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Chinese herbal medicine for gout: a systematic review of randomized clinical trials

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Abstract

Patients with gout referring to Chinese herbal medicine are not rare in China, and a great number of clinical trials on herbal medicine have been published. However, there has not been a systematic review to summarize the evidence of Chinese herbal medicine for gout. The aim of this study is to evaluate the evidence for the effectiveness and safety of Chinese herbal medicine for gout. We searched for randomized clinical trials on Chinese herbal medicine for gout till December 2012. Cochrane risk of bias tool was used to assess the methodological quality. RevMan 5.2 was used to synthesize the results. We included 57 trials involving 4,527 gout patients. The quality of trials was generally poor. No trial reported health-related quality of life in patients. There is not enough evidence showing that herbal medicine was statistically more effective than conventional medications in pain relief [mean difference (MD), −0.03; 95 % confidence interval (CI), −0.06, 0.00], but herbal medicine combined with conventional medicines may have better effectiveness (MD, −0.33; 95 % CI, −0.59, −0.07). Trials that reported function limitation relief found herbal medicine more effective than conventional medications (MD, −0.23; 95 % CI, −0.32, −0.15). There was no evidence showing that herbal medicine prevents gout recurrence better. Twenty-five out of 41 trials, involving 23 different herbal prescriptions, found statistical significance in lowering serum uric acid level, and the overall effect from Chinese herbal medicine in inflammation relief is better than conventional therapies in 19 trials with 17 different prescriptions. The current data show that herbal medicine leads to fewer side reactions compared to conventional therapies [risk ratio (RR), 0.11; 95 % CI, 0.08 to 0.15]. Chinese herbal medicine may have clinical effectiveness for functional recovery in patients with gout, and lead to a safe control of serum uric acid level and inflammation severity. Due to low quality of trials, trials with higher methodological quality and less heterogeneity are needed in the future.

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Funding statement

This research was funded under the Program for Innovative Research Team of Beijing University of Chinese Medicine (2011-CXTD-09) and the Project for Standard Operation Procedure of Clinical Appraisal in the Program for Significant New Drugs Development (2011ZX09302-006-01-03(5)).

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  1. Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Bei San Huan Dong Lu No.11, Chaoyang District, Beijing, 100029, China

    Xin-Xue Li, Mei Han, Yu-Yi Wang & Jian-Ping Liu

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  1. Xin-Xue Li
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Correspondence to Jian-Ping Liu.

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Li, XX., Han, M., Wang, YY. et al. Chinese herbal medicine for gout: a systematic review of randomized clinical trials. Clin Rheumatol 32, 943–959 (2013). https://doi.org/10.1007/s10067-013-2274-7

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