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Meta-Analysis
. 2019 Sep 19;14(9):e0222383.
doi: 10.1371/journal.pone.0222383. eCollection 2019.

Chinese herbal formulae for the treatment of menopausal hot flushes: A systematic review and meta-analysis

Mingdi Li  1 , Andrew Hung  2 , George Binh Lenon  1 , Angela Wei Hong Yang  1
Affiliations
Meta-Analysis

Chinese herbal formulae for the treatment of menopausal hot flushes: A systematic review and meta-analysis

Mingdi Li et al. PLoS One. .

Abstract

Objectives: This systematic review aimed to evaluate the therapeutic effects and safety of Chinese herbal medicine (CHM) formulae for managing menopausal hot flushes (MHF).

Methods: Seven English and Chinese databases were searched for studies from respective inceptions to February 2019. Randomized controlled trials investigating the clinical effects and safety of CHM formulae on MHF were considered for inclusion. The outcomes of subjective feelings (MHF and quality of life), objective changes (hormones and peripheral blood flow) and safety were analyzed. The most frequently prescribed formulae and herbs were summarized.

Results: Nineteen randomized clinical trials involving 2469 patients were included. When compared to menopausal hormone therapy, CHM had similar effects to menopausal hormone therapy on total effectiveness rate (OR 1.41, 95% CI 0.84 to 2.35) and total Kupperman index (KI) score (SMD -0.13, 95% CI -0.61 to 0.36), and could significantly reduce vasomotor symptom score (MD -0.43, 95% CI -0.55 to -0.31) and upper-body peripheral blood flow (MD -3.56, 95% CI -5.14 to -1.98 under the jaw, MD -7.10, 95% CI -11.01 to -3.19 in the fingertip). When compared to placebo, CHM could reduce MHF severity (MD -0.70, 95% CI-1.00 to -0.40) and improve total KI score (MD -12.61, 95% CI -15.21 to -10.01). However, no statistically significant changes to hormone levels were detected. Most commonly seen adverse events were mild gastrointestinal tract reactions. The most popularly studied formula was Kun Tai capsule and the most frequently prescribed herb was Bai shao (Paeoniae Radix Alba, Paeonia lactiflora Pall.). More than 50% included studies had low risks of bias in the domains of selection, performance, attrition and reporting.

Conclusions: This review indicated that CHM formulae were safe to be applied in MHF females and able to improve MHF-related symptom scores as well as the peripheral blood flow. Further studies should focus on specific formulae.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart on study selection procedures of Chinese herbal medicines for the management of menopausal hot flushes.
Fig 2
Fig 2. Risk of bias graph: Review authors' judgements about each risk of bias item presented as percentages across all included studies.
Fig 3
Fig 3. Risk of bias summary: Review authors' judgements about each risk of bias item for each included study.
Fig 4
Fig 4. Meta-analysis of the total effectiveness rate of Chinese herbal medicine compared to menopausal hormone therapy for the treatment of menopausal hot flushes.
Fig 5
Fig 5. Meta-analysis of the total KI score of Chinese herbal medicine compared to menopausal hormone therapy for the treatment of menopausal hot flushes.
Fig 6
Fig 6. Meta-analysis of the vasomotor domain score of quality of life of Chinese herbal medicine compared to placebo for the treatment of menopausal hot flushes.
Fig 7
Fig 7. The network of herb pairs in the prescribed CHM formulae from included studies.
See this image and copyright information in PMC

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