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Background: Colorectal adenoma (CRA) is a significant precancerous lesion of sporadic colorectal cancer (CRC). CRA is likely to recur after polypectomy, increasing the risk of CRC. Chinese herbal medicine (CHM) has been used to reduce CRA recurrence. This review aims to evaluate the effectiveness and safety of oral CHM in reducing CRA recurrence compared to other treatments (placebo, routine care, no treatment, and conventional medicine).

Methods: We will search for randomised controlled trials (RCTs) from nine major biomedical databases in English and Chinese from their inception to July 2023. The RCTs that investigate the effects of oral CHM in reducing CRA recurrence compared to other treatments will be involved. We will exclude trials using CHM extract or external application of CHM, cohort study and cross-section study. The Cochrane Risk of Bias Tool version 2 will be used to assess the quality of included studies. Data will be analysed using Review Manager software 5.4 and STATA. The random effect model will be used. The heterogeneity of intervention effects will be tested by Chi2 (Cochrane Q) and I2 statistics. Funnel plots will assess publication bias if more than ten studies are included. Subgroup and sensitivity analysis will be conducted when possible.

Discussion: This review will discuss the effectiveness and safety of oral CHM in reducing CRA recurrence. It will show the critical information for clinicians in the decision-making process and countries to develop clinical guidelines on CRA management. Systematic review registration PROSPERO CRD42023324197.

Competing Interests: The authors declare that they have no competing interests.

(Copyright: © 2023 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Titel:	Oral Chinese herbal medicine in reducing the recurrence of colorectal adenoma after polypectomy: A protocol for the systematic review and meta-analysis.
Autor/in / Beteiligte Person:	Cheng, Y ; Di, YM ; Zhang, AL ; Zhang, B ; Xue, CC
Link:	Full Text Finder (Volltext)
Zeitschrift:	PloS one, Jg. 18 (2023-10-20), Heft 10, S. e0293244
Veröffentlichung:	San Francisco, CA : Public Library of Science, 2023
Medientyp:	academicJournal
ISSN:	1932-6203 (electronic)
DOI:	10.1371/journal.pone.0293244
Schlagwort:	Humans Meta-Analysis as Topic Systematic Reviews as Topic Drugs, Chinese Herbal therapeutic use Medicine
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, Non-U.S. Gov't Language: English [PLoS One] 2023 Oct 20; Vol. 18 (10), pp. e0293244. <i>Date of Electronic Publication: </i>2023 Oct 20 (<i>Print Publication: </i>2023). MeSH Terms: Drugs, Chinese Herbal* / therapeutic use ; Medicine* ; Humans ; Meta-Analysis as Topic ; Systematic Reviews as Topic References: J Ethnopharmacol. 2022 Jan 10;282:114617. (PMID: 34509605) ; Gastrointest Endosc. 2003 Dec;58(6 Suppl):S3-43. (PMID: 14652541) ; Lancet. 2019 Oct 19;394(10207):1467-1480. (PMID: 31631858) ; Gastroenterology. 2020 Jan;158(2):368-388. (PMID: 31563626) ; Lancet Gastroenterol Hepatol. 2020 Mar;5(3):267-275. (PMID: 31926918) ; Gastroenterology. 2012 Sep;143(3):844-857. (PMID: 22763141) ; N Engl J Med. 2014 Jun 26;370(26):2541. (PMID: 24963577) ; Ann Intern Med. 2016 Jun 21;164(12):836-45. (PMID: 27064677) ; Nat Rev Gastroenterol Hepatol. 2019 Dec;16(12):713-732. (PMID: 31455888) ; Dig Endosc. 2020 Jan;32(2):219-239. (PMID: 31566804) ; BMJ. 2019 Aug 28;366:l4898. (PMID: 31462531) ; Gut. 2021 Apr;70(4):717-724. (PMID: 32747412) ; Gastroenterology. 2020 Mar;158(4):1131-1153.e5. (PMID: 32044092) ; BMJ. 2008 Apr 26;336(7650):924-6. (PMID: 18436948) ; BMJ. 2021 Mar 29;372:n71. (PMID: 33782057) ; Front Med China. 2010 Dec;4(4):436-42. (PMID: 21128011) ; BMJ. 2015 Jan 02;350:g7647. (PMID: 25555855) ; J Gastroenterol. 2021 Apr;56(4):323-335. (PMID: 33710392) ; Endoscopy. 2017 Mar;49(3):270-297. (PMID: 28212588) ; Ann Intern Med. 2007 Mar 6;146(5):365-75. (PMID: 17339622) ; N Engl J Med. 2014 Aug 28;371(9):799-807. (PMID: 25162886) ; Gastroenterology. 2007 Oct;133(4):1077-85. (PMID: 17698067) ; Gut. 2012 Aug;61(8):1180-6. (PMID: 22110052) ; Cancer Res. 2011 Jan 15;71(2):413-23. (PMID: 21084270) ; N Engl J Med. 2000 Jul 20;343(3):162-8. (PMID: 10900274) ; Lancet. 2018 Dec 15;392(10164):2583-2594. (PMID: 30466866) Substance Nomenclature: 0 (Drugs, Chinese Herbal) Entry Date(s): Date Created: 20231020 Date Completed: 20231101 Latest Revision: 20231101 Update Code: 20231215 PubMed Central ID: PMC10588860

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Oral Chinese herbal medicine in reducing the recurrence of colorectal adenoma after polypectomy: A protocol for the systematic review and meta-analysis.