Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis
Background: Intrahepatic cholestasis of pregnancy (ICP) seriously threatens the health of pregnant women and newborns. A various number of Chinese prescriptions and patent medicines combined with ursodeoxycholic acid (UDCA) are used for treating ICP in China. However, there are still many doubts in...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-11-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.774884/full |
| _version_ | 1818421526390636544 |
|---|---|
| author | Yinxiao Jiang Haotian Li Dan Song Penghui Ye Nuo Xu Yuan Chen Wenwen Zhang Qichao Hu Xiao Ma Jianxia Wen Yeyu Li Yanling Zhao |
| author_facet | Yinxiao Jiang Haotian Li Dan Song Penghui Ye Nuo Xu Yuan Chen Wenwen Zhang Qichao Hu Xiao Ma Jianxia Wen Yeyu Li Yanling Zhao |
| author_sort | Yinxiao Jiang |
| collection | DOAJ |
| description | Background: Intrahepatic cholestasis of pregnancy (ICP) seriously threatens the health of pregnant women and newborns. A various number of Chinese prescriptions and patent medicines combined with ursodeoxycholic acid (UDCA) are used for treating ICP in China. However, there are still many doubts in choosing the suitable therapeutic drugs for the treatment of ICP in clinical practice.Methods: Several electronic databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang, and VIP, were comprehensively searched from the database inception to February 22, 2021. Randomized controlled trials (RCTs) reporting the use of UDCA only, Chinese prescriptions plus UDCA, and patent medicine plus UDCA for the treatment of ICP were collected according to their inclusion and exclusion criteria. Cochrane Reviewers’ Handbook version 5.2 was applied for the risk assessment of the included trials. STATA 16.0 software was used for network meta-analysis (NMA). The pruritus score and the serum levels of total bile acid (TBA), alanine aminotransferase (ALT), and aspartate transaminase (AST) in ICP patients served as the primary outcomes. Moreover, this study had been registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/#joinuppage), and the registration number is CRD42020188831.Results: Thirty-eight RCTs comprising 3,841 patients meeting the inclusion criteria were included in the network meta-analysis. The NMA results showed that compared with UDCA used alone, Yinchenhao decoction (seven different Chinese prescriptions or patent medicines) plus UDCA dramatically alleviated the primary outcomes of ICP, including the pruritus score, as well as the serum levels of TBA, ALT, and AST. The NMA results showed that the optimal drug ratio for the treatment of ICP was different from the dosage ratio of traditional Yinchenhao decoction. Significantly, the intervention plan f (IP-f) group [the similar prescription of Yinchenhao decoction 2 (Artemisia capillaris Thunb >15 g, Gardenia >9 g, and Rhubarb <5 g) + UDCA] was the best therapeutics among the eight therapies.Conclusion: Overall, the combined use of Chinese prescriptions or patent medicine with UDCA was generally better than UDCA used alone. The dose of IP-f might be a beneficial therapeutic method for the clinical medication of ICP.Clinical Trail Registration:https://www.crd.york.ac.uk/, identifier CRD42020188831. |
| first_indexed | 2024-12-14T13:11:46Z |
| format | Article |
| id | doaj.art-521c47edec8646d5ba00be90bfaafb58 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-14T13:11:46Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-521c47edec8646d5ba00be90bfaafb582022-12-21T23:00:09ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-11-011210.3389/fphar.2021.774884774884Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-AnalysisYinxiao Jiang0Haotian Li1Dan Song2Penghui Ye3Nuo Xu4Yuan Chen5Wenwen Zhang6Qichao Hu7Xiao Ma8Jianxia Wen9Yeyu Li10Yanling Zhao11State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Pharmacy, The Fifth Medical Center of PLA General Hospital, Beijing, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaState Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Food and Bioengineering, Xihua University, Chengdu, ChinaHospital of Chengdu University of Traditional Chinese Medicine, School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Pharmacy, The Fifth Medical Center of PLA General Hospital, Beijing, ChinaBackground: Intrahepatic cholestasis of pregnancy (ICP) seriously threatens the health of pregnant women and newborns. A various number of Chinese prescriptions and patent medicines combined with ursodeoxycholic acid (UDCA) are used for treating ICP in China. However, there are still many doubts in choosing the suitable therapeutic drugs for the treatment of ICP in clinical practice.Methods: Several electronic databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang, and VIP, were comprehensively searched from the database inception to February 22, 2021. Randomized controlled trials (RCTs) reporting the use of UDCA only, Chinese prescriptions plus UDCA, and patent medicine plus UDCA for the treatment of ICP were collected according to their inclusion and exclusion criteria. Cochrane Reviewers’ Handbook version 5.2 was applied for the risk assessment of the included trials. STATA 16.0 software was used for network meta-analysis (NMA). The pruritus score and the serum levels of total bile acid (TBA), alanine aminotransferase (ALT), and aspartate transaminase (AST) in ICP patients served as the primary outcomes. Moreover, this study had been registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/#joinuppage), and the registration number is CRD42020188831.Results: Thirty-eight RCTs comprising 3,841 patients meeting the inclusion criteria were included in the network meta-analysis. The NMA results showed that compared with UDCA used alone, Yinchenhao decoction (seven different Chinese prescriptions or patent medicines) plus UDCA dramatically alleviated the primary outcomes of ICP, including the pruritus score, as well as the serum levels of TBA, ALT, and AST. The NMA results showed that the optimal drug ratio for the treatment of ICP was different from the dosage ratio of traditional Yinchenhao decoction. Significantly, the intervention plan f (IP-f) group [the similar prescription of Yinchenhao decoction 2 (Artemisia capillaris Thunb >15 g, Gardenia >9 g, and Rhubarb <5 g) + UDCA] was the best therapeutics among the eight therapies.Conclusion: Overall, the combined use of Chinese prescriptions or patent medicine with UDCA was generally better than UDCA used alone. The dose of IP-f might be a beneficial therapeutic method for the clinical medication of ICP.Clinical Trail Registration:https://www.crd.york.ac.uk/, identifier CRD42020188831.https://www.frontiersin.org/articles/10.3389/fphar.2021.774884/fullintrahepatic cholestasis of pregnancyursodeoxycholic acidYinchenhao decoctiontraditional Chinese medicinenetwork meta-analysis |
| spellingShingle | Yinxiao Jiang Haotian Li Dan Song Penghui Ye Nuo Xu Yuan Chen Wenwen Zhang Qichao Hu Xiao Ma Jianxia Wen Yeyu Li Yanling Zhao Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis Frontiers in Pharmacology intrahepatic cholestasis of pregnancy ursodeoxycholic acid Yinchenhao decoction traditional Chinese medicine network meta-analysis |
| title | Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis |
| title_full | Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis |
| title_fullStr | Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis |
| title_full_unstemmed | Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis |
| title_short | Comparative Evidence for Intrahepatic Cholestasis of Pregnancy Treatment With Traditional Chinese Medicine Therapy: A Network Meta-Analysis |
| title_sort | comparative evidence for intrahepatic cholestasis of pregnancy treatment with traditional chinese medicine therapy a network meta analysis |
| topic | intrahepatic cholestasis of pregnancy ursodeoxycholic acid Yinchenhao decoction traditional Chinese medicine network meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.774884/full |
| work_keys_str_mv | AT yinxiaojiang comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT haotianli comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT dansong comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT penghuiye comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT nuoxu comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT yuanchen comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT wenwenzhang comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT qichaohu comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT xiaoma comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT jianxiawen comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT yeyuli comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis AT yanlingzhao comparativeevidenceforintrahepaticcholestasisofpregnancytreatmentwithtraditionalchinesemedicinetherapyanetworkmetaanalysis |