Chinese herbal medicine for children with idiopathic short stature (ISS): A systematic review and meta-analysis

• Published in: PloS one 2022-06, Vol.17 (6), p.e0270511-e0270511
• Main Authors: Li, Yingying, Chen, Xinying, Liu, Zhengduo, Yang, Jinghua
• Format: Article
• Language: English
• Subjects: Bias; Biology and Life Sciences; Biomedical materials; Body height; Bone growth; Care and treatment; Children; Chinese medicine; Clinical trials; Collaboration; Complications and side effects; Data search; Diseases; FDA approval; Growth hormones; Health risks; Herbal medicine; Hormones; Insulin-like growth factor I; Medicine and Health Sciences; Medicine, Chinese; Meta-analysis; Osteocalcin; Patient outcomes; People and Places; Physical Sciences; Research and Analysis Methods; Side effects; Standard deviation; Statistical analysis; Stature, Short; Systematic review; Velocity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0270511

Background Idiopathic short stature (ISS) describes a heterogeneous group of children of many unidentified causes of short stature presently without definitive therapy. Chinese herbal medicine (CHM) is an alternative and complementary treatment for children with ISS and has been widely used for ISS while the evidence of its effectiveness is controversial. We conducted this systematic review and meta-analysis in order to evaluate the efficacy of CHM for ISS. Methods PubMed, Embase, Web of science, Sino-Med, Cochrane, CNKI, VIP, and Wangfang Data were electronically searched to collect randomized controlled trials (RCTs) of CHM treatment of ISS from inception to May 2021. Two researchers independently scanned the literature and extracted information on general characteristics, including patient, study design, interventions, and side effects, assessing the CHM intervention's efficacy and the risk of bias. Height, bone age, growth velocity, and IGF-1 level are the main consequences. Height standard deviations score (HtSDS), change in HtSDS ([DELTA]HtSDS), osteocalcin, the peak level of growth hormones (GHP), and predicted adult height (PAH) are the secondary outcomes. Meta-analysis was then performed by using RevMan 5.3 (Cochrane Collaboration). Results Seven articles (569 participants) were included. The Meta-analysis indicated that herbal medicine was associated with increased height (MD 2.16 points; 95%CI, 0.22 to 4.10; P = 0.03), growth velocity (MD 1.47 points; 95%CI, 0.28 to 2.67; P = 0.02), IGF-1 level (MD 28.13 points; 95%CI, 22.80 to 33.46; P