Su, C.X., Wang, L.Q., Grant, S.J., & Liu, J.P. (2014). Chinese herbal medicine for cancer-related fatigue: A systematic review of randomized clinical trials. Complementary Therapies in Medicine, 22, 567–579.
DOI Link
Purpose
STUDY PURPOSE: To assess the effectiveness and safety of Chinese herbal medicine (CHM) for the treatment of cancer-related fatigue (CRF)
TYPE OF STUDY: Systematic review
Search Strategy
DATABASES USED: English databases include Cochrane, PubMed, and Embase. Chinese databases include Chinese National Knowledge Infrastructure, VIP, SinoMed, and Wan Fang. Also, two registries were searched: The World Health Organization International Clinical Trial Registry Platform and the International Clinical Trial Registry by the US National Institutes of Health.
KEYWORDS: The following search terms were used separately or combined: cancer-related fatigue, Chinese traditional, Chinese herbal, oriental traditional, herb, herbal medicine, and controlled trial.
INCLUSION CRITERIA: Randomized clinical trials regardless of language, blinding, or publication type. People with a clinical diagnosis of CRF with a clear description of diagnostic criteria during and after cancer treatment (including palliative care) were included. There was no age, gender, tumor type, tumor stage, or type of cancer treatment restriction. CHM was defined as single herb, Chinese patent medicine, practitioner-prescribed herbal formula, and herbal products extracted from natural herbs. There was no limitation on the number of herb uses, dosages, administrations, or durations of treatments. The control included no treatment, placebo, and conventional therapy. Also included were trials on the combined therapy of CHM with conventional therapy versus the same conventional therapy. The primary outcome was patient-reported fatigue measured by reliable and valid assessment tools. The secondary outcomes included quality of life measured by a validated instrument or tool, improvement of depression or anxiety, and adverse events related to CHM.
EXCLUSION CRITERIA: Listed as inclusion criteria
Literature Evaluated
TOTAL REFERENCES RETRIEVED: 173 records were identified after duplicates were removed.
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Appropriate methods described, from study selection, to data extraction, to assessment of risk of bias, and to data analysis using RevMan 5.2 software to quantify and compare the efficacy outcomes of CHM versus the control groups.
Sample Characteristics
FINAL NUMBER STUDIES INCLUDED = 12 articles describing the results of 10 trials
TOTAL PATIENTS INCLUDED IN REVIEW = 751 with 448 in intervention groups and 303 in control groups
KEY SAMPLE CHARACTERISTICS: Eight articles were authored in China, and the others were authored in Korea and America. About 61% of participants were female. The mean age range was 27–71 years old. Two trials recruited CRF inpatients with spleen qi deficiency patterns. Type of cancer differed across trials with a majority focus on breast and lung cancer.
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Palliative care
Results
CHM used alone or in combination with chemotherapy or supportive care showed significant relief in CRF compared to placebo, chemotherapy, and supportive care based on single trials. CHM plus chemotherapy or supportive care was superior to chemotherapy or supportive care in improving quality of life. Data from one trial demonstrated that CHM exerted a greater beneficial effect on relieving anxiety but no difference in alleviating depression. Seven trials reported adverse events, and no severe adverse effects were found in CHM groups.
Conclusions
The work suggests that CHM may be effective and safe in the treatment of CRF. However, the current evidence is insufficient to draw a confirmatory conclusion due to the poor methodological quality of included trials.
Limitations
Quality of methods:
- Lack of information about randomization
- No blinding of participants or providers
- Few adequate allocation concealment
- Short-term interventions (approximately four weeks)
Nursing Implications
It is necessary to conduct rigorously designed trials on potential CHM.
Legacy ID
4783
