Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials

Abstract Background Chinese herbal medicine formula Yu ping feng san (YPFS) is commonly used for allergic rhinitis (AR). Previous review had summarized the effectiveness and safety of YPFS, however without any subgroup analysis performed to provide detailed evidence for guiding clinical practice. YP...

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Main Authors: Qiulan Luo, Claire Shuiqing Zhang, Lihong Yang, Anthony Lin Zhang, Xinfeng Guo, Charlie Changli Xue, Chuanjian Lu
Format: Article
Language:English
Published: BMC 2017-11-01
Series:BMC Complementary and Alternative Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12906-017-1988-5
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author Qiulan Luo
Claire Shuiqing Zhang
Lihong Yang
Anthony Lin Zhang
Xinfeng Guo
Charlie Changli Xue
Chuanjian Lu
author_facet Qiulan Luo
Claire Shuiqing Zhang
Lihong Yang
Anthony Lin Zhang
Xinfeng Guo
Charlie Changli Xue
Chuanjian Lu
author_sort Qiulan Luo
collection DOAJ
description Abstract Background Chinese herbal medicine formula Yu ping feng san (YPFS) is commonly used for allergic rhinitis (AR). Previous review had summarized the effectiveness and safety of YPFS, however without any subgroup analysis performed to provide detailed evidence for guiding clinical practice. YPFS was recommended for the management of AR by Chinese medicine clinical practice guideline, but the treatment duration of YPFS was also not specified. The aim of this study is to evaluate the effectiveness and safety of YPFS in treating adult AR with the most recent evidence, and attempt to specify the duration of utilisation through subgroup meta-analyses. Methods Seven databases were searched from their inceptions to September 2017. Randomized controlled trials (RCTs) evaluating YPFS for adult AR were included. Methodological quality of studies was assessed using the Cochrane risk of bias tool. Meta-analysis and subgroup meta-analyses were conducted for evaluating the effectiveness of YPFS. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for rating the quality of evidence. Results Twenty-two RCTs involving 23 comparisons were included in this review. YPFS was compared to placebo, pharmacotherapy, and used as an add-on treatment compared to pharmacotherapy. Meta-analyses were feasible for the outcomes of four individual nasal symptom scores and “effective rate”. Four individual nasal symptom scores decreased after YPFS’ combination treatment: itchy nose (MD-0.46, 95% CI[−0.50, −0.42]), sneezing (MD-0.41, 95% CI[−0.47, −0.35]), blocked nose (MD-0.46, 95% CI[−0.54, −0.39]) and runny nose (MD-0.42, 95% CI[−0.58, −0.26]). Based on “effective rate”, meta-analysis showed that YPFS did not achieve better effect than pharmacotherapy (RR1.07, 95%CI [0.94, 1.22), but its combination with pharmacotherapy seemed more effective than pharmacotherapy alone (RR1.27, 95%CI [1.19, 1.34]) (low quality). Subgroup analysis suggested that YPFS was not superior to the second-generation antihistamine (RR1.04, 95%CI [0.90, 1.19]) (low quality). Further, YPFS’ combination treatment seemed more beneficial when it was used for more than three weeks (RR1.15, 95%CI [1.01, 1.32]). In addition, YPFS was well-tolerated for treating adult AR. Conclusion Chinese herbal medicine formula YPFS seems beneficial for adult AR. This potential benefit need to be further evaluated by more rigorous RCTs.
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spelling doaj.art-139770f19b4b41f7930d9eee3724edda2022-12-22T02:43:19ZengBMCBMC Complementary and Alternative Medicine1472-68822017-11-0117112010.1186/s12906-017-1988-5Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trialsQiulan Luo0Claire Shuiqing Zhang1Lihong Yang2Anthony Lin Zhang3Xinfeng Guo4Charlie Changli Xue5Chuanjian Lu6The Second Affiliated Hospital of Guangzhou University of Chinese MedicineChina-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT UniversityThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineChina-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT UniversityThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineAbstract Background Chinese herbal medicine formula Yu ping feng san (YPFS) is commonly used for allergic rhinitis (AR). Previous review had summarized the effectiveness and safety of YPFS, however without any subgroup analysis performed to provide detailed evidence for guiding clinical practice. YPFS was recommended for the management of AR by Chinese medicine clinical practice guideline, but the treatment duration of YPFS was also not specified. The aim of this study is to evaluate the effectiveness and safety of YPFS in treating adult AR with the most recent evidence, and attempt to specify the duration of utilisation through subgroup meta-analyses. Methods Seven databases were searched from their inceptions to September 2017. Randomized controlled trials (RCTs) evaluating YPFS for adult AR were included. Methodological quality of studies was assessed using the Cochrane risk of bias tool. Meta-analysis and subgroup meta-analyses were conducted for evaluating the effectiveness of YPFS. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for rating the quality of evidence. Results Twenty-two RCTs involving 23 comparisons were included in this review. YPFS was compared to placebo, pharmacotherapy, and used as an add-on treatment compared to pharmacotherapy. Meta-analyses were feasible for the outcomes of four individual nasal symptom scores and “effective rate”. Four individual nasal symptom scores decreased after YPFS’ combination treatment: itchy nose (MD-0.46, 95% CI[−0.50, −0.42]), sneezing (MD-0.41, 95% CI[−0.47, −0.35]), blocked nose (MD-0.46, 95% CI[−0.54, −0.39]) and runny nose (MD-0.42, 95% CI[−0.58, −0.26]). Based on “effective rate”, meta-analysis showed that YPFS did not achieve better effect than pharmacotherapy (RR1.07, 95%CI [0.94, 1.22), but its combination with pharmacotherapy seemed more effective than pharmacotherapy alone (RR1.27, 95%CI [1.19, 1.34]) (low quality). Subgroup analysis suggested that YPFS was not superior to the second-generation antihistamine (RR1.04, 95%CI [0.90, 1.19]) (low quality). Further, YPFS’ combination treatment seemed more beneficial when it was used for more than three weeks (RR1.15, 95%CI [1.01, 1.32]). In addition, YPFS was well-tolerated for treating adult AR. Conclusion Chinese herbal medicine formula YPFS seems beneficial for adult AR. This potential benefit need to be further evaluated by more rigorous RCTs.http://link.springer.com/article/10.1186/s12906-017-1988-5Yu ping feng sanChinese herbal medicineAllergic rhinitisTreatment durationSystematic reviewMeta-analysis
spellingShingle Qiulan Luo
Claire Shuiqing Zhang
Lihong Yang
Anthony Lin Zhang
Xinfeng Guo
Charlie Changli Xue
Chuanjian Lu
Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
BMC Complementary and Alternative Medicine
Yu ping feng san
Chinese herbal medicine
Allergic rhinitis
Treatment duration
Systematic review
Meta-analysis
title Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
title_full Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
title_short Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials
title_sort potential effectiveness of chinese herbal medicine yu ping feng san for adult allergic rhinitis a systematic review and meta analysis of randomized controlled trials
topic Yu ping feng san
Chinese herbal medicine
Allergic rhinitis
Treatment duration
Systematic review
Meta-analysis
url http://link.springer.com/article/10.1186/s12906-017-1988-5
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