Efficacy and safety of traditional Chinese medicine for the treatment of epilepsy: a meta-analysis of randomized controlled trials

Abstract

Objective: To evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of epilepsy. Methods: A comprehensive search of database in both Chinese and English was performed. Data from the selected studies was extracted and analyzed independently by two authors. Results: Twenty-two randomized controlled trials were included in the meta-analysis with a total of 1773 patients. Among them, three trials (n=166) focused on TCM monotherapy, while the other 19 trials (n=1607) assessed the benefit of TCM add-on therapy to antiepileptic drugs (AEDs). For the efficacy, meta-analysis found (1) TCM monotherapy had a higher effective rate compared with AEDs (OR=6.007, 95%CI: 2.570-14.037, Z=6.007, P<0.001); (2) the add-on of TCM increased the effective rate (OR=3.123, 95%CI: 2.356, 4.140), Z=7.916, P<0.001). In terms of safety, the add-on of TCM reduced the rate of total AEs (OR = 0.407, 95%CI: 0.274-0.605, P <0.0001) as well as AEs regarding the gastrointestinal and nervous system. Nineteen different TCM prescription was used in these RTCs. Among them, the five most frequently used herbs were Acorus tatarinowii (14 out of 19), Wolfiporia Cocos (10 out of 19), Pinellia Ternata (9 out of 19), Licorice Root (9 out of 19) and Rhizoma Gastrodiae (8 out of 19). Conclusion: TCM is an efficacy and safety strategy for the mono- or add-on treatment of epilepsy. However, as the small sample size, the diversified composition of TCM prescriptions, and the low quality of study design, further studies remain needed.