Chinese herbal formulae for the treatment of menopausal hot flushes: A systematic review and meta-analysis
Autoři:
Mingdi Li aff001; Andrew Hung aff002; George Binh Lenon aff001; Angela Wei Hong Yang aff001
Působiště autorů:
School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
aff001; School of Science, RMIT University, Melbourne, Victoria, Australia
aff002
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222383
Souhrn
Objectives
This systematic review aimed to evaluate the therapeutic effects and safety of Chinese herbal medicine (CHM) formulae for managing menopausal hot flushes (MHF).
Methods
Seven English and Chinese databases were searched for studies from respective inceptions to February 2019. Randomized controlled trials investigating the clinical effects and safety of CHM formulae on MHF were considered for inclusion. The outcomes of subjective feelings (MHF and quality of life), objective changes (hormones and peripheral blood flow) and safety were analyzed. The most frequently prescribed formulae and herbs were summarized.
Results
Nineteen randomized clinical trials involving 2469 patients were included. When compared to menopausal hormone therapy, CHM had similar effects to menopausal hormone therapy on total effectiveness rate (OR 1.41, 95% CI 0.84 to 2.35) and total Kupperman index (KI) score (SMD -0.13, 95% CI -0.61 to 0.36), and could significantly reduce vasomotor symptom score (MD -0.43, 95% CI -0.55 to -0.31) and upper-body peripheral blood flow (MD -3.56, 95% CI -5.14 to -1.98 under the jaw, MD -7.10, 95% CI -11.01 to -3.19 in the fingertip). When compared to placebo, CHM could reduce MHF severity (MD -0.70, 95% CI-1.00 to -0.40) and improve total KI score (MD -12.61, 95% CI -15.21 to -10.01). However, no statistically significant changes to hormone levels were detected. Most commonly seen adverse events were mild gastrointestinal tract reactions. The most popularly studied formula was Kun Tai capsule and the most frequently prescribed herb was Bai shao (Paeoniae Radix Alba, Paeonia lactiflora Pall.). More than 50% included studies had low risks of bias in the domains of selection, performance, attrition and reporting.
Conclusions
This review indicated that CHM formulae were safe to be applied in MHF females and able to improve MHF-related symptom scores as well as the peripheral blood flow. Further studies should focus on specific formulae.
Klíčová slova:
Biology and life sciences – Organisms – Eukaryota – Plants – Herbs – Anatomy – Body fluids – Blood – Blood flow – Physiology – Biochemistry – Hormones – Peptide hormones – Luteinizing hormone – Research and analysis methods – Database and informatics methods – Database searching – Mathematical and statistical techniques – Statistical methods – Metaanalysis – Medicine and health sciences – Complementary and alternative medicine – Herbal medicine – Pharmaceutics – Drug therapy – Hormonal therapy – Endocrinology – Endocrine physiology – Menopause – Physical sciences – Mathematics – Statistics
Zdroje
1. Hunter MS, Liao K. A psychological analysis of menopausal hot flushes. British Journal of Clinical Psychology. 1995;34(4): 589–99.
2. Berek JS, Novak E. Berek & Novak's gynecology. 15th ed. Berek JS, Novak E, editors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012.
3. Smith RL, Gallicchio L, Miller SR, Zacur HA, Flaws JA. Risk factors for extended duration and timing of peak severity of hot flashes. PLOS ONE. 2016;11(5): e0155079. doi: 10.1371/journal.pone.0155079 27149066
4. Grady D, Sawaya GF. Discontinuation of postmenopausal hormone therapy. American Journal of Medicine. 2005;118 (12B): 163–5. doi: 10.1016/j.amjmed.2005.09.051 16414343.
5. Avis NE, Colvin A, Bromberger JT, Hess R, Matthews KA, Ory M, et al. Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women's Health Across the Nation. Menopause. 2009;16(5): 860–9. doi: 10.1097/gme.0b013e3181a3cdaf 19436224.
6. Sturdee DW, Hunter MS, Maki PM, Gupta P, Sassarini J, Stevenson JC, et al. The menopausal hot flush: A review. Climacteric. 2017;20(4): 296–305. doi: 10.1080/13697137.2017.1306507 28379074.
7. Pinkerton JAV, Aguirre FS, Blake J, Cosman F, Hodis H, Hoffstetter S, et al. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause. 2017;24(7): 728–53. doi: 10.1097/GME.0000000000000921 28650869
8. Carpenter J, Gass ML, Maki PM, Newton KM, Pinkerton JV, Taylor M, et al. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015;22(11): 1155–74. doi: 10.1097/GME.0000000000000546 26382310
9. National Guideline Clearinghouse. Menopause: Diagnosis and management Rockville MD: Agency for Healthcare Research and Quality (AHRQ); 2015 [08/11/2017]. Available from: https://www.guideline.gov/summaries/summary/49904/menopause-diagnosis-and-management?q=menopausal.
10. Shams T, Firwana B, Habib F, Alshahrani A, Alnouh B, Murad MH, et al. SSRIs for hot flashes: A systematic review and meta-analysis of randomized trials. Journal of General Internal Medicine. 2014;29(1): 204–13. doi: 10.1007/s11606-013-2535-9 23888328.
11. Hunter MS, Gentry-Maharaj A, Ryan A, Burnell M, Lanceley A, Fraser L, et al. Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: Impact of age, body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross-sectional cohort study of 10,418 British women aged 54–65. British Journal of Obstetrics and Gynaecology. 2012;119(1): 40–50. doi: 10.1111/j.1471-0528.2011.03166.x 22008610.
12. Bair YA, Gold EB, Zhang G, Rasor N, Utts J, Upchurch DM, et al. Use of complementary and alternative medicine during the menopause transition: Longitudinal results from the Study of Women's Health Across the Nation. Menopause. 2008;15(1): 32–43. doi: 10.1097/gme.0b013e31813429d6 18090037
13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. England: Wiley; 2011.
14. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine. 2009;151(4): 264–9. doi: 10.7326/0003-4819-151-4-200908180-00135 19622511
15. The Cochrane Collaboration. Review manager (RevMan) (Version 5.3) [Computer software]. Copenhagen, Denmark: The Nordic Cochrane Centre; 2014.
16. Suurmond R, van Rhee H, Hak T. Introduction, comparison, and validation of Meta-Essentials: A free and simple tool for meta-analysis. Research Synthesis Methods. 2017;8(4): 537–53. doi: 10.1002/jrsm.1260 28801932
17. Fragkos KC, Tsagris M, Frangos CC. Publication bias in meta-analysis: Confidence intervals for Rosenthal’s fail-safe number. International Scholarly Research Notices. 2014;2014: Article ID 825383.
18. Azizi H, Feng Liu Y, Du L, Hua Wang C, Bahrami-Taghanaki H, Ollah Esmaily H, et al. Menopause-related symptoms: Traditional Chinese medicine vs hormone therapy. Alternative therapies in health and medicine. 2011;17(4): 48–53. 22314633.
19. Chen HL. 50 Cases with menopausal syndrome treated by Kun Tai capsule. China Pharmaceuticals. 2014;23(14): 108–9.
20. Fu LH, Fan LY, Qiao QZ, Zhang YX, Feng LX. Observation of clinical efficacy on perimenopausal syndrome treated with herbal formulas. World Journal of Integrated Traditional and Western Medicine. 2015;(1): 89–91.
21. Li HY, Qiu WF, Xu YP, Zhao DN, He J, Ning XP. Therapeutic effects of Dingkundan on female climacteric symptoms. Hebei Medical Journal. 2018;40(23): 3610–2.
22. Liu XY. Clinical observation of modified Danzhi Xiaoyao San in the treatment of climacteric syndrome in 64 participants. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2008;14(9): 47–8.
23. Luan YQ, Yang X, Peng XL, Fu C, Meng ZX, Zhang J. Double-blind double dummy randomized parallel clinical trial of Kun-Tai capsule in the treatment of perimenopausal symptoms. Chinese Journal of Clinical Pharmacology. 2004;20(6): 452–5.
24. Sun AJ, Wang YP, Gu B, Zheng TP, Lin SQ, Bai WP, et al. A multi-center, randomized, controlled and open clinical trial of Heyan Kuntai Capsule and hormone therapy in perimenopausal women. Chinese Journal of Integrative Medicine. 2018;24(7): 487–93. doi: 10.1007/s11655-016-2266-y 27650094
25. Ushiroyama T, Ikeda A, Sakuma K, Ueki M. Comparing the effects of estrogen and an herbal medicine on peripheral blood flow in post-menopausal women with hot flashes: Hormone replacement therapy and Gui-zhi-fu-ling-wan, a kampo medicine. American Journal of Chinese Medicine. 2005;33(2): 259–67. doi: 10.1142/S0192415X05002813 15974485
26. Zhou YJ, Li J. Combination of ear pallet and Chinese herbal medicine in treating climacteric syndrome. Jiangxi Medical Journal. 2016;51(2): 170–2.
27. Davis SR, Briganti EM, Chen RQ, Dalais FS, Bailey M, Burger HG. The effects of Chinese medicinal herbs on postmenopausal vasometer symptoms of Australian women: a randomised controlled trial. Medical Journal of Australia. 2001;174(2): 68–71. 11245505.
28. Fu SF, Zhao YQ, Ren M, Zhang JH, Wang YF, Han LF, et al. A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine granules for the treatment of menopausal symptoms by stages. Menopause. 2016;23(3): 311–23. doi: 10.1097/GME.0000000000000534 26671188.
29. Grady D, Sawaya GF, Johnson KC, Koltun W, Hess R, Vittinghoff E, et al. MF101, a selective estrogen receptor beta modulator for the treatment of menopausal hot flushes: A phase II clinical trial. Menopause. 2009;16(3): 458–65. doi: 10.1097/gme.0b013e31818e64dd CN-00703125. 19182698
30. Haines CJ, Lam PM, Chung TK, Cheng KF, Leung PC. A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women. Climacteric. 2008;11(3): 244–51. doi: 10.1080/13697130802073029 18568789.
31. Nedeljkovic M, Tian L, Ji P, Deglon-Fischer A, Stute P, Ocon E, et al. Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: Results of a four-arm randomized controlled pilot trial. Menopause. 2014;21(1): 15–24. doi: 10.1097/GME.0b013e31829374e8 23676632.
32. Plotnikoff GA, Watanabe K, Torkelson C, La Valleur J, Radosevich DM, Plotnikoff GA, et al. The TU-025 keishibukuryogan clinical trial for hot flash management in postmenopausal women: Results and lessons for future research. Menopause. 2011;18(8): 886–92. doi: 10.1097/gme.0b013e31821643d9 21738077.
33. van der Sluijs CP, Bensoussan A, Chang S, Baber R. A randomized placebo-controlled trial on the effectiveness of an herbal formula to alleviate menopausal vasomotor symptoms. Menopause. 2009;16(2): 336–44. doi: 10.1097/gme.0b013e3181883dc1 19057416
34. Xia Y, Zhao Y, Ren M, Zhang J, Wang Y, Chang Y, et al. A randomized double-blind placebo-controlled trial of a Chinese herbal medicine preparation (Jiawei Qing'e Fang) for hot flashes and quality of life in perimenopausal women. Menopause. 2012;19(2): 234–44. doi: 10.1097/gme.0b013e3182273177 22089177.
35. Zhong LL, Tong Y, Tang GW, Zhang ZJ, Choi WK, Cheng KL, et al. A randomized, double-blind, controlled trial of a Chinese herbal formula (Er-Xian decoction) for menopausal symptoms in Hong Kong perimenopausal women. Menopause. 2013;20(7): 767–76. doi: 10.1097/GME.0b013e31827cd3dd 23793167.
36. Zhou J, Qu F, Nan R, Tang D. The effect of chinese medicinal herbs in relieving menopausal symptoms in ovariectomized chinese women. Explore. 2007;3(5): 478–84. doi: 10.1016/j.explore.2007.06.002 17905357.
37. Lee SH, Jung BH, Kim SY, Chung BC. Determination of phytoestrogens in traditional medicinal herbs using gas chromatography–mass spectrometry. Journal of Nutritional Biochemistry. 2004;15(8): 452–60. doi: 10.1016/j.jnutbio.2004.01.007 15302079
38. Hao Q, Wang J, Niu J, Zhao P, Cui Y, Sun L, et al. Study on phytoestrogenic-like effects of four kinds of Chinese medicine including Radix Rehmanniae preparata, Radix Paeoniae alba, Radix Angelicae sinensis, Rhizoma chuanxiong. China Journal of Chinese Materia Medica. 2009;34(5): 620–4. 19526797
39. Zhao P, Wang D, Niu J, Wang J, Wang L. Evaluation on phytoestrogen effects of ten kinds of Chinese medicine including flos carthami. China Journal of Chinese Materia Medica. 2007;32(5): 436–9. 17511154
40. Xu H, Su Z-R, Huang W, Choi RC-Y, Zheng Y-Z, Lau DT-W, et al. Er Zhi Wan, an ancient herbal decoction for woman menopausal syndrome, activates the estrogenic response in cultured MCF-7 cells: An evaluation of compatibility in defining the optimized preparation method. Journal of Ethnopharmacology. 2012;143(1): 109–15. doi: 10.1016/j.jep.2012.06.009 22710293
41. Spetz Holm A-CE, Frisk J, Hammar ML. Acupuncture as treatment of hot flashes and the possible role of calcitonin gene-related peptide. Evidence-Based Complementary and Alternative Medicine. 2012;2012: e579321.
42. Chen JT, Shiraki M. Menopausal hot flash and calciotonin gene-related peptide; effect of Keishi-bukuryo-gan, a kampo medicine, related to plasma calciotonin gene-related peptide level. Maturitas. 2003;45(3): 199–204. 12818465
43. Chen H, Cho WC, Sze S, Tong Y. Treatment of menopausal symptoms with Er-xian decoction: A systematic review. American Journal of Chinese Medicine. 2008;36(02): 233–44.
44. Scheid V, Ward T, Cha W-S, Watanabe K, Liao X. The treatment of menopausal symptoms by traditional East Asian medicines: Review and perspectives. Maturitas. 2010;66(2): 111–30. doi: 10.1016/j.maturitas.2009.11.020 20079585
45. Xu L-W, Jia M, Salchow R, Kentsch M, Cui X-J, Deng H-Y, et al. Efficacy and side effects of chinese herbal medicine for menopausal symptoms: A critical review. Evidence-Based Complementary and Alternative Medicine. 2012;2012: e568106.
46. Li Y, Zhu X, Bensussan A, Li P, Moylan E, Delaney G, et al. Herbal medicine for hot flushes induced by endocrine therapy in women with breast cancer: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2016;2016: e1327251.
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