Evidence Of Chinese Herbal Medicine Duhuo Jisheng Decoction For Lumbar Disc Herniation:A Systematic Review

Objective: To systematically evaluate the efficacy and safety of Duhuo Jisheng decoction in the treatment of LDH,this review compiles the evidence from randomised clinical trials and quantifies the effects of DJD on LDH via meta-analysis.Methods: 7 databases at home and abroad were investigated up to Decmber 2019.Randomised clinical trials investigating treatment of LDH for which DJD was used either as a monotherapy or in combination with conventional therapy compared to no intervention,placebo or conventional therapy,were included.Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network,and the Meta-analysis was performed by RevMan 5.3 software.Results: 20 studies with 2360 participants were identified.The quality presente d a high risk of bias.Compared with control groups,meta-analysis found that exper imental groups presented more remarkable in total effective rates(Z=9.68,P<0.00001,RR=1.16,95%CI[1.13~1.20]),VAS scores(Z=3.34,P=0.0008,MD=-1.52,95%CI[-2.42~-0.63]),JOA scores(Z=9.07,P<0.00001,SMD=1.30,95%CI[1.02~1.58]),the levels of TNF-?(Z=2.86,P=0.004,SMD=-0.58,95%CI[-0.97~-0.18]),a nd the levels of IL-1(Z=7.71,P<0.00001,MD=-8.77,95%CI[-11.00~-6.54]).The effect between the two groups in the levels of IL-6 make no difference(Z=0.23,P=0.82,SMD=0.13,95%CI[-1.02~1.29]).Information on the safety of DJD or comprehensive therapies was insufficient in few studies.Conclusion:The Duhuo Jisheng decoction can effectively relieve the clinical symptoms of patients with lumbar disc herniation,with obvious clinical efficacy.B ut in view of the limitations of clinical studies,there are some limitations in this study,and more studies with high quality of evidence are needed to further confir m its efficacy and safety.