Efficacy and safety of Traditional Chinese Medicine for the treatment of acquired immunodeficiency syndrome: a systematic review

Abstract

ObjectiveTo systematically review the efficacy and safety of Traditional Chinese Medicine (TCM) interventions, compared with control interventions (placebo or conventional Western medical therapy), in the treatment of acquired immunodeficiency syndrome (AIDS). MethodsElectronic databases including PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched to identify relevant randomized controlled trials (RCTs) published as of May 2012. Studies were selected according to the specified inclusion and exclusion criteria and then subjected to methodological quality assessment, data extraction, and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions. ResultsTwelve RCTs involving 881 patients with AIDS were included. Methodological quality assessment showed that two were high-quality, two were moderate-quality, and eight were low-quality. Meta-analysis showed that TCM interventions were associated with significantly reduced plasma viral load compared with placebo [odds ratio OR=2.46, 95% confidence interval CI (1.02, 5.94); P=0.04]. However, the reductions in plasma viral load significantly favored conventional Western medical therapy alone over integrated traditional Chinese and Western medical therapy [OR=0.16, 95% CI (0.05, 0.55); P=0.004]. Patients receiving TCM interventions had significantly higher CD4 + T lymphocyte counts compared with those on placebo [OR=2.54, 95% CI (1.40, 4.60); P=0.002]. In addition, TCM interventions were significantly more likely to have improved clinical symptoms [OR=2.82, 95% CI (1.85, 4.31); P < 0.00001]. TCM interventions conferred a similar risk of adverse events (AEs) compared with control interventions [OR=1.87, 95% CI (0.58, 6.01); P=0.29]. ConclusionCurrent evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and increasing CD4+ T lymphocyte count in patients with AIDS. When compared with conventional Western medical therapy, TCM interventions were significantly less effective in reducing plasma viral load, although they were associated with a higher percentage of patients with improved symptoms. Patients receiving TCM interventions did not seem to be at an increased risk of AEs.