Chinese Herbal Medicine for Weight Management: A Systematic Review and Meta-Analyses of Randomised Controlled Trials

Table 1

Characteristics of 39 included studies.

Study ID	Characteristics	Country	Sample size (R/A)	Gender, T (M : F)/C (M : F)	Age mean (SD)	Baseline body weight, T/C mean (SD)	Baseline BMI, T/C mean (SD)	Duration	Treatment group	Control group
CHM versus placebo
Cho 2013 [22]	OW	KR	39 : 30/30 : 23	3 : 27/5 : 18	42.90 (12.67)/41.83 (14.82)	71.84 (10.57)/67.89 (7.85)	28.35 (3.95)/26.51 (2.21)	2 m	CHM: target herbal ingredient, 50 mL, tid	Placebo: THI (no herbal ingredient), 50 mL, tid
Cho 2017 [23]	OW	KR	30 : 30/20 : 19	10 : 20/8 : 22	39.5 (11.2)/41.7 (11.1)	75.0 (11.0)/72.6 (10.8)	27.2 (1.5)/27.1 (1.2)	12 w	CHM: YY-312, 3 tablets 400 mg each, bid	Placebo: placebo (no herbal ingredient), 3 tablets 400 mg each, bid
Chung 2016 [24]	OW, COB, MET	KR	13 : 13/10 : 10	6 : 4/6 : 4	50.00 (5.85)/45.20 (9.52)	79.30 (14.16)/80.96 (11.16)	29.5 (3.6)/28.9 3.0)	8 w	CHM: Qingxue Dan, 3 capsules 300 mg each, qd	Placebo: placebo (no herbal ingredient), 3 capsules 300 mg each, qd
Hioki 2004 [28]	OB, IGT	JP	44 : 41/41 : 40	0 : 41/0 : 40	52.6 (14.0)/54.8 (12.5)	90.8 (17.9)/90.3 (12.2)	36.7 (6.8)/36.1 (3.3)	24 w	CHM: Bofu-Tsusho-San (ephedrine 24 mg/day and inhibition of cAMP phosphodiesterase activity corresponding to 280 mg caffeine/day, 24 mg/day, tid	Placebo: placebo, 24 mg/day, tid
Lenon 2012 [33]	OB	AU	59 : 58/50 : 42	10 : 49/10 : 48	39.3 (13.2)/40.4 (10.2)	99.5 (15.1)/98.2 (17.3)	35.9 (4.9)/35.9 (5.9)	12 w	CHM: RCM-104, 4 capsules 500 mg each, tid	Placebo: placebo (no herbal ingredient), 4 capsules 500 mg each, tid
Park 2013 [41]	OB, HBP, NIDDM, HLD	KR	58 : 55/57 : 55	7 : 50/10 : 45	39.2 (9.5)/38.8 (10.1)	82.2 (10.5)/83.7 (14.4)	31.8 (2.60)/31.9 (3.80)	12 w	CHM: TJ001 extract, 7 g, tid	Placebo: placebo extract, 7 g, tid
CHM versus WM
Hong 2016 [29]	OW, OB, PCOS	CN	23 : 22/23 : 22	0 : 23/0 : 22	24.3 (5.8)/25.1 (6.2)	NR	27.9 (2.6)/28.3 (2.8)	3 m	CHM: Jian Pi Qu Tan Tong Luo Fang, 200 mL/day, bid	WM: metformin tablet, 500 mg, tid
Li 2003 [34]	OW, OB, NIDDM, HLD	CN	30 : 28/30 : 28	NR	NR	NR	28.23 (1.40)/27.87 (1.36)	8 w	CHM: An Yi Jiao Nang, 3 capsules 0.35 g each, tid, 3.15 g/day	WM: metformin tablet, 0.5 g, tid
Shi 2006 [43]	OW, OB, IGT	CN	32 : 30/32 : 30	17 : 15/15 : 15	60-76yo/60-78yo	82.34 (11.18)/82.16 (12.23)	NR	8 w	CHM: Fufang Cangzhu Tang, 150 mL/day, bid	WM: metformin, 0.25 g, tid
Ye 2016 [51]	COB, HLD	CN	50 : 50/50 : 50	27 : 23/28 : 22	42.7 (9.5)/42.9 (10.1)	NR	27.1 (2.8)/27.4 (2.8)	1 m	CHM: Qu Tan Tiao Zhi Tang, 500 mL/day, bid	WM: atorvastatin tablet, 10 mg, qd
Yu 2018 [52]	OB, NIDDM	CN	225 : 225/215 : 199	104 : 111/98 : 101	52.82 (9.01)/52.90 (8.52)	77.82 (12.08)/76.86 (12.06)	28.24 (3.31)/28.01 (3.22)	12 w	CHM: Jiang Tang Tiao Zhi granule, 1 bag, bid	WM: metformin tablet, 0.25 g tid
CHM plus LI versus same LI
Arentz 2017 [19]	OW, OB, PCOS	AU	60 : 62/60 : 62	0 : 60/0 : 62	29.2 (5.6)/28.9 (5.6)	93.2 (18.9)/97.3 (21.3)	34.1 (7.2)/35.2 (6.8)	3 m	CHM: Tablet 1, 3 tablets, qd; MediHerb Tribulus Forte, 3 tablets, qd. for 10 day; LI: same as comparator	LI: diet follows evidence-based guidelines, exercise for at least 150 min per week including 90 min of aerobic activity
Chen 2017 [20]	OB, NAFLD	CN	30 : 30/30 : 30	19 : 11/17 : 13	32.8 (7.97)/37.4 (11.5)	88.4 (8.70)/87.2 (15.5)	32.4 (2.32)/32.3 (3.03)	12 w	CHM: Shan Zha Xiao Zhi Jiao Nang, 3 capsules, tid; LI: same as comparator	LI: diet control, exercise routine
Ding 2014 [25]	OW, OB	CN	47 : 47/47 : 47	18 : 29/16 : 31	37.3 (9.8)/36.7 (9.6)	NR	28.92 (3.91)/28.71 (3.86)	4 w	CHM: Jian Pi Hua Zhuo Tang, 400 mL/day, bid; LI: Same as comparator	LI: low fat, low sugar diet with 60 min exercise for 5 times weekly
Huang 2017 [31]	OB	CN	36 : 36/36 : 36	19 : 17/20 : 16	43.3 (16.21)/42.1 (17.42)	81.52 (6.31)/82.16 (5.67)	31.14 (3.57)/30.51 (3.09)	8 w	CHM: Jia Wei Ling Gui Zhu Gan Tang, 150 mL/day, tid; LI: same as comparator	LI: diet control and 30 min aerobic exercise for 5 times weekly
Lai 2017 [32]	OB	CN	30 : 30/30 : 30	14 : 16/14 : 16	32.13 (8.18)/34.16 (9.46)	NR	32.62 (3.34)/33.16 (2.33)	12 w	CHM: Shan Zha Xiao Zhi Jiao Nang, 1 capsule 0.7 g, tid; LI: same as comparator	LI: according to the “Chinese Adult Obesity Prevention and Control Guidelines”
Li 2007 [36]	OW, OB	CN	25 : 25/25 : 25	11 : 14/10 : 15	42.76 (9.79)/43.44 (14.02)	80.68 (8.35)/80.40 (9.62)	29.48 (1.91)/29.07 (2.15)	60 d	CHM: Jian Fei Tiao Zhi Jiao Nang, 4 capsules 0.5 g each, tid; LI: same as comparator	LI: strict diet control, no alcohol, 30 min exercise for 3 times weekly
Li 2019 [35]	OW, OB	CN	27 : 28/27 : 28	11 : 16/13 : 15	39.86 (7.23)/31.17 (1.98)	87.16 (8.61)/92.43 (8.47)	32.41 (1.89)/31.17 (1.98)	12 w	CHM: Pei Lan Ma Huang Fang, 300 mL/day, bid; LI: same as comparator	LI: dietary intake 1000–1500 kcal/day, 30–45 min aerobic exercise for 3–5 times weekly
Si 2014 [44]	OB	CN	30 : 30/30 : 30	47 : 13	36.25 (8.17)	82.33 (4.53)/81.83 (5.91)	29.94 (1.74)/29.40 (1.80)	2 m	CHM: Wen Shen Jian Pi Hua Tan Fang, 1 decoction/day, qd; LI: same as comparator	LI: low calorie, high fibre diet, exercise routine
Xu 2013 [48]	OW, OB	CN	30 : 30/30 : 30	10 : 20/12 : 18	NR	73.24 (7.78)/74.87 (6.76)	NR	6 m	CHM: Dao Tan Tang Jia Jian, 200 mL/day, bidvLI: same as comparator	LI: diet control, exercise routine
Yang 2016 [50]	OW, OB	CN	40 : 40/40 : 40	21 : 19/18 : 22	45.63 (18.13)/46.51 (17.34)	NR	27.19 (1.36)/26.93 (1.21)	12 w	CHM: Qu Tan Qing Wei Fang granule, bidvLI: same as comparator	LI: reduce sugary/oily foods, no smoking or drinking, 30 min aerobic exercise 3 times weekly
Zhang 2016 [53]	OW, OB	CN	42 : 42/42 : 42	8 : 34/10 : 32	30 (12)/30 (9)	79.0 (10.20)/78.9 (10.70)	24.43 (3.39)/28.90 (3.32)	60 d	CHM: Jin Long Jiang Zhi San, 20 g, tidvLI: same as comparator	LI: low carbohydrate, low fat, low sugar diet, 80% full meals, water intake 5 mL/day
CHM plus LI versus placebo plus same LI
Sheng 2017 [42]	OB	CN	35 : 35/34 : 34	10 : 24/13 : 21	37.74 (12.39)/39.29 (10.11)	NR	31.68 (2.87)/31.77 (4.07)	28 d	CHM: Jian Pi Shu Gan Jiang Zhi Fang, granule, bid; LI: same as comparator	PL: placebo granule, bidvLI: low sugar, sodium, fat, high protein diet, no binge eating, sufficient aerobic exercise, increase fat-burning exercise
CHM plus LI versus WM plus same LI
Dong 2014 [26]	COB, MET	CN	61 : 61/59 : 59	33 : 26/32 : 27	42.7 (4.6)/43. (4.7)	76.35 (7.56)/75.88 (6.95)	28.31 (1.29)/28.71 (1.23)	120 d	CHM: Hong He Qing Jiang capsule, 4 capsules, tid; LI: same as comparator	WM: metformin 0.5 g bid; captopril 25 mg bid; simvastatin 10 mg qd; LI: health education, diet control, increase physical activity
Gao 2018 [27]	OW, OB	CN	48 : 48/48 : 48	28 : 20/25 : 23	42.3 (11.6)/40.2 (13.1)	99.58 (8.43)/100.31 (10.25)	NR	12 w	CHM: Hua Tan Qu Yu Jian Fei Tang, 100 mL/day, bid; LI: same as comparator	WM: orlistat, one tablet, tid; LI: abstain from strong flavour and difficult-to-digest foods, reduce carbohydrates, increase fruits, vegetables, and exercise
Hou 2019 [30]	OB	CN	41 : 40/41 : 40	NR	18–65	91.4 (14.7)/92.1 (16.9)	32.4 (4.0)/33.3 (4.6)	12 w	CHM: Xie Re Hua Zhuo Fang, 1 decoction/day, bid; LI: same as comparator	WM: orlistat tablet, 120 mg, bid; LI: calorie restrict 1500–1800 kcal/day; exercise 40–60  min for 5 times weekly
Liu 2016 [38]	OW, OB, NAFLD	CN	32 : 30/32 : 30	18 : 14/16 : 14	39.5 (10.2)/39.1 (9.1)	NR	29.82 (3.35)/29.06 (3.15)	6 m	CHM: Qiang Gan Jiao Nang, 1 capsule 2.0 g, bid; LI: same as comparator	WM: atorvastatin tablet, 20 mg, qd; LI: no alcohol, reduce calorie intake, increase exercise
Ma 2014 [40]	OW, OB	CN	30 : 30/25 : 25	NR	NR	78.11 (10.08)/78.16 (9.88)	28.61 (2.78)/28.72 (2.14)	3 m	CHM: Pei Lian Ma Huang Fang, 150 mL/day, bid; LI: same as comparator	M: orlistat tablet, 0.12 g, tid; LI: calorie intake 1000–1500 kcal/day; aerobic activity 30 min, 3–5 times weekly
Xiao 2017 [47]	OB, IGT	CN	40 : 40/40 : 40	24 : 16/26 : 14	52.8 (7.8)/53.2 (6.5)	NR	26.15 (2.13)/26.14 (2.26)	3 m	CHM: Jia Wei Xiao Xian Xiong Tang, 300 mL/day, bid; LI: same as comparator	WM: acarbose, 50 mg, tid; LI: diet control, exercise routine
Zhu 2013 [57]	OB, IGT	CN	74 : 70/67 : 64	53 : 21/47 : 23	46.3 (4.6)/48.6 (3.2)	NR	30.57 (3.24)/30.70 (3.11)	6 m	CHM: Sheng Yang Li Shi Fang Ke Li Chong Ji, 100 mL, bid; LI: same as comparator	WM: metformin, 0.5 g, tid; LI: adjust ratio of 3 major nutrients, exercise 30 min/day
CHM plus WM and LI versus same WM and LI
Cheng 2016 [21]	OW, OW, NIDDM	CN	60 : 60/60 : 60	NR	NR	92.00 (4.48)/90.30 (3.49)	26.67 (1.99)/26.52 (2.17)	12 w	CHM: Fu Fang Fan Shi Liu Zhi Ji, 100 mL/day, tid; WM and LI: same as comparator	WM: metformin tablet, 0.25 g, tid; LI: diet control and exercise routine
Lian 2014 [37]	OB, IR	CN	30 : 30/30 : 30	11 : 16/13 : 15	39.00 (18.25)/41.00 (17.50)	NR	23.72 (4.71)/28.23 (2.73)	12 w	CHM: Fei Pang No.1 formula, 200 mL/day, bid; WM and LI: same as comparator	WM: metformin tablet, 850 mg, bid; LI: basic calorie 3347–6276 kJ/day, balance 3 major nutrients, reduce sweet/oily food, no alcohol, exercise 30 min for 3 times weekly
Lu 2016 [39]	OB, IR	CN	41 : 41/41 : 41	24 : 17/22 : 19	38.8 (5.7)/39.5 (5.6)	NR	29.82 (2.62)/30.09 (2.58)	24 w	CHM: Cang Chai Tiao Zhong Tang, 1 decoction/day, bid; WM and LI: same as comparator	WM: sitagliptin tablet, 100 mg, qd; LI: diet regulation, avoid high sugar and fat foods, no smoking, alcohol, or snacks, exercise 30 min for 2–4 times weekly
Tao 2018 [45]	OW, OB, NIDDM	CN	40 : 40/40 : 40	21 : 19/23 : 17	49.15 (11.29)/49.78 (11.09)	NR	25.20 (0.67)/24.98 (0.31)	12 w	CHM: Jian Pi Qu Shi Fang, 200 mL/day, bid; WM and LI: same as comparator	WM: metformin tablet, 0.5 g, tid; LI: diet control, sufficient exercise
Wang 2007 [46]	OW, OB, HBP	CN	31 : 29/31 : 29	19 : 12/18 : 11	50.97 (11.10)/49.24 (10.07)	76.18 (6.88)/78.41 (6.44)	28.02 (2.17)/28.72 (2.23)	8 w	CHM: Ping Gan Yi Shen Tiao Tan Yin, 1 decoction/day, bid; WM and LI: same as comparator	WM: benazepril, 10 mg, qd; LI: sufficient exercise and reasonable diet
Yan 2015 [49]	OW, OB, MET	CN	30 : 30/30 : 30	17 : 13/19 : 11	33.7 (7.56)/32.9 (7.17)	NR	28.1 (1.1)/27.9 (1.2)	8 w	CHM: Wu Ling San Jia Wei, 1 bag, bid; WM and LI: same as comparator	WM: metformin tablet, 0.5 g, tid; LI: heath education, aerobic exercise
Zhang 2017 [54]	OB, NIDDM	CN	58 : 58/58 : 58	38 : 20/37 : 21	46.04 (10.19)/46.30 (10.49)	NR	29.48 (3.48)/29.18 (3.59)	60 d	CHM: Tian Mai Xiao Ke Pian, 2 tablets, bid; WM and LI: same as comparator	WM: sitagliptin 1 tablet, qd; LI: strict diet control
Zhao 2016 [55]	OB, HBP	CN	40 : 40/40 : 40	11 : 29/18 : 22	62.34 (9.32)/64.18 (8.67)	NR	31.04 (1.33)/30.88 (1.79)	12 w	CHM: Ban Xia Bai Zhu Tian Ma Tang, 400 mL/day, bid; WM and LI: same as comparator	WM: valsartan tablet 80 mg, qd; LI: low sodium, low fat diet
Zhou 2019 [56]	OW, PCOS	CN	30 : 30/30 : 30	0 : 30/0 : 30	27.20 (3.73)/27.80 (4.35)	NR	26.88 (2.20)/26.76 (2.03)	3 m	CHM: He Qi San, 1 sachet, bid; WM and LI: same as comparator	WM: metformin, 500 mg, qd; LI: increase exercise, reduce oily, sugary, and raw foods

Notes: Not included in meta-analysis; NR, not reported.