Jia Wei Xiao Yao San could potentially enhance the effectiveness of antithyroid drugs in treating hyperthyroidism especially in symptom relief and side effect reduction.
Systematic Review Jia Wei Xiao Yao San
To evaluate this claim, a systematic and comprehensive dive into eight databases and three trial registries up until May 2023 was performed. From this, Randomized Controlled Trials (RCTs) were earmarked and subjected to further analysis using the Review Manager software application (RevMan 5.4) and Stata 14.0. Assessments of bias in these studies were conducted using the Cochrane risk of bias tool 1.0, while the GRADE tool was implemented for overall quality assessment. In addition, any case reports utilizing JWXYS in singular use and relevant pharmacological studies were summarized for further understanding.
This investigation involved 13 RCTs with a total of 979 participants. It was found that, when compared with standalone antithyroid drug treatment, the combination of JWXYS and antithyroid drugs resulted in improved control of thyroid hormones, better efficacy in treating traditional Chinese medicinal syndrome, lesser incidence of goiter, fewer side effects, and lower levels of thyroid stimulating hormone receptor antibodies. Furthermore, dosage reduction of antithyroid drugs when used in combination with JWXYS also led to fewer side effects. However, when compared to antithyroid drugs treatment in a single trial, JWXYS showed mixed results indicating it is not recommended for use as a standalone treatment except in patients intolerant to antithyroid drugs. The evaluation of three case reports highlighted that patients may opt for traditional Chinese medicine only as an alternative due to severe side effects and recurrent relapses. Three other pharmacological studies showed the potential of JWXYS in restoring Th17/Treg balance, regulating thyroid cell growth, and alleviating oxidative stress in liver.
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