PMID- 34015584
OWN - NLM
STAT- MEDLINE
DCOM- 20210809
LR  - 20220716
IS  - 1950-6007 (Electronic)
IS  - 0753-3322 (Print)
IS  - 0753-3322 (Linking)
VI  - 140
DP  - 2021 Aug
TI  - Tibetan herbal pain-relieving plaster for low back pain: A systematic review and 
      meta-analysis.
PG  - 111727
LID - S0753-3322(21)00509-6 [pii]
LID - 10.1016/j.biopha.2021.111727 [doi]
AB  - ETHNOPHARMACOLOGICAL RELEVANCE: Tibetan traditional medicine CheeZheng 
      Pain-Relieving Plaster (CZPRP) is frequently used as an over-the-counter external 
      analgesic for musculoskeletal pain; however, its evidence for low back pain (LBP) 
      has not been evaluated. AIM OF THE STUDY: This study aims to assess the efficacy 
      and safety of CZPRP for both acute, subacute and chronic LBP through a systematic 
      review and meta-analysis of clinical trials. MATERIALS AND METHODS: PubMed, 
      CENTRAL, CNKI, CQVIP, and Wanfang databases were searched through April 20, 2020 
      for randomized controlled trials of CZPRP for LBP. Eligible comparators were 
      placebo, active treatment, or usual care. Clinical outcomes included pain 
      severity, lower back function score, pain-free rate, and adverse events (AEs). 
      Qualitative evaluations were conducted using the Cochrane risk of bias assessment 
      tools. Quantitative analyses were conducted using a random-effects model. 
      RESULTS: This study includes 1674 LBP patients from nine clinical studies. Pooled 
      analyses among subjects with acute LBP show 1) significant pain reductions (mean 
      difference -0.84, 95% confidence interval[CI] -1.31, -0.37) in CZPRP plus 
      diclofenac versus diclofenac, 2) significant improvements in lower back function 
      (standard mean difference -1.50, 95% CI -2.16, -0.85) in CZPRP versus diclofenac, 
      and 3) a higher pain-free rate in CZPRP alone (risk ratio 1.48, 95% CI 1.16, 
      1.89; I(2) = 61%) or CZPRP plus nonsteroidal anti-inflammatory drugs (NSAIDs) 
      (risk ratio 1.66, 95% CI 1.14, 2.40; I(2) = 0%) versus NSAIDs. However, in a 
      heterogeneous population with mixed LBP subtypes, there was no significant 
      difference in pain outcomes between CZPRP and diclofenac. Additionally, CZPRP use 
      did not increase AEs compared with no CZPRP (p = 0.40). All nine studies are 
      associated with moderate to high risk of bias. CONCLUSIONS: The use of CZPRP is 
      associated with improved acute LBP outcomes compared to diclofenac. However, due 
      to the moderate to high risk of bias of the studies, future rigorous randomized 
      controlled trials are needed to evaluate the effects of CZPRP for acute and 
      chronic LBP.
CI  - Copyright (c) 2021 The Authors. Published by Elsevier Masson SAS.. All rights 
      reserved.
FAU - Yang, Mingxiao
AU  - Yang M
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA. 
      Electronic address: yangm2@mskcc.org.
FAU - Li, Susan Q
AU  - Li SQ
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA.
FAU - Smith, Colleen M
AU  - Smith CM
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA.
FAU - Zhang, Yi Lily
AU  - Zhang YL
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA.
FAU - Bao, Ting
AU  - Bao T
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA.
FAU - Mao, Jun J
AU  - Mao JJ
AD  - Memorial Sloan Kettering Cancer Center, Department of Medicine, Bendheim 
      Integrative Medicine Center, 1429 First Avenue, New York, NY 10021, USA. 
      Electronic address: maoj@mskcc.org.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210518
PL  - France
TA  - Biomed Pharmacother
JT  - Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
JID - 8213295
RN  - 0 (Analgesics)
RN  - 0 (Plant Preparations)
RN  - 144O8QL0L1 (Diclofenac)
SB  - IM
MH  - Analgesics/*therapeutic use
MH  - Animals
MH  - Diclofenac/therapeutic use
MH  - Humans
MH  - Low Back Pain/*drug therapy
MH  - *Medicine, Traditional
MH  - Plant Preparations/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Tibet
PMC - PMC9254726
MID - NIHMS1705870
OTO - NOTNLM
OT  - Camphor-based external analgesic
OT  - CheeZheng pain-relieving plaster
OT  - Efficacy
OT  - Low back pain
OT  - Tibetan herbal formula
EDAT- 2021/05/21 06:00
MHDA- 2021/08/10 06:00
PMCR- 2022/07/05
CRDT- 2021/05/20 20:18
PHST- 2021/02/15 00:00 [received]
PHST- 2021/04/20 00:00 [revised]
PHST- 2021/05/11 00:00 [accepted]
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/08/10 06:00 [medline]
PHST- 2021/05/20 20:18 [entrez]
PHST- 2022/07/05 00:00 [pmc-release]
AID - S0753-3322(21)00509-6 [pii]
AID - 10.1016/j.biopha.2021.111727 [doi]
PST - ppublish
SO  - Biomed Pharmacother. 2021 Aug;140:111727. doi: 10.1016/j.biopha.2021.111727. Epub 
      2021 May 18.