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Chinese Herbal Medicine for Chronic Neck Pain due to Cervical Degenerative Disc Disease

Trinh, Kien, MD, BSc, MSc, FCFP, FRSS*; Cui, Xuejun, PhD; Wang, Yong-Jun, MD, PhD

doi: 10.1097/BRS.0b013e3181edfd17
Cochrane Collaboration
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SDC

Study Design. Systematic review.

Objective. To assess the efficacy of Chinese herbal medicines in treating chronic neck pain with radicular signs or symptoms.

Summary of Background Data. Chronic neck pain with radicular signs or symptoms is a common condition. Many patients use complementary and alternative medicine, including traditional Chinese medicine, to address their symptoms.

Methods. We electronically searched CENTRAL, MEDLINE, EMBASE, CINAHL, and AMED (up to 2009), the Chinese Biomedical Database and related herbal medicine databases in Japan and South Korea (up to 2007). We also contacted content experts and hand searched a number of journals published in China.

We included randomized controlled trials with adults with a clinical diagnosis of cervical degenerative disc disease, cervical radiculopathy, or myelopathy supported by appropriate radiologic findings. The interventions were Chinese herbal medicines. The primary outcome was pain relief, measured with a visual analogue scale, numerical scale, or other validated tool.

Results. All 4 included studies were in Chinese; 2 of which were unpublished. Effect sizes were not clinically relevant and there was low quality evidence for all outcomes due to study limitations and sparse data (single studies). Two trials (680 participants) found that Compound Qishe Tablets relieved pain better in the short-term than either placebo or Jingfukang; one trial (60 participants) found than an oral herbal formula of Huangqi relieved pain better than Mobicox or Methycobal, and another trial (360 participants) showed that a topical herbal medicine, Compound Extractum Nucis Vomicae, relieved pain better than Diclofenac Diethylamine Emulgel.

Conclusion. There is low quality evidence that an oral herbal medication, Compound Qishe Tablet, reduced pain more than placebo or Jingfukang and a topical herbal medicine, Compound Extractum Nucis Vomicae, reduced pain more than Diclofenac Diethylamine Emulgel. Further research is very likely to change both the effect size and our confidence in the results.

The results from this systematic review on the efficacy of Chinese herbal medicine in treating chronic back pain have shown low quality evidence that an oral herbal medication reduced pain more than placebo or Jingfukang and a topical herbal medicine, reduced pain more than Diclofenac Diethylamine Emulgel.

From the *DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; †Research Institute of Spine Diseases, Shanghai Research Institute of Acupuncture and Meridian, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; and ‡Research Institute of Spine Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

The legal regulatory status of the device(s)/drug(s) that is/are the subject of this manuscript is not applicable in my country.

Federal funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by the State Administration of Traditional Chinese Medicine of the People's Republic of China(06–07JQ05), China.

Editorial Group: Cochrane Back Group.

K.V.T. searched the literature, screened trials for inclusion, assessed risk of bias, edited and contributed to the body of the review and prepared the submission and re-submission to the Cochrane Back Review Group; X.C. conceived the idea, designed the review, developed the literature search strategy, searched the literature, wrote the body of the review, contacted experts for trials and clarification of methods, screened trials for inclusion, assessed risk of bias and prepared the submission for the Cochrane Back Review Group; Y.W. screened trials for inclusion, edited final version of protocol and review; An-Fu Hsiao revised the protocol.

Address correspondence and reprint requests to Kien Trinh, MD, BSc, MSc, FCFP, FRSS, DeGroote School of Medicine, Office of MD Admissions, McMaster University, 1200 Main St West, MDCL-3015, Hamilton, ON, Canada, L8N 3Z5; E-mail: trinhk@mcmaster.ca

© 2010 Lippincott Williams & Wilkins, Inc.