Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials

Chun Ho Ma, Wai Ling Lin, Sing Leung Lui, Xun-Yuan Cai, Vivian Taam Wong, Eric Ziea, Zhang-Jin Zhang, Chun Ho Ma, Wai Ling Lin, Sing Leung Lui, Xun-Yuan Cai, Vivian Taam Wong, Eric Ziea, Zhang-Jin Zhang

Abstract

Chinese herbal medicine is commonly used as a treatment for benign prostatic hyperplasia (BPH), but its efficacy and safety remain to be examined. To compare the efficacy and adverse events of Chinese herbal medicine alone or used adjuvantly with Western medications for BPH. Two independent reviewers searched the major electronic databases for randomized controlled trials comparing Chinese herbal medicine, either in single or adjuvant use with Western medication, with placebo or Western medication. Relevant journals and grey literature were also hand-searched. The outcome measures included changes in urological symptoms, urodynamic measures, prostate volume and adverse events. The frequency of commonly used herbs was also identified. Out of 13 922 identified citations of publications, 31 studies were included. Eleven studies with a Jadad score ≥ 3 were selected for meta-analysis. Chinese herbal medicine was superior to Western medication in improving quality of life and reducing prostate volume. The frequency of adverse events in Chinese herbal medicine was similar to that of placebo and less than that of Western medication. The evidence is too weak to support the efficacy of Chinese herbal medicine for BPH due to the poor methodological quality and small number of trials included. The commonly used herbs identified here should provide insights for future clinical practice and research. Larger randomized controlled trials of better quality are needed to truly evaluate the efficacy of Chinese herbal medicine.

Figures

Figure 1
Figure 1
Selection of trials for inclusion in the review.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Risk of bias summary.
Figure 4
Figure 4
Quality of life when using Chinese herbal medicine (CHM) and Western medicine (WM) for benign prostatic hyperplasia. AAB, alpha-adrenergic blocker; PHY, phytomedicine.
Figure 5
Figure 5
Prostate volume when using Chinese herbal medicine (CHM) and Western medicine (WM) for benign prostatic hyperplasia. AAB, alpha-adrenergic blocker; PHY, phytomedicine; 5ARI, 5-alpha reductase inhibitor.
Figure 6
Figure 6
Likelihood of adverse events when using Chinese herbal medicine (CHM) and placebo.
Figure 7
Figure 7
Likelihood of adverse events when using Chinese herbal medicine (CHM) and Western medicine (WM). AAB, alpha-adrenergic blocker; PHY, phytomedicine; 5ARI, 5-alpha reductase inhibitor.
Figure 8
Figure 8
Likelihood of adverse events with the adjuvant use of Chinese herbal medicine (CHM) and Western medicine versus (WM) Western medicine alone. AAB, alpha-adrenergic blocker; PHY, phytomedicine.

Source: PubMed

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