The Third Clinical Medical College, Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310051, P. R. China.
Department of Orthopedics, Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan 250014, P. R. China.
Am J Chin Med. 2020;48(7):1593-1616. doi: 10.1142/S0192415X20500792. Epub 2020 Nov 5.
Spinal cord injury (SCI) is a catastrophic disease associated with damaged neurological structures and has become a significant social and economic burden for the health care system and patients' families. The use of Chinese Herbal Medicine (CHM) to treat SCI has been increasing in recent years. This meta-analysis aimed to investigate the effectiveness of CHM for patients with SCI. Therefore, we included randomized controlled trials (RCTs) of CHM for SCI in seven databases. A total of 26 studies involving 1961 participants were included in this study. No serious heterogeneity or publication bias was observed across each study. The results showed that significant improvements of the American Spinal Injury Association (ASIA)-grading improvement rate ([Formula: see text], [Formula: see text]), clinical effective rate ([Formula: see text], [Formula: see text]), ASIA motor score ([Formula: see text], [Formula: see text]), ASIA sensory score (total) ([Formula: see text], [Formula: see text]), ASIA sensory score (light touch) ([Formula: see text], [Formula: see text]), ASIA sensory score (pinprick) ([Formula: see text], [Formula: see text]), and activities of daily living (ADL) score ([Formula: see text], [Formula: see text]) in CHM group compared with the control group. Among the CHM groups, Buyang Huanwu decoction was the most frequently prescribed herbal formula, while was the most commonly used single herb. In addition, there were no serious and permanent adverse effects in the two groups. The methodological quality of the most included RCTs was poor and the quality of evidence for the main outcomes was from very low to moderate according to the GRADE system. Current evidence suggests that CHM is an effective and safe treatment for SCI and could be treated as a complementary and alternative option with few side effects. However, considering the low quality, small size, and high risk of the studies identified in this meta-analysis, higher methodological quality, rigorously designed RCTs with large sample sizes are needed to confirm the results.
脊髓损伤（SCI）是一种与神经结构损伤相关的灾难性疾病，已成为医疗保健系统和患者家庭的重大社会和经济负担。近年来，使用中药（CHM）治疗 SCI 的情况有所增加。本荟萃分析旨在研究 CHM 治疗 SCI 患者的疗效。因此，我们纳入了 7 个数据库中关于 CHM 治疗 SCI 的随机对照试验（RCT）。本研究共纳入了 26 项研究，涉及 1961 名参与者。各研究之间无显著异质性或发表偏倚。结果表明，CHM 组在以下方面的改善明显优于对照组：美国脊髓损伤协会（ASIA）分级改善率（[Formula: see text]，[Formula: see text]）、临床有效率（[Formula: see text]，[Formula: see text]）、ASIA 运动评分（[Formula: see text]，[Formula: see text]）、ASIA 感觉评分（总分）（[Formula: see text]，[Formula: see text]）、ASIA 感觉评分（轻触觉）（[Formula: see text]，[Formula: see text]）、ASIA 感觉评分（刺痛觉）（[Formula: see text]，[Formula: see text]）和日常生活活动（ADL）评分（[Formula: see text]，[Formula: see text]）。在 CHM 组中，使用最多的中药方剂是补阳还五汤，而使用最广泛的单味中药是。此外，两组均未出现严重且永久性的不良反应。纳入的大多数 RCT 的方法学质量较差，根据 GRADE 系统，主要结局的证据质量从极低到中等。现有证据表明，CHM 是治疗 SCI 的一种有效且安全的方法，可以作为一种副作用较少的补充和替代选择。然而，考虑到本次荟萃分析中确定的研究存在方法学质量低、样本量小和高风险的问题，需要开展更高质量、设计严谨、样本量大的 RCT 来证实这些结果。
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