Journal of Pharmacopuncture (대한약침학회지)

KOREAN PHARMACOPUNCTURE INSTITUTE (대한약침학회)
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Efficacy of Herbal Medicines on Lung Function in Asthma: a systematic review and meta-analysis of randomized controlled trials

  • Alireza Derakhshan (Faculty of Traditional Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences) ;
  • Masoumeh Sadeghi (Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences) ;
  • Amir-Mohammad-Hashem Asnaashari (Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences) ;
  • Mohsen Dehghani (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences) ;
  • Roshanak Salari (Faculty of Traditional Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences) ;
  • Majid Khadem-Rezaiyan (Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences) ;
  • Majid Mirsadraee (Department of Internal Medicine, Faculty of Medicine, Islamic Azad University-Mashhad Branch) ;
  • Shahin Saeidinejat (Faculty of Traditional Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences) ;
  • Shima Jalali (Department of Internal, Mashhad University of Medical Sciences) ;
  • Shabnam Jalali (Department of Internal, Mashhad University of Medical Sciences)
  • Received : 2022.09.14
  • Accepted : 2023.02.17
  • Published : 2023.06.30
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Abstract

Objectives: The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients. Methods: A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inversevariance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity. Results: As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD: 3.73, 95% CI: 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I2 = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD: 5.16; 95% CI: 2.68-7.63) compared to children (WMD = 1.27; 95% CI: -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs: 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically. Conclusion: Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. This improvement is more likely to be observed amongst adults.

Keywords

Acknowledgement

The research was supported by the Vice-Chancellor for Research at the Mashhad University of Medical Sciences (MUMS) as part of a traditional Persian medical doctoral dissertation. Funding sources had no role in study design, data collection, analysis, interpretation, and manuscript preparation.

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