Herbal Medicine for Hot Flushes Induced by Endocrine Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis

Table 1

Characteristics of 5 articles.

Author; (year)	Country	n	Age	Comparison and sample size	Endocrine therapy	Intervention (usage, dosage, and duration)	Treatment duration	Outcomes and measurement	Design	Results
Hernández Muñoz  and Pluchino  2003 [43]	Venezuela	136	35–52	(i) Intervention: Cimicifuga racemosa (); (ii) Control: no treatment group ()	TAM	(i) CR BNO 1055 (one tablet corresponds to 20 mg of herbal drug Cimicifuga racemosa), one tablet twice daily (bid), 12 months; (ii) No treatment	12 months	(i) Frequency & intensity of hot flushes measured by a diary and menopausal symptoms; (ii) Questionnaire; (iii) AEs measured by a self-report of events	Two-armed, randomised, and open study	(i) Frequency and severity of hot flushes were reduced after intervention; (ii) Minor AEs events were reported
Jiang et al. 2012 [44]	China	60	46.60 ± 5.51 versus 44.57 ± 6.99	(i) Intervention: CHM Yishen Tiaogan Decoction (); (ii) Control: CHM Gengnianan ()	Not mentioned	(i) kidney-reinforcing and liver-regulating formula bid (containing Shendi, Shanyao, Shanyurou, Danpi, Baihe, Baishao, Yujin, Foshou, Fuxiaomai, Muli, Nvzhenzi, Gancao, and Hanliancao); (ii) Gengnian An capsule 0.3 g tid (containing Shenshudi, Zexie, Maidong, Yuanshen, Fuxiaomai, Danpi, Fuling, Zhenzhumu, Xianmao, Wuweizi, Cishi, Shouwuteng, Gouteng, and Zhishouwu)	8 weeks	(i) Overall menopausal symptoms scores measured by reduction rate of Kupperman Index (KI) scores; (ii) Successful rate; (iii) Quality of life (QoL) measured by Karnofsky scores (KPS); (iv) Hormone profile measured by hormone levels in serum; (v) AEs measured by full blood counts and liver and renal functions in serum and ECG	Two-armed, randomised, and; open study	(i) The main clinical symptoms were ameliorated after treatment, especially; (ii) The hectic fever and sweating and irritability
Li and Zuo  2009 [45]	China	64	35.23 ± 5.33 versus 36.86 ± 4.98	(i) Intervention: CHM Zhibo Dihuang Wan (); (ii) Control: no treatment ()	TAM	(i) Zhibai Dihuang Wan (containing Zhimu, Huangbai, Dihuang, Shanyurou, Danpi, Fuling, Zexie, and Shanyao); 8 wan (3 g) tid; (ii) No treatment	2 months	(i) Overall menopausal symptoms scores measured by reduction rate of KI; (ii) Hormone profile measured by E2 and FSH in serum; (iii) Endometrium thickness measured by ultrasound scan; (iv) AEs measured by liver and renal functions, urine routine test, and full blood counts	Randomised single-blind study	(i) Improvements on flush, perspiration, insomnia, fatigue, and irritation, without obvious side effects
Sun et al.  2009 [46]	China	73	45.9 ± 5.1; versus 46.4 ± 4.1	(i) Intervention: CHM Shugan Liangxue Decoction (n = 37); (ii) Control: placebo (n = 36)	TAM	(i) Shugan-Liangxue compound (containing Chaihu, Danpi, Baiwei, Baishao, Wuweizi, etc.) 100 mL daily; (ii) Placebo (Shanzha, bitter flavor)	3 weeks	(i) Frequency and severity of hot flushes measured by KI; (ii) Sleep quality measured by a self-reported diary; (iii) AEs measured by a self-report, full blood counts, liver and renal function, and hormone levels	Double-blind, randomised placebo-controlled study	(i) Effective in alleviating hot flashes and mi proving the condition of sleep
Zhang et al.  2000 [47]	China	60	35–70	(i) Intervention: CHM Ruxian 1# (); (ii) Control: CHM Ruxian 2# ()	TAM	(i) Formula based on principle of regulating liver Qi and tonifying kidney Yin, combined with formula based on principle of clearing heat and toxin; (ii) Formula based on principle of clearing heat and toxin	30 days	(i) Hot flushes and other menopausal symptoms measured by indefinable tool; (ii) QoL measured by KPS	Randomised, parallel study	(i) Symptoms such as flush, insomnia, night sweat, palpitation, depression, and heat sensation in the chest, palms, and soles were improved and QoL changed significantly