Evidence-Based Complementary and Alternative Medicine / 2018 / Article / Tab 2

Research Article

A Systematic Review of Herbal Medicine for Chemotherapy Induced Peripheral Neuropathy

Table 2

Summary of the included randomised controlled trials of herbal medicines (therapeutic effect) for CIPN.

First author (year)Sample size (dropouts): type of cancer; type of CTx. Treatment methodMain outcomesMain results: (A) versus (B)
(at end of treatment)
Effects estimate
RR or MD (95% CI)
Common treatment in both groups(A) Intervention group (regimen, participants)(B) Control group (regimen, participants)

Herbal medicine for hand and foot baths or fumigation
Jia, 200960 (2): gastrointestinal cancer, FOLFOX4n.c.Hand and foot baths of wenloutong formula (30 min bid for 7 days, )Warm water for hand and foot baths (30 min bid for 7 days, )(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) Adverse events
(1) CR/PR/NP
25/3/2 versus 6/3/19 ()
(2) No adverse events
(1) Effective rate
2.90 (1.68, 5.02)
Han (2011)63 (2): various types of cancer, various types of regimenn.c.Hand and foot baths of wenjing huoxue tongluo formula (30 min qd for 2 wk, )Warm water for hand and foot baths (30 min qd for 2 wk, )(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) QoL (CACA form)
(3) Adverse events
(1) PR/NP
26/5 versus 13/17 ()
(2) versus ()
(3) No adverse events
(1) Effective rate
1.94 (1.25, 3.00)
(2) 3.13 (0.56, 5.70)
Lou (2014)102 (1): various types of cancer, oxaliplatinn.c.Hand and foot baths of wenjing tongluo formula (20 min, bid for 7 days, )Hand and foot baths of placebo (20 min, bid for 7 days, )(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) NRS (pain)
(3) NCCN (pain)
(4) Adverse events
(1) CR/PR/NP
24/27/17 versus 2/10/22 ()
(2) to ()
(3) to ()
(4) 2 cases in intervention group
(1) Effective rate
2.13 (1.32, 3.42)
(2) −1.95 (−2.94, −0.96)
(3) −13.63 (−20.15, −7.11)
Wei (2014)66 (2): various types of cancer, various types of CTx.n.c.Hand and foot baths of wenyang tongbi formula (30 min qd for 2 wk, )Vitamin B12 (30 min qd for 2 weeks, )(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) QoL (CACA form)
(3) Adverse events
(1) PR/NP
29/4 versus 19/12 ()
(2) Improvement/stabilisation/decent
8/18/7 versus 3/13/15 ()
(3) No adverse events
(1) Effective rate
1.43 (1.05, 1.95)
(2) Improvement rate
2.51 (0.73, 8.60)
Shen (2015)60 (0): various types of cancer, oxaliplatinVitamin B12 (0.5 mg tid for 2 wk),
aidi injections and thymalfasin (2 wk)
Hand and foot baths of modified huangqi guizhi wuwu formula (30 min qd for 2 wk, )No additional Tx. ()(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) Adverse events
(1) PR/NP
22/8 versus 12/18 ()
(2) No adverse events
(1) Effective rate
1.83 (1.12, 2.99)
Ke (2016)40 (0): multiple myeloma, n.r.Vitamin B12 (0.5 mg, tid for 30 days)Hand and foot baths of herbal formula (30 min bid for 30 days, )No additional Tx. ()(1) Clinical improvement (NCI-CTC; sensory neuropathy)
(2) NCS
 (1) MNCV: median nerve
 (2) MNCV: fibular nerve
 (3) SNCV: median nerve
 (4) SNCV: fibular nerve
(1) PR/NP
17/3 versus 14/6 ()
(2.1) versus ()
(2.2) versus () 
(2.3) versus ()
(2.4) versus ()
(1) Effective rate
1.21 (0.86, 1.71)
(2.1) 7.80 (6.68, 8.92)
(2.2) 9.70 (8.23, 11.17)
(3.1) 6.90 (5.59, 8.21)
(3.2) 8.00 (6.50, 9.50)
Chen (2012)48 (0): gastrointestinal cancer, various types of regimenLipoic acid and vitamin B12 (qd for 2 wk)(1) Modified zhixiao xuanbi decoction (bid for 2 wk)
(2) Fumigation of modified zhixiao xuanbi formula
(2 wk, )
No additional Tx. ()(1) Clinical improvement (researcher’s own criteria)
(2) NCS
 (1) MNCV: median nerve
 (2) MNCV: fibular nerve
 (3) SNCV: median nerve
 (4) SNCV: fibular nerve
(1) PR/NP
19/4 versus 15/10 ()
(2.1) versus ()
(2.2) versus ()
(2.3) versus ()
(2.4) versus ()
(1) Effective rate
1.38 (0.95, 2.00)
(2.1) 5.60 (2.93, 8.27)
(2.2) 4.60 (1.71, 7,49)
(3.1) 4.70 (1.93, 7.47)
(3.2) 4.30 (1.37, 7.23)
Zhou (2013)74 (0): gastrointestinal cancer, oxaliplatinNicotinamide, vitamin B1 and B6 (20 days)Fumigation of herbal formula (30 to 40 min qd for 20 days, )No additional Tx. ()(1) Clinical improvement (researcher’s own criteria)(1) Complete recovery/prominent effect/good effect/ineffectuality
12/15/7/4 versus 5/12/4/15 ()
(1) Effective rate
1.53 (1.14, 2.06)

Herbal medicine for oral dosage form
Zhang (2011)60 (0): various types of cancer, various types of regimenn.c.Bawei yangmai decoction (150 ml, bid for 8 wk, )Vitamin B12 (0.5 mg tid for 8 wk, )(1) Clinical improvement (WHO grade)
(2) QoL (CACA form)
(3) Adverse events
(1) Effective rate
23/30 versus 13/30 ()
(2) versus ()
(3) No adverse events
(1) Effective rate
1.77 (1.12, 2.79)
(2) 6.84 (3.72, 9.96)
Kaku (2012)31 (2): ovarian or endometrial cancer, PCVitamin B12 (1500 μg/day for 6 wk)Goshajinkigan granules (7.5 g/day for 6 wk, )No additional Tx. ()(1) Clinical improvement (NCI-CTC)
 (1) Motor neuropathy
 (2) Sensory neuropathy
(2) QoL (FACT-Taxane)
(3) VAS (pain)
(4) CTP
(1.1) versus ()
(1.2) versus ()
(2) versus ()
(3) versus ()
(4) NS
(1.1) 0.00 (−0.73, 0.73)
(1.2) 0.10 (−0.48, 0.68)
(2) −0.70 (−6.35, 4.95)
(3) −0.30 (−2.54, 1.94)

wk: week, FOLFOX: folinic acid, fluorouracil, and oxaliplatin, n.c.: no common treatment, bid: twice a day, NCI-CTC: National Cancer Institute Common Toxicity Criteria for Adverse Events, CR: complete remission, PR: partial remission, NP: not perceptible, qd: once daily, QoL: quality of life, CACA: China Anti-Cancer Association, NCCN: National Comprehensive Cancer Network Guidelines for Adult Cancer, Tx.: treatment, NCS: nerve conduction study, tid: three times a day, MNCV: motor nerve conduction velocity, SNCV: sensory nerve conduction velocity, NS: no significant differences between intervention and control groups, FACT-Taxane: Functional Assessment of Cancer Therapy-Taxane, VAS: Visual Analogue Scale, and CTP: current perception threshold.

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