Abstract
This study aimed to analyze and summarize the existing evidence regarding herbal medicine treatments for amyotrophic lateral sclerosis (ALS). Studies on herbal medicine treatment in patients with ALS were searched within English, Chinese, Japanese, and Korean databases up to July 31, 2021. In the selected studies, we collected the following information: the first author, year of publication, country, language, study methodology, sample size, demographic characteristics of the study participants, disease duration, diagnostic criteria, treatment method, treatment periods, evaluation tools, results, and side effects. The organized data were classified and analyzed narratively. This study included 59 studies. The first clinical study on the effect of herbal medicine was published in 1995; moreover, most studies were conducted in China. Among the 59 selected studies, 47.5% were observational studies, including case reports and case series. Moreover, there was one meta-analysis. The El Escorial criteria were the most commonly used diagnostic criterion for ALS; moreover, the ALS functional rating scale was the most common evaluation tool. Buzhongyiqitang, Sijunzitangjiawei, and Jianpiyifeitang were the most commonly used herbal medicines, with anti-inflammatory, protein aggregation, and anti-oxidant effects. There remain evidence of gaps in the effectiveness of herbal medicine for ALS. To allow effective treatment of patients with ALS using herbal medicine, large-scale and rigorously designed high-quality clinical studies should be performed.
Highlights
Amyotrophic lateral sclerosis (ALS) is a representative motor neuron disease involving invasion of the upper and lower motor neurons. e cerebral cortex, brainstem, and spinal motor nerves are selectively invaded, which results in gradual muscle weakness and death from respiratory muscle paralysis within 2–4 years [1]. e disease was first reported by Charles Bell in 1824 and was termed ALS in 1874 by JeanMartin Charcot, who linked the symptoms to neurological problems [2]
We searched 746 studies; among them, we reviewed the titles and abstracts of 472 studies after excluding 274 duplicates
Approximately 70% of the studies were published from 2010 to 2019, which indicates that studies have been more actively conducted in recent years. e included studies were conducted in China and South Korea, with over 70% of the studies being conducted in China
Summary
Amyotrophic lateral sclerosis (ALS) is a representative motor neuron disease involving invasion of the upper and lower motor neurons. e cerebral cortex, brainstem, and spinal motor nerves are selectively invaded, which results in gradual muscle weakness and death from respiratory muscle paralysis within 2–4 years [1]. e disease was first reported by Charles Bell in 1824 and was termed ALS in 1874 by JeanMartin Charcot, who linked the symptoms to neurological problems [2]. Amyotrophic lateral sclerosis (ALS) is a representative motor neuron disease involving invasion of the upper and lower motor neurons. E disease was first reported by Charles Bell in 1824 and was termed ALS in 1874 by JeanMartin Charcot, who linked the symptoms to neurological problems [2]. 90% and 10% of ALS cases are sporadic and familial, respectively. The ALS prevalence rate in South Korea remains unclear. A recent study reported an ALS incidence of 0.6 to 3.8/100,000 per year, with men having a slightly higher prevalence rate than women. E age of onset for sporadic and familial ALS is 58–63 years and 47–52 years, respectively; the incidence rate rapidly decreases after the age of 80 years. E cause of sporadic ALS is unknown; it involves environmental and genetic risk factors Familial ALS is mainly associated with mutations in genes, including superoxide dismutase 1 and transactive response DNAbinding protein. e cause of sporadic ALS is unknown; it involves environmental and genetic risk factors
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