Research Article

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

Table 3

Summary of findings.

OutcomesNo. of Participants (RCTs)Anticipated absolute effects (95% CI)Relative effect (95% CI)I2 valueQuality of evidence (Grade)Comments
Risk with control groupRisk with SYM group

SYM versus placebo
Daytime SBP (mmHg)Total113 (1)MD 8.84 lower (15.36–2.32 lower)Not applicable⊕⊕⊕⃝
Moderate
Risk of bias (−1)
Daytime DBP (mmHg)Total113 (1)MD 9.11 lower (12.03–6.19 lower)Not applicable⊕⊕⊕⃝
Moderate
Risk of bias (−1)
PHQ-9Total113 (1)MD 3.52 lower (4.40–2.64 lower)Not applicable⊕⊕⊕⃝
Moderate
Risk of bias (−1)
TER (TCM syndrome score)Total113 (1)737 per 1,000892 per 1,000 (744–1,000)RR 1.21 (1.01–1.45)Not applicable⊕⃝⃝⃝
Very low
Risk of bias (−1)
Indirectness (−1)
Imprecision (−1)
Adverse eventTotal113 (1)88 per 1,00071 per 1,000 (20–253)RR 0.81 (0.23–2.88)Not applicable⊕⃝⃝⃝
Very low
Risk of bias (−1)
Imprecision (−2)

SYM versus active controls
Daytime SBP (mmHg)Total305 (3)MD 2.54 lower (4.18–0.89 lower)83%⊕⃝⃝⃝
Very low
Risk of bias (−1)
Inconsistency (−2)
Versus antihypertensives54 (1)MD 5.00 higher (0.16–9.84 higher)Not applicable⊕⊕⃝⃝
Low
Risk of bias (−1)
Imprecision (−1)
Versus antidepressants251 (2)MD 3.52 lower (5.26–1.77 lower)15%⊕⊕⊕⃝
Moderate
Risk of bias (−1)
Daytime DBP (mmHg)Total305 (3)MD 2.67 lower (3.73–1.60 lower)56%⊕⊕⃝⃝
Low
Risk of bias (−1)
Inconsistency (−1)
Versus antihypertensives54 (1)MD 2.20 higher (2.73 lower–7.13 higher)Not applicable⊕⃝⃝⃝
Very low
Risk of bias (−1)
Imprecision (−2)
Versus antidepressants251 (2)MD 2.90 lower (4.00–1.81 lower)0%⊕⊕⊕⃝
Moderate
Risk of bias (−1)
SASTotal (antidepressants)176 (1)MD 10.58 lower (11.57–9.59 lower)Not applicable⊕⊕⊕⃝
Moderate
Risk of bias (−1)
SDSTotal (antidepressants)176 (1)MD 10.94 lower (12.17–9.71 lower)Not applicable⊕⊕⊕⃝
Moderate
Risk of bias (−1)
HAMATotal (antidepressants)75 (1)MD 0.28 lower (0.95 lower–0.39 higher)Not applicable⊕⃝⃝⃝
Very low
Risk of bias (−1)
Imprecision (−2)
Adverse eventTotal (antidepressants)75 (1)0 per 1,0000 per 1,000 (0–0)Not estimableNot applicable⊕⊕⃝⃝
Low
Risk of bias (−1)
Imprecision (−1)

SYM plus active controls versus active controls
Daytime SBP (mmHg)Total (antihypertensives)113 (2)MD 3.22 lower (6.15–0.29 lower)0%⊕⊕⊕⃝
Moderate
Risk of bias (−1)
Daytime DBP (mmHg)Total (antihypertensives)113 (2)MD 2.46 lower (5.09 lower–0.18 higher)72%⊕⃝⃝⃝
Very low
Risk of bias (−1)
Inconsistency (−1)
Imprecision (−1)
Nighttime SBP (mmHg)Total (antihypertensives)154 (2)MD 1.79 lower (3.81 lower–0.23 higher)0%⊕⊕⃝⃝
Low
Risk of bias (−1)
Imprecision (−1)
Nighttime DBP (mmHg)Total (antihypertensives)154 (2)MD 0.35 higher (1.78 lower–2.48 higher)0%⊕⊕⃝⃝
Low
Risk of bias (−1)
Imprecision (−1)
TER (BP)Total (antihypertensives)254 (3)740 per 1,000903 per 1,000 (807–1,000)RR 1.22 (1.09 to 1.37)61%⊕⃝⃝⃝
Very low
Risk of bias (−1)
Indirectness (−1)
Imprecision (−1)
TER (TCM syndrome)Total (antihypertensives)154 (2)688 per 1,000881 per 1,000 (743–1,000)RR 1.28 (1.08 to 1.52)0%⊕⊕⃝⃝
Low
Risk of bias (−1)
Indirectness (−1)
Du's hypertension quality of life scaleTotal (antihypertensives)60 (1)MD 9.85 lower (15.87–3.83 lower)Not applicable⊕⊕⃝⃝
Low
Risk of bias (−1)
Imprecision (−1)
Adverse eventTotal (antihypertensives)60 (1)33 per 1,00011 per 1,000 (0–262)RR 0.33 (0.01 to 7.87)Not applicable⊕⃝⃝⃝
Very low
Risk of bias (−1)
Imprecision (−2)

BP, blood pressure; CI, confidence interval; DBP, diastolic blood pressure; HAMA, Hamilton anxiety rating scale; MD, mean difference; PHQ-9, patient health questionnaire-9; RCT, randomized controlled trial’ RR, risk ratio; 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.