Cargando…

Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis

Introduction: The effectiveness and safety of the Chinese herbal medicine (CHM) Xiao Yao San (XYS) used for treating anxiety disorders are still unknown. Thus, we conducted this systematic review with meta-analysis and trial sequential analysis (TSA) to determine its safety and efficacy. Methods: We...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Yifan, Chen, Xiaofeng, Wei, Wei, Ding, Yiyun, Guo, Rongjuan, Xing, Jia, Wang, Jialin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613521/
https://www.ncbi.nlm.nih.gov/pubmed/37905203
http://dx.doi.org/10.3389/fphar.2023.1169292
_version_ 1785128850463653888
author Wang, Yifan
Chen, Xiaofeng
Wei, Wei
Ding, Yiyun
Guo, Rongjuan
Xing, Jia
Wang, Jialin
author_facet Wang, Yifan
Chen, Xiaofeng
Wei, Wei
Ding, Yiyun
Guo, Rongjuan
Xing, Jia
Wang, Jialin
author_sort Wang, Yifan
collection PubMed
description Introduction: The effectiveness and safety of the Chinese herbal medicine (CHM) Xiao Yao San (XYS) used for treating anxiety disorders are still unknown. Thus, we conducted this systematic review with meta-analysis and trial sequential analysis (TSA) to determine its safety and efficacy. Methods: We searched 12 databases for relevant studies from the inception of each database till 10 August 2023. We selected randomized controlled trials to compare the efficacy and safety of XYS (including XYS only and XYS + anxiolytics) to those of anxiolytics in patients with anxiety. Results: We found 14 trials with 1,256 patients in total that met the requirements for inclusion. We assessed the majority of studies (8 out of 14) as being at high risk of bias; 6 were assessed as having a moderate risk of bias. Three trials compared oral XYS to anxiolytic medication, and 11 trials compared oral XYS plus anxiolytics to anxiolytic treatment alone. The pooled results showed that the efficacy of treatment in the XYS + anxiolytics groups was significantly higher than that of the anxiolytics alone group (RR = 1.19; 95% CI: [1.13, 1.26]; p < 0.00001; I(2) = 0) and the adverse event rates in the XYS + anxiolytics groups were significantly lower than those in the anxiolytics alone group (RR = 0.44; 95% CI: [0.28, 0.82]; p = 0.001 < 0.05; I(2) = 13). The efficacy of treatment in the XYS alone groups was also significantly higher than that of the anxiolytics alone groups (RR = 5.41; 95% CI: [2.23, 13.11]; p < 0.0001; I(2) = 0). However, there was no statistical difference between the adverse events of the XYS alone group and the anxiolytics alone group, although the incidence of adverse events in the XYS alone group was lower than that in the anxiolytics alone group. The results of the TSA confirmed the above findings. Conclusion: The use of XYS combined with anxiolytics for treating anxiety was found to be safe and effective. However, although XYS alone is effective in the treatment of anxiety disorder, more large-scale research is needed to investigate adverse events. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=350358, identifier CRD42022350358.
format Online
Article
Text
id pubmed-10613521
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-106135212023-10-30 Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis Wang, Yifan Chen, Xiaofeng Wei, Wei Ding, Yiyun Guo, Rongjuan Xing, Jia Wang, Jialin Front Pharmacol Pharmacology Introduction: The effectiveness and safety of the Chinese herbal medicine (CHM) Xiao Yao San (XYS) used for treating anxiety disorders are still unknown. Thus, we conducted this systematic review with meta-analysis and trial sequential analysis (TSA) to determine its safety and efficacy. Methods: We searched 12 databases for relevant studies from the inception of each database till 10 August 2023. We selected randomized controlled trials to compare the efficacy and safety of XYS (including XYS only and XYS + anxiolytics) to those of anxiolytics in patients with anxiety. Results: We found 14 trials with 1,256 patients in total that met the requirements for inclusion. We assessed the majority of studies (8 out of 14) as being at high risk of bias; 6 were assessed as having a moderate risk of bias. Three trials compared oral XYS to anxiolytic medication, and 11 trials compared oral XYS plus anxiolytics to anxiolytic treatment alone. The pooled results showed that the efficacy of treatment in the XYS + anxiolytics groups was significantly higher than that of the anxiolytics alone group (RR = 1.19; 95% CI: [1.13, 1.26]; p < 0.00001; I(2) = 0) and the adverse event rates in the XYS + anxiolytics groups were significantly lower than those in the anxiolytics alone group (RR = 0.44; 95% CI: [0.28, 0.82]; p = 0.001 < 0.05; I(2) = 13). The efficacy of treatment in the XYS alone groups was also significantly higher than that of the anxiolytics alone groups (RR = 5.41; 95% CI: [2.23, 13.11]; p < 0.0001; I(2) = 0). However, there was no statistical difference between the adverse events of the XYS alone group and the anxiolytics alone group, although the incidence of adverse events in the XYS alone group was lower than that in the anxiolytics alone group. The results of the TSA confirmed the above findings. Conclusion: The use of XYS combined with anxiolytics for treating anxiety was found to be safe and effective. However, although XYS alone is effective in the treatment of anxiety disorder, more large-scale research is needed to investigate adverse events. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=350358, identifier CRD42022350358. Frontiers Media S.A. 2023-10-12 /pmc/articles/PMC10613521/ /pubmed/37905203 http://dx.doi.org/10.3389/fphar.2023.1169292 Text en Copyright © 2023 Wang, Chen, Wei, Ding, Guo, Xing and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Wang, Yifan
Chen, Xiaofeng
Wei, Wei
Ding, Yiyun
Guo, Rongjuan
Xing, Jia
Wang, Jialin
Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title_full Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title_fullStr Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title_full_unstemmed Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title_short Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
title_sort efficacy and safety of the chinese herbal medicine xiao yao san for treating anxiety: a systematic review with meta-analysis and trial sequential analysis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613521/
https://www.ncbi.nlm.nih.gov/pubmed/37905203
http://dx.doi.org/10.3389/fphar.2023.1169292
work_keys_str_mv AT wangyifan efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT chenxiaofeng efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT weiwei efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT dingyiyun efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT guorongjuan efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT xingjia efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis
AT wangjialin efficacyandsafetyofthechineseherbalmedicinexiaoyaosanfortreatinganxietyasystematicreviewwithmetaanalysisandtrialsequentialanalysis