Rehmannia glutinosa for perimenopausal syndrome in patients with breast cancer: A systematic review and meta-analysis.

2025-07
Saudi medical journal 46(7)
- Dejia Kong
- Feixiang Huang
- Wenhua Liu
- Ma Lin
- Zhumei Sheng
- Junmiao Xu

PubMed: 40628433
DOI: 10.15537/smj.2025.46.7.20240572

Study Design

Type: Meta-Analysis
Sample size: n = 139
Population: 1,139 patients with perimenopausal syndrome in breast cancer from 17 RCTs
Methods: Meta-analysis of RCTs comparing CHM with Rehmannia glutinosa as the principal ingredient vs Western medicine
Funding: Unclear

Objectives

To carry out a quantitative assessment of the therapeutic effect of Chinese herbal medicine (CHM), with Rehmannia glutinosa as the main ingredient, in treating perimenopausal syndrome (PMS) in breast cancer patients.

Methods

Randomized controlled trials (RCTs) comparing CHM with Rehmannia glutinosa as the principal ingredient and Western medicine in treating PMS among breast cancer patients were retrieved from multiple databases. These databases included PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine Database. The primary outcome was the change in the Kupperman index by the end of the follow-up period. Secondary outcomes were changes in Karnofsky performance status (KPS), the functional assessment of cancer therapy - breast (FACT-B), the percentages of T-cells, levels of gonadal hormones, and tumor markers in peripheral blood at the end of follow-up, and adverse events.

Results

The meta-analysis included 17 RCTs involving 1,139 patients showing that CHM with Rehmannia glutinosa as the monarch drug significantly improved the Kupperman index (MD= -12.79, p<0.01), KPS score and increased the percentage of CD4 cells, reduced the percentage of CD8 cells, and improved the CD4/CD8 ratio in peripheral blood, compared to Western medicine. There were no significant differences in FACT-B scores. Levels of gonadal hormones in peripheral blood did not exhibit significant variations, and no severe adverse reactions were detected.

Conclusion

These data suggest that CHM with Rehmannia glutinosa as the monarch drug may be applied in the treatment of PMS in patients with breast cancer. These results should be considered in the context of the methodological flaws and high heterogeneity of the included RCTs.PROSPERO No. ID: CRD42022384810.

Research Insights

Rehmannia→Changed Gonadal Hormone Level
Levels of gonadal hormones in peripheral blood did not exhibit significant variations
Effect
Neutral
Effect size
Small
Rehmannia→Improved CD4+/CD8+ Ratio
improved the CD4/CD8 ratio in peripheral blood
Effect
Beneficial
Effect size
Moderate
Rehmannia→Improved FACT-B Score
There were no significant differences in FACT-B scores
Effect
Neutral
Effect size
Small
Rehmannia→Improved Karnofsky Performance Status
CHM with Rehmannia glutinosa as the monarch drug significantly improved ... KPS score
Effect
Beneficial
Effect size
Moderate
Rehmannia→Improved Kupperman Index
CHM with Rehmannia glutinosa as the monarch drug significantly improved the Kupperman index (MD= -12.79, p<0.01)
Effect
Beneficial
Effect size
Large
Rehmannia→Increased CD4+ T Cell Count
increased the percentage of CD4 cells
Effect
Beneficial
Effect size
Moderate
Rehmannia→Reduced CD8 Cell Percentage
reduced the percentage of CD8 cells
Effect
Beneficial
Effect size
Moderate

Adverse Events Reported

Rehmannia→Overall tolerability
no severe adverse reactions were detected
Finding
Reported