Abstract
BackgroundIn East Asia, numerous reports describe the utilization of traditional Chinese herbal decoctions to treat gout. However, the reported clinical effects vary.ObjectivesIn this study, we reviewed and analyzed a large number of randomized controlled clinical trials to systematically assess the clinical efficacy and adverse reactions of Chinese herbal decoctions for treating gout.MethodsWe performed a comprehensive search of databases, such as PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database, et al. In addition, we manually searched the relevant meeting information in the library of the Third Military Medical University.ResultsFinally, 17 randomized controlled trials with a sample size of 1,402 cases met the criteria and were included in the study. The results of the meta-analysis showed that when gout had progressed to the stage of acute arthritis, there was no significant difference in clinical efficacy between Chinese herbal decoctions and traditional Western medicine, as indicated based on the following parameters: serum uric acid (standardized mean difference (SMD):0.35, 95% confidence interval (CI): 0.03 to 0.67), C reactive protein (SMD: 0.25, 95% CI: −0.18 to 0.69), erythrocyte sedimentation rate (SMD: 0.21, 95% CI: −0.02 to 0.45) and overall clinical response (relative risk (RR): 1.05, 95% CI: 1.01 to 1.10). However, the Chinese herbal decoction was significantly better than traditional Western medicine in controlling adverse drug reactions (RR: 0.06, 95% CI: 0.03 to 0.13).ConclusionsThrough a systematic review of the clinical efficacy and safety of Chinese herbal decoctions and traditional Western medicine for the treatment of gout, we found that Chinese herbal decoction and traditional Western medicine led to similar clinical efficacy, but the Chinese herbal decoctions were superior to Western medicine in terms of controlling adverse drug reactions.
Highlights
Gout, occurs when purine metabolism is disrupted, which causes increased synthesis or reduced discharge of uric acid and subsequently results in the excruciatingly painful inflammatory Arthritis [1]
Through a systematic review of the clinical efficacy and safety of Chinese herbal decoctions and traditional Western medicine for the treatment of gout, we found that Chinese herbal decoction and traditional Western medicine led to similar clinical efficacy, but the Chinese herbal decoctions were superior to Western medicine in terms of controlling adverse drug reactions
When the serum uric acid concentration is too high, uric acid is deposited in the joints, cartilage and kidney in the form of a sodium salt, leading to a type of arthritis in which the tissue initiates an inflammatory response against foreign bodies
Summary
Occurs when purine metabolism is disrupted, which causes increased synthesis or reduced discharge of uric acid and subsequently results in the excruciatingly painful inflammatory Arthritis [1]. The clinical manifestations of gout include the characteristic recurrent acute arthritis, tophi deposition, chronic gouty arthritis and deformed joints [2,3]. This disease often affects the kidneys, causing chronic interstitial nephritis and the formation of urinary tract stones composed of uric acid. During the past 20 years, the prevalence of gout has increased in European countries and the United States. Compared with Europe and the United States, the prevalence of gout in Asia began increasing after World War II and has shown a significantly increasing trend over the past 20 years.
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