned the data extraction and statistical analysis; Liu XP and Tan CE provided critical insights; All authors have approved and contributed to the final written manuscript.
Supported by the National Natural Science Foundation of China, No. 81973754; Shaanxi University of Traditional Chinese Medicine Innovation Team Project, No. 2019-QN06.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to 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: Cong-E Tan, PhD, School of Basic Medicine, Shaanxi University of Chinese Medicine, Xixian Avenue, Xixian New District, Xianyang 712046, Shaanxi Province, China. tanzime@163.com
Received: October 27, 2021
Peer-review started: October 27, 2021
First decision: February 14, 2022
Revised: March 10, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: June 16, 2022
Processing time: 224 Days and 21.3 Hours
ARTICLE HIGHLIGHTS
Research background

Yougui pills are a classic ancient prescription of Ming Dynasty in China, which has been widely used in combination with levothyroxine sodium in the treatment of hypothyroidism. However, the level of evidence in clinical reports is inconsistent, and the credibility is poor. Thus, we conducted this meta-analysis to further confirm the efficacy and safety of Yougui pills and provide higher level evidence.

Research motivation

By strict study selection and quality evaluation, a total of 9 studies were included for further analysis to evaluate the clinical efficacy and safety. The results of this meta-analysis could help in rational drug use, the scientific research work and the government’s health care decisions.

Research objectives

We aimed to find the latest and most reasonable treatment plan for the specific clinical problems of hypothyroidism patients. Further, we collected and summarized the homogenous data of the original study of Yougui pills combined with levothyroxine sodium in the treatment of hypothyroidism.

Research methods

We conducted this meta-analysis to evaluate the clinical efficacy and safety of Yougui pill combined with levothyroxine sodium in the treatment of hypothyroidism. Meta-analysis could combine clinical trial data of multiple small samples to improve the statistical efficiency of the original results and solve the inconsistency of research results. The results from strict meta-analysis have advantage in sample size, coverage, reliability and representativeness.

Research results

Compared with pure levothyroxine sodium, Yougui pills combined with levothyroxine sodium could effectively reduce or eliminate the adverse reactions caused by taking hormone, improve serum hormone secretion and significantly improve the clinical symptoms of hypothyroidism. However, this meta-analysis is still limited by relatively low quality and relatively high heterogeneity. Thus, this conclusion needs to be further verified by randomized controlled trial studies.

Research conclusions

With the aid of modern scientific research means and systematic evaluation meta-analysis in evidence-based medicine, the rationality and scientific nature of the combined use of traditional Chinese medicine (TCM) Yougui pill and Western medicine levothyroxine sodium was studied.

Research perspectives

Improving the quality of the original literature is necessary to strengthen the standardization of TCM syndrome diagnosis methods, and high-quality randomized controlled trials of TCM are necessary to evaluate TCM syndromes. The Endocrine Society should develop uniform testing methods to ensure consistency among units and references in China, which would help in enhancing academic exchange among different regions. Although Chinese herbal medicines are generally safe and have relatively few adverse reactions and the mechanisms of adverse effects caused by Chinese medicine are still unclear, we should still pay attention to adverse events in clinical practice and investigate the mechanisms in scientific studies.