PMID- 37090900
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230425
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Chinese Herbal Medicine Combined With Antiepileptic Drugs for Intractable 
      Epilepsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
PG  - 917099
LID - 10.3389/fphar.2022.917099 [doi]
LID - 917099
AB  - Background: Intractable epilepsy (IE) is still a major concern in neurology, and 
      existing therapies do not adequately control symptoms. Chinese Herbal Medicine 
      (CHM) has been widely used as an adjunct to antiepileptic drugs (AEDs) for IE. 
      However, because of the contradictory findings reported in previous studies, it 
      is uncertain if the present evidence is robust enough to warrant its usage. The 
      purpose of this meta-analysis was to systematically evaluate the efficacy of the 
      combination of CHM and AEDs for IE. Methods: From inception to September 2021, 
      Medline, Ovid, Embase, Cochrane Library, Chinese Biomedical Database, China 
      National Knowledge Infrastructure, VIP Database, and Wanfang Database were 
      searched. Only randomized controlled trials (RCTs) that assessed the efficacy of 
      the combination of CHM and AEDs for IE were included. We defined monthly seizure 
      frequency as the primary outcome. The secondary outcomes included the abnormal 
      rate of electroencephalogram (EEG), seizure duration, quality of life (QoL), and 
      adverse events (AEs). Results: Twenty studies with 1,830 patients were enrolled. 
      Most trials had poor methodological quality. The meta-analysis showed that the 
      combination of CHM and AEDs was more efficient than AEDs alone in reducing 
      monthly seizure frequency [MD = -1.26%, 95% CI (-1.62, -0.91); p < 0.00001], the 
      abnormal rate of EEG [RR = 0.66%, 95% CI (0.53, 0.82); p = 0.0002], and improving 
      the QoL [MD = 6.96%, 95% CI (3.44, 10.49); p = 0.0001]. There was no significant 
      difference in seizure duration between groups. Moreover, the combination of CHM 
      and AEDs significantly reduced the AEs [RR = 0.45%, 95% CI (0.32, 0.64); p < 
      0.00001]. Conclusion: The combination of CHM and AEDs could improve seizure 
      control by reducing monthly seizure frequency and abnormal rate of EEG with a 
      decreased risk of adverse events in patients with IE. However, these findings 
      must be interpreted carefully due to the high or uncertain risk of bias in the 
      included trials. To provide stronger evidence for the use of CHM combined with 
      AEDs in IE, high-quality RCTs will be urgently warranted in the future.
CI  - Copyright (c) 2022 Zhao, Zhou, Liu, Liu, Wu, Yuan, Xu, Wang, Wang, Li and Liu.
FAU - Zhao, Ying
AU  - Zhao Y
AD  - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Zhou, Hufang
AU  - Zhou H
AD  - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Liu, Qingxuan
AU  - Liu Q
AD  - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Liu, Jialin
AU  - Liu J
AD  - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Wu, Mengwei
AU  - Wu M
AD  - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Yuan, Siyuan
AU  - Yuan S
AD  - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
FAU - Xu, Weiwei
AU  - Xu W
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Wang, Ying
AU  - Wang Y
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Wang, Kaiyue
AU  - Wang K
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Li, Lili
AU  - Li L
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Liu, Jinmin
AU  - Liu J
AD  - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
LA  - eng
PT  - Systematic Review
DEP - 20220720
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC10117129
OTO - NOTNLM
OT  - Chinese herbal medicine
OT  - antiepileptic drugs
OT  - intractable epilepsy
OT  - meta-analysis
OT  - systematic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.The authors declare that the research was conducted in the 
      absence of any commercial or financial relationships that could be construed as a 
      potential conflict of interest.
EDAT- 2023/04/24 06:42
MHDA- 2023/04/24 06:43
PMCR- 2022/07/20
CRDT- 2023/04/24 03:48
PHST- 2022/04/10 00:00 [received]
PHST- 2022/05/20 00:00 [accepted]
PHST- 2023/04/24 06:43 [medline]
PHST- 2023/04/24 06:42 [pubmed]
PHST- 2023/04/24 03:48 [entrez]
PHST- 2022/07/20 00:00 [pmc-release]
AID - 917099 [pii]
AID - 10.3389/fphar.2022.917099 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 Jul 20;13:917099. doi: 10.3389/fphar.2022.917099. 
      eCollection 2022.