Outcomes of Chinese herb medicine for the treatment of multidrug-resistant tuberculosis: a systematic review and meta-analysis

Several studies have suggested that Chinese herb medicine (CHM) in combination with chemotherapy has efficacy in the treatment of multidrug-resistant tuberculosis (MDR-TB). The purpose of this meta-analysis was to assess the efficacy of CHM as a concomitant therapy for MDR-TB. Six databases were searched up to October 2014. Controlled trials comparing CHM combined with chemotherapy (treatment group) with chemotherapy alone (control group) for the treatment of MDR-TB were analyzed. Twenty studies, comprising 1823 patients across China, were included in this review. The meta-analysis showed CHM combined with chemotherapy was associated with a superiority in treatment success (odds ratio [OR], 1.33; 95% confidence interval [CI]: 1.15-1.54; P < 0.001), and radiological improvement (OR, 1.32; 95% CI: 1.14-1.52; P < 0.001). Patients who received CHM combined with chemotherapy were associated with a similar likely to relapse (OR, 0.88; 95% CI: 0.62-1.25, P=0.478). CHM combination with chemotherapy appeared to be associated with a low incidence of adverse effects for MDT-TB treatment. According to the pooled results and the poor quality of the included trials, it might be uncertainty that there was a superiority of CHM combined with chemotherapy for treating MDR-TB. More rigorous controlled trials are required to substantiate or refute these early findings. (C) 2015 Elsevier Ltd. All rights reserved.