Pinellia ternata-containing traditional Chinese medicine combined with 5-HT3RAs for chemotherapy-induced nausea and vomiting: A PRISMA-compliant systematic review and meta-analysis of 22 RCTs.

Xiangyang Zhai, Qida He, Min Chen, Lili Yu, Chiin Tong, Ying Chen, Jue Wang, Xingxing Fan, Han Xie, Zimao Liang, Xinbing Sui, Li Zeng, Qibiao Wu

Journal: Phytomedicine : international journal of phytotherapy and phytopharmacology 2023;115():154823

PMID: 37099981

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Pinellia ternata (P. ternata, Banxia)-containing traditional Chinese medicine (TCM) is widely used in China as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV). However, evidence of its efficacy and safety remains limited.

PURPOSE

To investigate the efficacy and safety of P. ternata-containing TCM combined with 5-hydroxytryptamine-3 receptor antagonists (5-HT3RAs) in the treatment of CINV.

STUDY DESIGN

Systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS

All relevant RCTs were systematically retrieved from seven internet databases (up to February 10, 2023). P. ternata-containing TCM combined with 5-HT3RAs to treat CINV was included in all RCTs. The clinical effective rate (CER) was defined as the primary outcome, while appetite, quality of life (QOL), and side effects were secondary outcomes.

RESULTS

The meta-analysis included 22 RCTs with 1,787 patients. Our results indicated that P. ternata-containing TCM combined with 5-HT3RAs significantly improved the CER of CINV (RR = 1.46, 95% CI = 1.37-1.57, p < 0.00001), appetite (RR = 1.77, 95% CI = 1.42-2.20, p < 0.00001), QOL (RR = 7.67, 95% CI = 1.56-13.78, p = 0.01), the CER of several 5-HT3RA medications (RR = 1.47, 95% CI = 1.37-1.57, p < 0.00001), and acute and delayed vomiting (RR = 1.23, 95% CI = 1.12-1.36, p < 0.0001) compared with the 5-HT3RAs alone, while the combination therapy decreased the incidence of side effects induced by 5-HT3RAs for CINV (RR = 0.50, 95% CI = 0.42-0.59, p < 0.00001).

CONCLUSION

According to the findings of this systematic review and meta-analysis, P. ternata-containing TCM combined with 5-HT3RAs was safer and more effective than 5-HT3RAs alone for CINV patients. However, due to the limitations of the included studies, more high-quality clinical trials are required to further validate our findings.

Address: Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China; College of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China; Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China.; School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China; College of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China; Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China. Electronic address: [email protected].; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China. Electronic address: [email protected].; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China; Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong University of Technology, Guangzhou, Guangdong, China; Zhuhai MUST Science and Technology Research Institute, Zhuhai, Guangdong, China. Electronic address: [email protected].

DOI: 10.1016/j.phymed.2023.154823

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MeSH Terms: Humans, Medicine, Chinese Traditional, Pinellia, Vomiting, Nausea, Antineoplastic Agents