PMID- 37780612
OWN - NLM
STAT- MEDLINE
DCOM- 20231003
LR  - 20231003
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 14
DP  - 2023
TI  - Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: 
      a systematic review.
PG  - 1241962
LID - 10.3389/fendo.2023.1241962 [doi]
LID - 1241962
AB  - OBJECTIVES: To evaluate the effectiveness and potential mechanism of traditional 
      Chinese medicine Jiawei-Xiaoyao-San (JWXYS) as an adjunct or mono- therapy for 
      antithyroid drugs (ATDs) in the treatment of hyperthyroidism. METHODS: Eight 
      databases and three trial registries were searched from inception until May 2023. 
      Randomized controlled trials (RCTs) were included and meta-analysis was conducted 
      using RevMan 5.4 and Stata 14.0. The Cochrane risk of bias (ROB) tool 1.0 and 
      GRADE tool was used for quality appraisal. The findings from case reports using 
      mono-JWXYS and pharmacological studies were summarized in tables. RESULTS: 
      Thirteen RCTs with 979 participants were included. The majority of the included 
      studies were assessed as high risk of bias in one ROB domain. Compared with ATDs, 
      JWXYS plus ATDs resulted in lower free triiodothyronine (FT3) (MD = -1.31 pmol/L, 
      95% CI [-1.85, -0.76]; low-certainty), lower free thyroxine (MD = -3.24 pmol/L, 
      95% CI [-5.06, -1.42]; low-certainty), higher thyroid stimulating hormone (MD = 
      0.42 mIU/L, 95% CI [0.26, 0.59]; low-certainty), higher effectiveness rate of 
      traditional Chinese medicine syndrome (RR = 1.28, 95% CI [1.08, 1.52]; 
      low-certainty), lower goiter score (MD = -0.66, 95% CI [-1.04, -0.29]; very 
      low-certainty), lower thyrotrophin receptor antibody (SMD = -0.44, 95% CI [-0.73, 
      -0.16]; low-certainty) and fewer adverse events (AEs) (RR = 0.34, 95% CI [0.18, 
      0.67]; moderate-certainty). Compared with regular dosage of ATDs, JWXYS plus 
      half-dose ATDs resulted in fewer AEs (RR = 0.24, 95% CI [0.10, 0.59]; 
      low-certainty). Compared with ATDs in 1 trial, JWXYS resulted in higher FT3, 
      lower goiter score and fewer AEs. Three case reports showed that the reasons 
      patients sought TCM-only treatment include severe AEs and multiple relapses. 
      Three pharmacological studies demonstrated that JWXYS restored Th17/Treg balance, 
      lowered deiodinases activity, regulated thyroid cell proliferation and apoptosis, 
      and alleviated liver oxidative stress in mouse or rat models. CONCLUSION: JWXYS 
      may enhance the effectiveness of ATDs for hyperthyroidism, particularly in 
      relieving symptoms and reducing AEs. Mono-JWXYS is not recommended except in 
      patients intolerant to ATDs. The findings should be interpreted with caution due 
      to overall high risk of bias. Further pharmacological studies with more reliable 
      models are needed. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/prospero/, identifier CRD42023394923.
CI  - Copyright (c) 2023 Ma, Zhang, Zhao, Tang, Zhu, Liu, Xu, Wang, Peng, Liu and Liu.
FAU - Ma, Wenxin
AU  - Ma W
AD  - Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese 
      Medicine, Beijing, China.
FAU - Zhang, Xiaowen
AU  - Zhang X
AD  - Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese 
      Medicine, Beijing, China.
FAU - Zhao, Ruotong
AU  - Zhao R
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Tang, Yang
AU  - Tang Y
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Zhu, Xiaoyun
AU  - Zhu X
AD  - Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
FAU - Liu, Longkun
AU  - Liu L
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Xu, Mingyuan
AU  - Xu M
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Wang, Ge
AU  - Wang G
AD  - Guang'anmen Hospital South Campus, China Academy of Chinese Medical Sciences, 
      Beijing, China.
FAU - Peng, Peiyue
AU  - Peng P
AD  - Beijing University of Chinese Medicine, Beijing, China.
FAU - Liu, Jianping
AU  - Liu J
AD  - Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese 
      Medicine, Beijing, China.
AD  - Department of Community Medicine, Faculty of Health Science, UiT The Arctic 
      University of Norway, Tromso, Norway.
FAU - Liu, Zhaolan
AU  - Liu Z
AD  - Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese 
      Medicine, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230913
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (kamisyoyo san)
SB  - IM
MH  - Animals
MH  - Humans
MH  - Mice
MH  - Rats
MH  - *Goiter
MH  - *Hyperthyroidism/drug therapy
MH  - Case Reports as Topic
PMC - PMC10534980
OTO - NOTNLM
OT  - Jiawei-Xiaoyao-San
OT  - hyperthyroidism
OT  - meta-analysis
OT  - pharmacological studies
OT  - randomized controlled trials
OT  - systematic review
OT  - traditional Chinese medicine
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.
EDAT- 2023/10/02 06:42
MHDA- 2023/10/03 06:47
PMCR- 2023/01/01
CRDT- 2023/10/02 04:31
PHST- 2023/06/18 00:00 [received]
PHST- 2023/08/21 00:00 [accepted]
PHST- 2023/10/03 06:47 [medline]
PHST- 2023/10/02 06:42 [pubmed]
PHST- 2023/10/02 04:31 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2023.1241962 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2023 Sep 13;14:1241962. doi: 
      10.3389/fendo.2023.1241962. eCollection 2023.