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Objectives:Bupleurum chinense (BC; Radix Bupleuri) formulae are widely used in herbal medicine clinical practice for major depressive disorder (MDD). This study provides an up-to-date and comprehensive systematic review and meta-analysis of BC formula for MDD. Design: Randomized controlled trials were retrieved from English and Chinese databases, from their inceptions to March 2019. Included studies compared BC formula alone or as integrative medicine to selective serotonin reuptake inhibitor (SSRI) antidepressants. Studies included adults 18–65 years of age. People with other types of depression or physical comorbidities, such as poststroke depression, bipolar, and other mental or physical disorders, were excluded. Meta-analysis was performed using STATA software. Grading of Recommendations Assessment, Development, and Evaluation was also conducted to assess the quality of evidence. Results: Thirty studies compared BC formula to antidepressants and 25 studies compared BC formula plus antidepressants to antidepressants alone. BC formula was more effective than antidepressants at improving depression severity measured on the Hamilton Rating Scale for Depression (HRSD) (standardized mean difference [SMD] −0.35, 95% confidence interval [CI] −0.52 to −0.18, I2 = 81.2%). Integrative use of BC formula plus SSRIs was also superior to SSRIs alone at improving HRSD scores (SMD −1.03, 95% CI −1.43 to −0.62, I2 = 94.2%). However, heterogeneity of the included studies was high and quality was low. The total number and severity of adverse events in the BC formula groups were less than that in the antidepressant groups. Conclusions: BC formula alone or given as integrative medicine with antidepressants reduced depression severity. However, the evidence is low quality and at risk of bias. Well-designed studies are needed to validate the results we identified in this review. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the traditional use of Chinese herbal medicine (CHM) for insomnia in pre-contemporary times. Materials and methods: The Encyclopedia of Traditional Chinese Medicine (fifth edition) was systematically searched using seven Chinese medicine disease nomenclatures to identify insomnia citations. Citations were coded, and frequently used herbal formulae specific for insomnia were analyzed. Results: Insomnia treatments were mentioned in 940 citations, and insomnia diagnosis treated with Chinese herbal formulae was specifically described in 800 citations. The traditional use of CHM appeared to be individualized based on the cause, pathogenesis, phase, phenotype, demographics, and concurrent medical conditions of insomnia. The most common herbal formulae for insomnia included Wen dan tang, Suan zao ren tang, Ban xia shu mi tang, and Gui pi tang. The most frequently cited herb was suan zao ren (Ziziphi spinosae semen). Conclusions: A number of herbal formulae for insomnia were cited in the historical literature. The commonly cited formulae such as Wen dan tang and Suan zao ren tang are consistent with current clinical practice and are good prospects for further therapeutic development. [ABSTRACT FROM AUTHOR]

Background: Psoriasis vulgaris is a chronic disease that significantly affects patient's quality of life and poses an economic burden. Acitretin is a second-generation retinoid used for psoriasis in clinical practice. Orally administered Chinese herbal medicine (CHM), alone or combined with acitretin, has been used for the clinical management of psoriasis vulgaris. This systematic review evaluates the efficacy of oral CHM in comparison with acitretin and the add-on effect of oral CHM to acitretin. Methods: Five English databases and four Chinese databases were searched from their inceptions to May 2014. Included randomized, controlled trials (RCTs) were published in English or Chinese, compared oral CHM or the combination of oral CHM and acitretin with acitretin, and used Psoriasis Area and Severity Index (PASI) as the outcome measure. Results: A total of 25 RCTs were included in this review: 8 studies compared oral CHM with acitretin, 12 compared the combination with acitretin alone, and 5 were three-arm studies that compared both with acitretin. Conclusion: The meta-analysis indicated that oral CHM was effective for psoriasis vulgaris as follows: (1) Oral CHM is neither superior nor inferior to acitretin, and (2) oral CHM could produce add-on effects when combined with acitretin. Oral CHM itself appeared safe for treating psoriasis vulgaris and possibly could reduce the common adverse events seen with acitretin. However, the long-term effect and safety of oral CHM could not be assessed. Further research should consider including a placebo control and using outcome measures according to international guidelines to evaluate CHM, as well as include follow-ups to monitor longer-term efficacy and safety. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to quantitatively assess the effectiveness of self-practiced qigong for treatment of essential hypertension. Methods: Six major electronic databases were searched up to July 2006 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of self-practiced qigong for essential hypertension reported in any language, with main outcome measures as systolic blood pressure (SBP) and diastolic blood pressure (DBP). The quality of included studies were assessed with the Jadad Scale and a customized standard quality assessment scale. Results: Ninety-two (92) studies were identified. Nine (9) of these studies qualified for meta-analysis, comprising a total of 908 cases. Results were as follows: (1) The mean decrease of SBP in those practicing qigong was a 17.03 mm Hg reduction (95% confidence interval (CI) 11.53–22.52) compared with nonspecific intervention controls, but not superior to that in drug controls (1.19 mm Hg, 95% CI −5.40–7.79) and conventional exercise controls (−1.51 mm Hg, 95% CI −6.98–3.95). (2) Mean decrease of DBP in those practicing qigong was 9.98 mm Hg (95% CI 2.55–17.41) compared with nonspecific intervention controls, but not superior to that in drug controls (2.49 mm Hg, 95% CI −0.16–5.13) and conventional exercise controls (−1.59 mm Hg, 95% CI −4.91–1.74). (3) No obvious side effects were identified. Conclusions: Self-practiced qigong for less than 1 year is better in decreasing BP in patients with essential hypertension than in no-treatment controls, but is not superior to that in active controls. More methodologically strict studies are needed to prove real clinical benifits of qigong, and to explore its potential mechanism. [ABSTRACT FROM AUTHOR]