Effects and core patterns of Chinese herbal medicines on hematologic manifestations in systemic lupus erythematosus: A systematic review and meta-analysis

• Published in: Explore (New York, N.Y.) N.Y.), 2024-03, Vol.20 (2), p.168-180
• Main Authors: Wei, Chen-Ying, Shen, Hsuan-Shu, Yu, Han-Hua
• Format: Article
• Language: English
• Subjects: Chinese herbal medicine; Drugs, Chinese Herbal - therapeutic use; Hematologic Diseases - drug therapy; Hematology; Hemoglobins - analysis; Hemoglobins - metabolism; Herbal; Humans; Leukocyte Count; Lupus; Lupus Erythematosus, Systemic - drug therapy; Meta-analysis; Platelet Count; Randomized Controlled Trials as Topic; SLE; Thrombocytopenia - drug therapy; Thrombocytopenia - etiology
• ISSN: 1550-8307; 1878-7541; 1878-7541
• DOI: 10.1016/j.explore.2023.08.004

•Leukopenia, hemolytic anemia, and thrombocytopenia are generally considered as the major components of hematologic abnormalities in SLE, and their treatment is challenging.•Integrative therapy combining Chinese herbal medicines with conventional treatment improve leukopenia, anemia, and thrombocytopenia in patients with SLE.•Qing Re Hua Yu Zi Yin decoction, as the mostly frequently prescribed basic polyherbal formula, demonstrate a significant superior therapeutic effect in elevating white blood cell count.•Huang Qi and Shen Di Huang, as the top two frequently used single herbs, exert significant superior therapeutic effect in elevating hemoglobin levels. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of Chinese herbal medicines (CHMs) on hematologic manifestations in patients with systemic lupus erythematosus (SLE). PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Airiti Library were searched for the period January 2000 to February 2022. RCTs involving CHMs in patients with SLE with available hematologic data. The primary outcomes included white blood cell (WBC) count, hemoglobin level, and platelet count. The Cochrane risk of bias tool was used to assess the quality of the included RCTs. Sensitivity analysis of RCTs with abnormal hematologic data before intervention was performed to verify the robustness of the results. Subgroup analysis was also applied for results with high heterogenicity. Core patterns of used herbal drug pairs had also been analyzed and visualized. Fifteen RCTs involving 1183 participants were included. The effects of elevating WBC count (weighted mean difference [WMD]: 0.69; 95% confidence interval [CI]: 0.33–1.06; p