PMID- 36454862 OWN - NLM STAT- MEDLINE DCOM- 20230330 LR - 20230330 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 17 IP - 12 DP - 2022 TI - Chinese herbal therapy in the management of rhinosinusitis-A systematic review and meta-analysis. PG - e0278492 LID - 10.1371/journal.pone.0278492 [doi] LID - e0278492 AB - This systematic review aims to assess the effects and safety of Chinese herbal medicines (CHMs) in the management of rhinosinusitis (RS); inform clinicians of the current state of the evidence; identify the best available evidence; and suggest further directions for research. Five English and four Chinese language databases, and four clinical trial registries were searched. Eligible studies were randomised controlled trials (RCTs). Participants were diagnosed with RS based on established criteria. Test interventions were CHMs administered orally and/or nasally, excluding injections and displacement techniques. Control interventions included placebos, no additional treatment, and conventional non-invasive treatments including pharmacotherapies and/or nasal irrigation, and/or inhalations. Polyposis and post-surgical recovery were excluded. Outcomes were Sino-Nasal Outcome Test (SNOT), visual analogue scales (VAS), Lund-Mackay computed tomography score (LM), Lund-Kennedy Endoscopic score (LK), Mucociliary transport time (MTT), Mucociliary transport rate (MTR), quality of life and adverse events (AEs). Risk of bias used the Cochrane tool. Meta-analysis in Review Manager 5.4.1 used random effects for mean difference (MD) or risk ratio (RR) with 95% confidence intervals. Heterogeneity was assessed as I2. Thirty-four RCTs were included, 30 of chronic RS (CRS) and four of acute RS (ARS). These enrolled 3,752 participants. Five RCTs blinded participants. For CRS, comparisons with placebo showed greater improvements in the CHM groups for SNOT-20 and VAS-TNS (total nasal symptoms). Blinded comparisons with pharmacotherapies showed no differences between groups in the degree of improvement for SNOT-20, VAS-TNS, and LM, suggesting these CHMs had similar effects, at least in the short term. In ARS, pooled results found improved scores on VAS-TNS and LK suggesting a benefit for combining these CHMs with pharmacotherapies. Limitations included inadequacies in study design and methodological reporting, and insufficient reporting of AEs. Heterogeneity in some pooled results precluded strong conclusions. Further well-designed studies are needed to test whether the results are replicable. Systematic review registration number: PROSPERO (CRD42019119586). CI - Copyright: (c) 2022 Cui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. FAU - Cui, Jing AU - Cui J AD - China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. FAU - Lin, Wenmin AU - Lin W AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - Department of Otolaryngology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - May, Brian H AU - May BH AD - China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. FAU - Luo, Qiulan AU - Luo Q AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - Department of Otolaryngology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Worsnop, Christopher AU - Worsnop C AD - Department of Respiratory Medicine, Austin Health, Heidelberg, Victoria, Australia. FAU - Zhang, Anthony Lin AU - Zhang AL AD - China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. FAU - Guo, Xinfeng AU - Guo X AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. FAU - Lu, Chuanjian AU - Lu C AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. FAU - Li, Yunying AU - Li Y AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - Department of Otolaryngology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Xue, Charlie C AU - Xue CC AUID- ORCID: 0000-0001-6937-9088 AD - China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. AD - Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20221201 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Humans MH - China MH - Nasal Lavage MH - Phytotherapy MH - *Sinusitis/drug therapy PMC - PMC9714754 COIS- The authors have declared that no competing interests exist. EDAT- 2022/12/02 06:00 MHDA- 2022/12/06 06:00 PMCR- 2022/12/01 CRDT- 2022/12/01 14:05 PHST- 2022/08/25 00:00 [received] PHST- 2022/11/17 00:00 [accepted] PHST- 2022/12/01 14:05 [entrez] PHST- 2022/12/02 06:00 [pubmed] PHST- 2022/12/06 06:00 [medline] PHST- 2022/12/01 00:00 [pmc-release] AID - PONE-D-22-23604 [pii] AID - 10.1371/journal.pone.0278492 [doi] PST - epublish SO - PLoS One. 2022 Dec 1;17(12):e0278492. doi: 10.1371/journal.pone.0278492. eCollection 2022.