Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2024; 12(2): 335-345
Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.335
Efficacy and safety of Yangxue Qingnao Granules in treatment of migraine: A systematic review and meta-analysis
Bo Zhou, Gui-Shu Wang, Yu-Ning Yao, Tong Hao, Huan-Qin Li, Ke-Gang Cao
Bo Zhou, Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
Gui-Shu Wang, Department of Infectious Disease, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
Yu-Ning Yao, Tong Hao, Ke-Gang Cao, Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing 100700, China
Huan-Qin Li, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, China
Author contributions: Zhou B and Cao KG designed the study, conducted the analysis, and drafted the manuscript; Wang GS and Yao YN performed the literature selection; Li HQ and Cao KG did the quality assessment; Fan HH and Hao T performed the data extraction; Zhou B and Wang GS did part of the statistical work; Cao KG and Li HQ critically revised the manuscript.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
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: Ke-Gang Cao, MD, Chief Physician, Institute for Brain Disorders, Beijing University of Chinese Medicine, No. 5 Dongzhimen, Dongcheng District, Beijing 100700, China. kgdoctor@sina.com
Received: October 26, 2023
Peer-review started: October 26, 2023
First decision: November 8, 2023
Revised: November 22, 2023
Accepted: December 21, 2023
Article in press: December 21, 2023
Published online: January 16, 2024
Processing time: 77 Days and 2.1 Hours
ARTICLE HIGHLIGHTS
Research background

Migraine stands as the most prevalent form of neurological disorder, imposing a significant burden on healthcare services. Yangxue Qingnao Granules (YXQN) represents a commonly utilized Chinese patent medicine for managing migraine. Yet, the available evidence remains insufficient to comprehensively assess the efficacy of YXQN for treating migraine.

Research motivation

Traditional Chinese medicine has been extensively employed as a treatment method for migraine. Clinical studies have validated the effectiveness of YXQN in migraine treatment. Nevertheless, there remains insufficient evidence to comprehensively evaluate the efficacy of YXQN for migraine. Consequently, the objective of this meta-analysis was to systematically consolidate data from these clinical trials, aiming to assess both the effectiveness and safety of YXQN as an independent treatment for migraine. This study also intended to establish an evidence-based foundation for guiding its further clinical applications and research endeavors in this field.

Research objectives

To assess the efficacy and safety of YXQN alone for treatment of migraine.

Research methods

We conducted a comprehensive search across 10 databases to identify pertinent randomized controlled trials (RCTs) published before September 2022. Two review authors independently conducted the literature search and screening and data extraction, and assessed the methodological quality of the studies employing criteria from ROB 2.0. Data analyses were performed using Review Manager 5.4 software.

Research results

A total of 12 RCTs including 767 participants with migraine met the selection criteria. We divided these studies into comparisons of YXQN with placebo, routine treatment drugs, and other Chinese patent medicines. The meta-analysis showed the following: (1) Efficacy: The YXQN group outperformed the placebo group [relative risk (RR) = 0.29, 95% confidence interval (95%CI): 0.15–0.43, P < 0.00001], routine treatment group (RR = 0.18, 95%CI: 0.09–0.27, P < 0.0001), and other Chinese patent medicine group (RR = 0.27, 95%CI: 0.13–0.41, P < 0.001); (2) frequency of headache: There was a significant difference between YXQN vs placebo [mean difference (MD) = -1.25, 95%CI: -1.60 to -0.90, P < 0.00001), routine treatment drugs (MD = -0.85, 95%CI: -1.15 to -0.56, P < 0.00001), and other Chinese patent medicines (MD = -0.91, 95%CI: -1.35 to -0.46, P < 0.0001); (3) headache duration: There was great heterogeneity between studies, with no differences between YXQN and placebo (MD = -0.61, 95%CI: -1.53 to -0.31, P = 0.19) and routine treatment drugs (MD = -0.22, 95%CI: -0.89 to 0.46, P < 0.53). YXQN was more effective than other Chinese patent medicines in reducing headache duration (MD = -1.24, 95%CI: -1.70 to -0.77; P < 0.00001); and (4) headache severity: There was no significant difference between YXQN vs placebo (MD = -1.67, 95%CI: -3.52 to 0.19, P = 0.08), routine treatment drugs (MD = -0.53, 95%CI: -2.02 to 0.96, P = 0.68), and other Chinese patent medicines (MD = -0.49, 95%CI: -2.83 to 1.85, P = 0.68). Mild gastrointestinal adverse reactions were reported in three cases.

Research conclusions

This study revealed that YXQN is effective and safe for treatment of migraine.

Research perspectives

Our meta-analysis indicated that YXQN represents a promising alternative for the treatment of migraines. However, due to the inadequate methodological quality observed in the included studies, further data and extensive investigation are imperative to establish its efficacy definitively. Additionally, there is a necessity for additional research to explore the effectiveness of YXQN for treating migraine in diverse ethnic populations.