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Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis.

  • 2020-04-30
  • Frontiers in pharmacology 11
    • Yufeng Zhang
    • Lina Gu
    • Qingqing Xia
    • Lijun Tian
    • Jia Qi
    • Mengshu Cao

Study Design

Type
Systematic Review
Population
patients with idiopathic pulmonary fibrosis (IPF)
Methods
Systematic review and meta-analysis of randomized controlled trials; searched databases; assessed quality using Jadad scale and Cochrane risk of bias; meta-analysis using RevMan5.3.

Introduction

There are many clinical studies in the treatment of idiopathic pulmonary fibrosis (IPF) with herbal medicine including Astragalus mongholicus Bunge, Radix Astragali (RA) and Angelica sinensis (Oliv.) Diels, Radix Angelicae Sinensis (RAS). These have obtained good curative effect. There is no systematic evaluation on the clinical efficacy of RA and RAS in patients with IPF. The aim of this systematic review and meta-analysis was to critically evaluate the current evidence of efficacy and safety of RA and RAS in IPF.

Methods

We searched the primary database for randomized controlled trial (RCT) of RA and RAS treating IPF. We assessed the quality of included studies using the Jadad rating scale and referred to the Cochrane Reviewer's Handbook for guidelines to assess the risk of bias. We extracted the main outcomes of included RCTs and a meta-analysis was conducted using the Cochrane Collaboration's RevMan5.3 software.

Results

Seventeen eligible RCTs were identified and made a systematic review and meta-analysis. Risk of bias and quality of included RCTs were carried out. The results of meta-analysis showed that total effective rate and traditional Chinese medicine syndrome effective rate were statistically significantly higher in the experimental group than the control group, main pulmonary function index, six minute walking distance and Borg scale questionnaire score were statistically significantly better in the experimental group than the control group and incidence of adverse reactions was statistically significantly lower in the experimental group than the control group.

Conclusion

RA and RAS are effective and safe in the treatment of IPF, which is beneficial to pulmonary function and exercise tolerance of these patients.

Research Insights

  • Astragalus→Improved Pulmonary Function

    main pulmonary function index, six minute walking distance and Borg scale questionnaire score were statistically significantly better in the experimental group than the control group

    Effect
    Beneficial
    Effect size
    Small
  • Astragalus→Improved Six Minute Walking Distance

    main pulmonary function index, six minute walking distance and Borg scale questionnaire score were statistically significantly better in the experimental group than the control group

    Effect
    Beneficial
    Effect size
    Small
  • Astragalus→Improved Traditional Chinese Medicine Syndrome Effective Rate

    total effective rate and traditional Chinese medicine syndrome effective rate were statistically significantly higher in the experimental group than the control group

    Effect
    Beneficial
    Effect size
    Small
  • Astragalus→Improved Treatment Response Rate

    total effective rate and traditional Chinese medicine syndrome effective rate were statistically significantly higher in the experimental group than the control group

    Effect
    Beneficial
    Effect size
    Small
  • Astragalus→Reduced Borg Scale Score

    main pulmonary function index, six minute walking distance and Borg scale questionnaire score were statistically significantly better in the experimental group than the control group

    Effect
    Beneficial
    Effect size
    Small
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