Ruoling Guo

Qigong for hypertension: a systematic review of randomized clinical trials.

Objectives To assess systematically the clinical evidence of qigong for hypertension. Methods Databases were searched up to August 2006. All randomized clinical trials (RCTs) testing qigong in patients with hypertension of any origin and assessing clinically relevant outcomes were considered. Trials using any type of control intervention were included. The selection of studies, data extraction and quality assessment were performed independently by at least two reviewers. Methodological quality was evaluated using the Jadad score. Results A total of 121 potentially relevant articles were identified and 12 RCTs were included. Seven RCTs tested qigong in combination with antihypertensive drugs compared with antihypertensive drugs alone. The meta-analysis of two trials reporting adequate data suggested beneficial effects in favour of qigong [weighted mean difference, systolic blood pressure (SBP) −12.1 mmHg, 95% confidence interval (CI) −17.1 to −7.0; diastolic blood pressure −8.5 mmHg, 95% CI −12.6 to −4.4]. Qigong was compared with waiting list control in two RCTs and was found to reduce SBP significantly (weighted mean difference −18.5 mmHg, 95% CI −23.1 to −13.9). In three further RCTs the comparisons made were: qigong combined with conventional therapy versus muscle relaxation combined with conventional therapy; qigong as a sole treatment versus exercise. All reported positive results in at least some of the relevant outcome measures. The methodological quality of the studies was low. Conclusion There is some encouraging evidence of qigong for lowering SBP, but the conclusiveness of these findings is limited. Rigorously designed trials are warranted to confirm these results.

Herbal medicines for the treatment of rhinosinusitis : A systematic review

OBJECTIVES: To assess the efficacy of herbal medicines for treating rhinosinusitis. DATA SOURCE: Five electronic databases, bibliographies of located papers, manufacturers, and experts in the field. REVIEW METHODS: Inclusion of randomized clinical trials (RCT) testing any herbal medicine in rhinosinusitis, as sole or adjunctive treatment. Data were extracted independently by two reviewers following a predetermined protocol. RESULTS: Ten RCTs, testing six different herbal products against placebo (8 RCTs) or “no additional treatment” (2 RCTs) were included. Four RCTs tested Sinupret as adjunctive treatment for either acute (3 RCTs) or chronic (1 RCT) rhinosinusitis. The quality of these studies varied, but two in acute sinusitis, including the largest and best quality study, and one in chronic sinusitis reported significant positive findings. Three RCTs tested bromelain in either acute sinusitis (2 RCTs) or patients of mixed diagnosis (chronic and acute sinusitis), and all reported some positive findings. Metanalysis of the two RCTs in acute sinusitis suggested that adjunctive use of bromelain significantly improves some symptoms of acute rhinosinusitis. Single RCTs were identified for 4 other herbal products (Esberitox, Myrtol, Cineole, and Bi Yuan Shu) as treatments for sinusitis, all reported some positive results. The median methodological quality score was 3 of 5. CONCLUSION: Evidence that any herbal medicines are beneficial in the treatment of rhinosinusitis is limited, particularly in chronic rhinosinusitis. There is encouraging evidence that Sinupret and bromelain may be effective adjunctive treatments in acute rhinosinusitis. Positive results from isolated RCTs of four other herbal products require independent replication.

Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis

OBJECTIVE To critically assess the efficacy of Pelargonium sidoides for treating acute bronchitis. DATA SOURCES Systematic literature searches were performed in 5 electronic databases: (Medline (1950 - July 2007), Amed (1985 - July 2007), Embase (1974 - July 2007), CINAHL (1982 - July 2007), and The Cochrane Library (Issue 3, 2007) without language restrictions. Reference lists of retrieved articles were searched, and manufacturers contacted for published and unpublished materials. REVIEW METHODS Study selection was done according to predefined criteria. All randomized clinical trials (RCTs) testing P. sidoides extracts (mono preparations) against placebo or standard treatment in patients with acute bronchitis and assessing clinically relevant outcomes were included. Two reviewers independently selected studies, extracted and validated relevant data. Methodological quality was evaluated using the Jadad score. Meta-analysis was performed using a fixed-effect model for continuous data, reported as weighted mean difference with 95% confidence intervals. RESULTS Six RCTs met the inclusion criteria, of which 4 were suitable for statistical pooling. Methodological quality of most trials was good. One study compared an extract of P. sidoides, EPs 7630, against conventional non-antibiotic treatment (acetylcysteine); the other five studies tested EPs 7630 against placebo. All RCTs reported findings suggesting the effectiveness of P. sidoides in treating acute bronchitis. Meta-analysis of the four placebo-controlled RCTs suggested that EPs 7630 significantly reduced bronchitis symptom scores in patients with acute bronchitis by day 7. No serious adverse events were reported. CONCLUSION There is encouraging evidence from currently available data that P. sidoides is effective compared to placebo for patients with acute bronchitis.

Herbal medicines for the treatment of allergic rhinitis: a systematic review.

OBJECTIVE To evaluate the efficacy of herbal medicines for the treatment of allergic rhinitis (AR). DATA SOURCES Five electronic databases until November 8, 2005; bibliographies of located articles; manufacturers of commercially available preparations; and experts in the field. STUDY SELECTION We only included double-blind randomized clinical trials (RCTs), which tested a herbal medicine against placebo or active comparator, in patients with AR, and evaluated clinically relevant outcomes. Study selection, data extraction, and evaluation of methodological quality were performed independently by 2 reviewers. Discrepancies were resolved by discussion and by seeking the opinion of the third reviewer. Meta-analysis was only performed if data were considered suitable for pooling. RESULTS Sixteen eligible RCTs, testing 10 different herbal products against placebo or active comparator, were included. Six RCTs studied Petasites hybridus (butterbur) extract for AR and suggest that P hybridus is superior to placebo or similarly effective compared with nonsedative antihistamines for intermittent AR. Two RCTs studied an Indian herbal combination, Aller-7, in patients with AR and reported positive results. Single RCTs were identified for 8 other herbal products as treatments for AR, reporting positive outcomes, except for grape seed extract. The median methodological quality score was 4 of a possible maximum of 5. CONCLUSIONS There is encouraging evidence suggesting that P hybridus may be an effective herbal treatment for seasonal (intermittent) AR. However, independent replication is required before a firm conclusion can be drawn because of the financial support from the manufacturer of P hybridus extract to the 3 large trials. There are also promising results generated for other herbal products, particularly Aller-7, Tinospora cordifolia, Perilla frutescens, and several Chinese herbal medicines. Although these results are confined to the paucity of data and the small sample size, confirmation in larger and more rigorously designed clinical trials is warranted.