Research Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
PLoS One. 2011;6(12):e28696. doi: 10.1371/journal.pone.0028696. Epub 2011 Dec 9.
our study had two objectives: a) to systematically identify all existing systematic reviews of Chinese herbal medicines (CHM) published in Cochrane Library; b) to assess the methodological quality of included reviews.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a systematic search of the Cochrane Database of Systematic Reviews (CDSR, Issue 5, 2010) to identify all reviews of CHM. A total of fifty-eight reviews were eligible for our study. Twenty-one of the included reviews had at least one Traditional Chinese Medicine (TCM) practitioner as its co-author. 7 reviews didn't include any primary study, the remaining reviews (n = 51) included a median of 9 studies and 936 participants. 50% of reviews were last assessed as up-to-date prior to 2008. The questions addressed by 39 reviews were broad in scope, in which 9 reviews combined studies with different herbal medicines. For OQAQ, the mean of overall quality score (item 10) was 5.05 (95% CI; 4.58-5.52). All reviews assessed the methodological quality of primary studies, 16% of included primary studies used adequate sequence generation and 7% used adequate allocation concealment. Of the 51 nonempty reviews, 23 reviews were reported as being inconclusive, while 27 concluded that there might be benefit of CHM, which was limited by the poor quality or inadequate quantity of included studies. 58 reviews reported searching a median of seven electronic databases, while 10 reviews did not search any Chinese database.
Now CDSR has included large numbers of CHM reviews, our study identified some areas which could be improved, such as almost half of included reviews did not have the participation of TCM practitioners and were not up-to-date according to Cochrane criteria, some reviews pooled the results of different herbal medicines and ignored the searching of Chinese databases.
我们的研究有两个目的:a)系统地识别已发表在 Cochrane Library 中的所有中药(CHM)系统评价;b)评估纳入评价的方法学质量。
方法/主要发现:我们对 Cochrane 系统评价数据库(CDSR,2010 年第 5 期)进行了系统检索,以识别所有关于 CHM 的综述。共有 58 篇综述符合我们的研究标准。纳入的 21 篇综述中至少有一位中医药从业者作为共同作者。7 篇综述未纳入任何原始研究,其余(n=51)综述纳入了中位数为 9 项研究和 936 名参与者。50%的综述在 2008 年之前最后一次评估为最新。39 篇综述所关注的问题范围广泛,其中 9 篇综述将不同的草药研究结合在一起。对于 OQAQ,整体质量评分(项目 10)的平均值为 5.05(95%置信区间;4.58-5.52)。所有综述均评估了原始研究的方法学质量,纳入的 16%原始研究采用了充分的随机序列生成,7%采用了充分的分配隐藏。在 51 篇非空综述中,23 篇综述报告结果为不确定,而 27 篇综述得出结论认为 CHM 可能有获益,但受到纳入研究质量差或数量不足的限制。58 篇综述报告中位数检索了 7 个电子数据库,而 10 篇综述未检索任何中文数据库。
现在 CDSR 已经纳入了大量的 CHM 综述,我们的研究发现了一些可以改进的领域,例如,几乎一半的纳入综述没有中医药从业者的参与,也不符合 Cochrane 标准的最新要求,一些综述汇总了不同草药的结果,忽略了对中文数据库的检索。