Herbal Medicine (Sihogayonggolmoryeo-Tang or Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for Treating Hypertension:A Systematic Review and Meta-Analysis

Table 1

General characteristics of the included studies.

Study ID	Sample size (A) : (B)	Mean age (range) (yr)	Population	(A) treatment group	(B) control group	Treatment period	Outcome	Results reported
Han [29]	60 (30 : 30)	56.4 (43–75)	(i) SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg; (ii) Pattern identification^※: ascendant hyperactivity of liver yang	SYM + (B)	Captopril 12.5 mg bid + amlodipine besylate 5 mg qd (if there was a severe cough caused by captopril, switch to amlodipine besylate 5 mg qd + furosemide 20 mg qd)	8 wks	(1) Daytime SBP; (2) Daytime DBP; (3) Nighttime SBP; (4) Nighttime DBP; (5) TER (BP); (6) TCM syndrome score; (7) TER (TCM syndrome score); (8) Du’s hypertension quality of life scale	(1) N.S; (2) N.S; (3) N.S; (4) N.S; (5) N.S; (6) (A) < (B)+; (7) (A) > (B) ( value was not presented); (8) (A) < (B)+ (total score, physiological symptoms, somatization symptoms, and obsessive-compulsive conditions), (A) < (B) (sleep status, anger and vitality, anxiety, hostility, depression, and interpersonal sensitivity)
Huang [30]	176 (88 : 88)	(A) 35.51 ± 3.56 (18–65); (B) 34.89 ± 3.41 (18–65)	(i) Essential hypertension; (ii) Anxiety (CCMD)	SYM + amlodipine besylate 5 mg 1T qd	Deanxit (flupentixol and melitracen) 0.5 mg 1T bid + amlodipine besylate 5 mg 1T qd	1 mo	(1) Daytime SBP; (2) Daytime DBP; (3) SAS; (4) SDS	(1) (A) < (B)+; (2) (A) < (B)+; (3) (A) < (B)+; (4) (A) < (B)+
Li [31]	80 (27 : 26 : 27)	(A1) 60.7 (42–78); (A2) 59.7 (39–72); (B) 58.7 (38–74)	(i) Grade 1 or 2 hypertension^#	(A1) SYM; (A2) SYM + (B)	Benazepril 10 mg qd	6 mo	(1) Daytime SBP; (2) Daytime DBP; (3) Serum PCIII	(1) (A1) > (B), (A2) < (B), (A1) > (A2); (2) N.S; (3) (A1) > (A2), (A2) < (B)
Song [32]	94 (47 : 47)	46.4 ± 9.3 (31–64)	(i) Isolated nocturnal hypertension; (ii) Daytime BP < 135/85 mmHg; nighttime BP ≥ 120/70 mmHg; (iii) Pattern identification: ascendant hyperactivity of liver yang	SYM + (B)	Amlodipine besylate 2.5 mg	2 wks	(1) Nighttime SBP; (2) Nighttime DBP; (3) TER (BP); (4) TER (TCM syndrome score)	(1) N.S; (2) (A) < (B); (3) (A) > (B); (4) (A) > (B)
Tang [33]	121 (60 : 61)	(A) 54.18 ± 9.79; (B) 53.84 ± 10.28	(i) Grade 1 or 2 hypertension; (ii) Depression (PHQ-9>4); (iii) Pattern identification: ascendant hyperactivity of liver yang	SYM + amlodipine besylate 5 mg qd	SYM placebo + amlodipine besylate 5 mg qd	4 wks	(1) Daytime SBP; (2) Daytime DBP; (3) PHQ-9; (4) TER (TCM syndrome score); (5) CRP (mg/L); (6) Inner diameter of brachial artery (mm); (7) Endothelium-dependent flow-mediated dilation (%); (8) Endothelium-independent response to glyceryl trinitrate (%)	(1) (A) < (B); (2) (A) < (B); (3) (A) < (B); (4) (A) > (B); (5) (A) > (B); (6) N.S; (7) (A) > (B); (8) (A) > (B)
Wang [34]	100 (50 : 50)	56.21 ± 3.72 (42–61)	(i) Essential hypertension	SYM + (B)	Amlodipine besylate 5 mg qd	NR	(1) TER (BP)	(1) (A) > (B)
Wu [35]	80 (40 : 40)	(A) 48.12 ± 8.25; (B) 50.12 ± 2.13	(i) Grade 1 or 2 hypertension; (ii) Anxiety (HAMA > 14, CCMD); (iii) Pattern identification: yin deficiency with yang hyperactivity	SYM + Amlodipine besylate 5 mg qd	Deanxit (flupentixol and melitracen) bid + amlodipine besylate 5 mg qd	4 wks	(1) Daytime SBP; (2) Daytime DBP; (3) HAMA; (4) TER (TCM syndrome score)	(1) (A) < (B); (2) N.S; (3) (A) < (B); (4) (A) > (B) (head distension, profuse dreaming, vexing heat in the chest, palms, and soles, and dry mouth and throat), N.S (dizziness, headache, constipation, insomnia, inability to sleep, tinnitus, eye redness, impatient and irritability, and lumbar aching and knee flaccidity)

An approach in some East Asian traditional medicines that enables individual treatment by categorizing the signs and symptoms of patients into a series of syndrome concepts. and + mean significant differences between two groups, and . N.S means no significant difference between two groups, . ^∗An approach in some East Asian traditional medicines that enables individual treatment by categorizing the signs and symptoms of patients into a series of syndrome concepts. ^#grade 1: SBP 140–159 mmHg and/or DBP 90–99 mmHg/grade 2: SBP 160–179 mmHg and/or DBP 100–109 mmHg. BP, blood pressure; CCMD, Chinese classification of mental disorders; CRP, C-reactive protein; DBP, diastolic blood pressure; HAMA, Hamilton anxiety rating scale; PCIII, procollagen III; PHQ-9, patient health questionnaire-9; SAS, Zung self-rating anxiety scale; SBP, systolic blood pressure; SDS, Zung self-rating depression scale; SYM, Sihogayonggolmoryeo-tang; TCM, traditional Chinese medicine; TER, total effective rate.