An herb is a plant or part of a plant that people take for health benefits as dietary supplements or medication. Herbal medicine may also be referred to as phytotherapy or use of botanicals. Herbal medicine interventions include a variety of substances and combinations of substances. Herbal medicine is contraindicated with some chemotherapy agents.
Chung, V.C., Wu, X., Lu, P., Hui, E.P., Zhang, Y., Zhang, A.L., . . . Wu, J.C. (2016). Chinese herbal medicine for symptom management in cancer palliative care: Systematic review and meta-analysis. Medicine, 95, e2793.
STUDY PURPOSE: To summarize the results from randomized, controlled trials (RCTs) of the effectiveness of Chinese herbal medicines (CHMs) for managing fatigue, paresthesias, chronic pain, anorexia, edema, and constipation
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Elder care, palliative care
Combining CHM with chemotherapy may improve fatigue in patients with breast cancer. Adding CHM to conventional treatment may improve pain control. CHM alone may improve constipation.
Further research needs to be performed on CHM treating cancer- and cancer treatment-related symptoms.
Chen, C.M., Lin, L.Z., & Zhang, E.X. (2014). Standardized treatment of Chinese medicine decoction for cancer pain patients with opioid-induced constipation: A multi-center prospective randomized controlled study. Chinese Journal of Integrative Medicine, 20, 496–502.
To determine the effect and influence of Chinese medicine (CM) treatment on the quality of life (QOL) of patients with opioid-induced constipation, and to determine any changes in analgesic effect
All patients were treated for 14 days. The control group received 100–200 mg tabs of oral phenolphthalein three times per day with the dose adjusted based on patient condition. The study group received a CM combination consisting of Xiaochengqi decoction (a purgative) and Zengye decoction (also a purgative but less effective). The decoction consisted of several types of plants. The basic formulation was adjusted for one of the four potential syndromes that affected patients.
Randomized, controlled trials at multiple centers
Both study groups had reduced CCS scores after treatment compared to baseline. CCS scores changed more in the CM group than the control group (93.5% versus 86.4%, p < .05). The CM group had better QOL scores in eight variables including constipation, nausea, and vomiting. Pain management was not affected in either group. Side effects included diarrhea, nausea, and abdominal pain.
Analgesia was not affected in this study. CM was effective in managing constipation in patients receiving opioids. The CM group had a 93.5% efficacy rate and the control group had a 86.4% efficacy rate. QOL was improved and side effects were mild.
The CM intervention was more effective in the management of constipation than the control medication, oral phenolphthalein.
Sun, D.Z., Jiao, J.P., Zhang, X., Xu, J.Y., Ye, M., Xiu, L.J., . . . Wei, P.K. (2014). Therapeutic effect of Jinlongshe Granule on quality of life of stage IV gastric cancer patients using EORTC QLQ-C30: A double-blind placebo-controlled clinical trial. Chinese Journal of Integrative Medicine, 2014(Nov.), 1–8.
To observe functional and symptomatic changes related to quality of life in patients with advanced gastric cancer with administration of Jinlongshe granule (JLSG, a Chinese herbal medicine)
Patients were randomized into a JLSG group or a placebo group. All patients received Chinese medicinal herbs prescribed individually. The intervention arm additionally received JLSG, and the other arm received a placebo three times daily. Patients were followed biweekly in clinic visits. Study measures were obtained at enrollment and at 3, 6, 9, 12, and 15 months after treatment.
Double-blind, placebo-controlled, randomized clinical trial
There were statistically significant group-by-time effects for multiple symptoms including cognitive function, fatigue, pain, dyspnea, insomnia, appetite loss, constipation, and and general quality of life (p < .05). For some symptoms, differences were due to increased symptoms in the placebo group. No information regarding any adverse effects is reported. The direction of change in symptom scores is not always clear in this manuscript.
This study has several limitations that make it difficult to assess the potential efficacy of JLSG for symptom management.
This study provides minimal evidence in support of a specific Chinese herbal medicine in patients with advanced gastric cancer. Further well-designed studies are needed for clinically meaningful evaluation of efficacy.