East Asian Herbal Medicine Combined with Conventional Therapy for Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

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BackgroundThere is an increasing demand to improve personal health and reduce the social burden in children with autism spectrum disorder (ASD). A comprehensive review of ASD interventions from the point of view of efficacy, safety, and compliance is needed. The purpose of this study was to evaluate the efficacy and safety of East Asian Herbal Medicine (EAHM) in the treatment of ASD. Materials and methodsEleven databases (PubMed, Cochrane Library, CINAHL, EMBASE, KISS, RISS, OASIS, KCI, CNKI, Wanfang data, and CiNii) were searched from their respective inception to July 2021. A search was conducted by combining the keywords Autism Spectrum Disorder and Herbal medicine. We included a randomized controlled trial in which oral administration of EAHM was combined with conventional treatment for pediatric ASD patients. The primary outcomes were the clinical efficacy rate and the improvement in Childhood Autism Rating Scale (CARS) score. ResultsA total of 7 studies involving 462 children with ASD were included. The results suggest that EAHM as part of a combined therapy enhances the CARS score (MD[95% confidential interval]=4.47[5.89,3.05], p<0.01) and the clinical efficacy rate (RR=1.31[1.14,1.51], p<0.01) in comparison to the control group using only conventional therapy. Safety information was reported in 4 of the 7 included studies, and there were no adverse events or the difference in the incidence of side effects between the two groups was not significant. ConclusionThis meta-analysis shows that EAHM may improves the clinical efficacy rate and CARS score in children with ASD. However, in that the quality of the included studies is not generally high and the numbers are difficult to be considered sufficient, larger scale and rigorously designed randomized controlled trials need to be conducted to strengthen the evidence.