Table 1.
Study characteristics of included systematic reviews.
| References | No. of primary studies | Quality of primary studies | Overall conclusion | Meta-analysis | Outcome measures | Quality of review (AMSTAR) |
|---|---|---|---|---|---|---|
| Cui and Liu (2015) | 19(1352) | Poor | …is better than… | CHM+CWM vs. CWM: the total score of UPDRS [SMD = −7.32, 95%CI(−8.50, −6.13), P < 0.00001; heterogeneity: Chi2 = 3.74, P = 0.81, I2 = 0%], UPDRS I [WMD = −0.76, 95%CI(−1.30, −0.23), P = 0.005; heterogeneity: Chi2 = 16.46, P = 0.002, I2 = 76%], UPDRS II [WMD = −3.07, 95%CI(−4.18, −1.97), P < 0.00001; heterogeneity: Chi2 = 6.06, P = 0.19, I2 = 34%], UPDRS III [WMD = −4.09, 95%CI(−5.05, −3.12), P < 0.00001; heterogeneity: Chi2 = 2.52, P = 0.93, I2 = 0%], UPDRS II and UPFRS III [WMD = −7.01, 95%CI(−11.61, −2.41), P = 0.003; heterogeneity: Chi2 = 7.36, P = 0.06, I2 = 59%], UPDRS IV [SMD = −0.63, 95%CI(−1.00, −0.26), P = 0.0009; heterogeneity: Chi2 = 27.05, P = 0.0001, I2 = 78%] | UPDRS | 7 |
| Huo and Yu (2014) | 22(1704) | Poor | …can relieve… …maybe superior to… |
CHM+CWM vs. CWM: the total score of UPDRS [WMD = −1.59, 95%CI(−2.59, −0.59), P = 0.002; heterogeneity: Chi2 = 2.82, P = 0.42, I2 = 0%], UPDRS II [WMD = −1.08, 95%CI(−1.53, −0.63), P < 0.00001; heterogeneity: Chi2 = 5.17, P = 0.40, I2 = 3.3%], UPDRS III [WMD = −1.15, 95%CI(−1.69, −0.61), P < 0.0001; heterogeneity: Chi2 = 6.04, P = 0.30, I2 = 17.2%] | UPDRS Adverse events |
6 |
| Wen et al. (2014) | 17(1461) | Poor | …is safe and effective… …maybe superior to… |
CHM vs. CWM: the total score of UPDRS [WMD = 1.41, 95%CI(−0.66, 3.47), P > 0.05; heterogeneity: Chi2 = 0.26, df = 1, I2 = 0%] CHM+CWM vs. CWM: the total score of UPDRS [WMD = 5.95, 95%CI(4.37, 7.42), P < 0.01; heterogeneity: Chi2 = 2.16, df = 4, I2 = 0%], UPDRS II [WMD = 2.13, 95%CI(1.62, 2.64), P < 0.01; heterogeneity: Chi2 = 4.94, df = 5, I2 = 30.7%], UPDRS III [WMD = 1.95, 95%CI(0.81, 2.42), P < 0.01; heterogeneity: Chi2 = 3.12, df = 5, I2 = 0%], UPDRS IV [SMD = 0.64, 95%CI(0.32, 0.97), P < 0.01; heterogeneity: Chi2 = 5.37, df = 4, I2 = 32.8%] |
UPDRS UPDRS Webster scale Adverse events |
5 |
| Zhang (2015) | 18(1504) | Poor | …is safe and effective… …maybe superior to… |
CHM+CWM vs. CWM: the total score of UPDRS [WMD = −4.67, 95%CI(−5.94, −3.40), P < 0.0001; heterogeneity: Chi2 = 13.29, P = 0.15, I2 = 32%], UPDRS II [WMD = −1.16, 95%CI(−1.35, −0.98), P < 0.00001; heterogeneity: Chi2 = 7.16, P = 0.52, I2 = 0%], UPDRS III [WMD = −3.05, 95%CI(−3.48, −2.63), P < 0.00001; heterogeneity: Chi2 = 3.26, P = 0.86, I2 = 0%], CHM syndrome integral scale [WMD = −3.04, 95%CI(−3.83, −2.25), P < 0.00001; heterogeneity: Chi2 = 2.83, P = 0.24, I2 = 29%] | UPDRS Webster scale Adverse events CHM syndrome integral scale |
8 |
| Zhang et al. (2014) | 10(582) | Poor | …may be beneficial to… | CHM+CWM vs. CWM: the total score of UPDRS [WMD = −7.35, 95%CI(−11.24, −3.47), P = 0.000; heterogeneity: P = 0.034, I2 = 65.5%] | UPDRS Adverse events |
8 |
| Wang et al. (2012) | 19(1371) | Poor | …may potentially alleviate… | CHM+CWM vs. CWM: the total score of UPDRS [WMD = −6.09, 95%CI(−8.08, −4.10), P < 0.001; heterogeneity: Chi2 = 4.25, P = 0.89, I2 = 0%], UPDRS I [WMD = −0.33, 95%CI(−0.58, −0.08), P < 0.001; heterogeneity: Chi2 = 3.69, P = 0.45, I2 = 0%], UPDRS II [WMD = −2.18, 95%CI(−3.03, −1.33), P < 0.001; heterogeneity: Chi2 = 3.26, P = 0.92, I2 = 0%], UPDRS III [WMD = −2.35, 95%CI(−4.61, −0.08), P < 0.05; heterogeneity: Chi2 = 89.22, P < 0.00001, I2 = 88%], UPDRS IV [WMD = −0.51, 95%CI(−0.83, −0.20), P < 0.05; heterogeneity: Chi2 = 5.21, P = 0.52, I2 = 0%] | UPDRS Adverse events |
7 |
| Chung et al. (2006) | 9(503) | Poor | …is insufficient to… | CHM+CWM vs. CWM: without meta-analysis CHM vs. CWM: without meta-analysis |
UPDRS Adverse events UPDRS PDQ-39 Webster scale Adverse events |
4 |
| Kim et al. (2012) | 64(4024) | Poor | …is no conclusive evidence… | CHM vs. placebo: without meta-analysis CHM vs. CWM: without meta-analysis CHM+CWM vs. CWM: without meta-analysis |
UPDRS UPDRS Webster scale UPDRS NMSQuest |
7 |
| Zhang et al. (2015) | 27(2314) | Poor | …potential superiority of… | CHM+CWM vs. CWM: the total score of UPDRS [WMD = 6.18, 95%CI(5.06, 7.31), P < 0.00001; heterogeneity: Chi2 = 8.93, P = 0.54, I2 = 0%], UPDRS I [SMD = 0.68, 95%CI(0.38, 0.98), P < 0.00001; heterogeneity: Chi2 = 21.85, P = 0.009, I2 = 59%], UPDRS II [WMD = 2.41, 95%CI (1.66, 2.62), P < 0.00001; heterogeneity: Chi2 = 10.98, P = 0.61, I2 = 0%], UPDRS III [WMD = 2.45, 95%CI(2.03, 2.86), P < 0.00001; heterogeneity: Chi2 = 25.23, P = 0.07, I2 = 37%], UPDRS IV [WMD = 0.32, 95%CI(0.15, 049), P = 0.0002; heterogeneity: Chi2 = 9.78, P = 0.46, I2 = 0%] | UPDRS Adverse events |
9 |
| Wei et al. (2017) | 11(869) | Poor | …has potential therapeutic benefits… | CHM+CWM vs. CWM: the total score of UPDRS [SMD = −0.36, 95%CI (−0.53, −0.20), P < 0.05; heterogeneity: Chi2 = 2.62, P = 0.85, I2 = 0%], UPDRS I [SMD = −0.40, 95%CI(−0.71, −0.09), P = 0.01; heterogeneity: Chi2 = 0.05, P = 0.82, I2 = 0%], UPDRS II [SMD = −0.47, 95%CI (−0.69, −0.25), P < 0.01; heterogeneity: Chi2 = 1.36, P = 0.85, I2 = 0%], UPDRS III [SMD = −0.35, 95%CI(−0.57, −0.13), P = 0.002; heterogeneity: Chi2 = 1.51, P = 0.83, I2 = 0%], UPDRS IV [SMD = −0.32, 95%CI(−0.60, −0.03), P = 0.03; heterogeneity: Chi2 = 3.43, P = 0.18, I2 = 42%]; PDQ-39 [SMD = −0.35, 95%CI(−0.59, −0.12), P < 0.05; heterogeneity: Chi2 = 0.12, P = 0.99, I2 = 0%]; CHM syndrome integral scale [SMD = −0.73, 95%CI(−1.05, −0.41), P < 0.05; heterogeneity: Chi2 = 0.98, P = 0.32, I2 = 0%] | UPDRS PDQ-39 CHM syndrome integral scale Adverse events |
9 |
| Shan et al. (2018) | 14(1311) | Poor | …supported the complementary use of… | CHM+CWM vs. CWM: the total score of UPDRS [WMD = −5.43, 95%CI(−8.01, −2.86), P < 0.0001; heterogeneity: Chi2 = 2.59, P = 0.76, I2 = 0%], UPDRS I [WMD = −0.30, 95%CI(−0.54, −0.06), P = 0.02; heterogeneity: Chi2 = 3.21, P = 0.52, I2 = 0%], UPDRS II [WMD = −2.21, 95%CI(−3.19, −1.22), P < 0.0001; heterogeneity: Chi2 = 3.46, P = 0.84, I2 = 0%], UPDRS III [WMD = −3.26, 95%CI(−4.36, −2.16), P < 0.00001; heterogeneity: Chi2 = 1.88, P = 0.98, I2 = 0%], UPDRS IV [WMD = −0.18, 95%CI(−0.37, −0.01), P = 0.06; heterogeneity: Chi2 = 5.76, P = 0.33, I2 = 13%]; PDQ-39 [WMD = −7.65, 95%CI(−11.46, −3.83), p < 0.0001; heterogeneity: Chi2 = 0.12, P = 0.94, I2 = 0%]; NMSQuest [WMD = −9.19, 95%CI(−13.11, −5.28), P < 0.00001; heterogeneity: Chi2 = 0.56, P = 0.45, I2 = 0%]; PDSS [WMD = 10.69, 95%CI(8.86, 12.53), P < 0.00001; heterogeneity: Chi2 = 0.48, P = 0.49, I2 = 0%] CHM vs. placebo: total UPDRS score (P > 0.05), UPDRS II (P > 0.05), UPDRS III (P > 0.05) |
UPDRS PDQ-39 NMSQuest PDSS Adverse events UPDRS |
9 |
CHM, Chinese herbal medicine; CWM, conventional western medicine; UPDRS, The Unified Parkinson's disease Rating Scale; PDQ-39, Parkinson's Disease Questionnaire-39; NMSQuest, Non-Motor Symptoms Questionnaire; PDSS, Parkinson's Disease Sleep Scale; SF36, the 36-Item Short Form Health Survey; HAM-D, The Hamilton Depression Rating Scale.