Clinical effect of wumei bolus on ulcerative colitis: A meta-analysis

Zepeng Chen; Linhai He; Wenwen Tang; Qinglong Gu; Yuji Wang; Kuiling Wang; Ruichao Chen; Yugen Chen

doi:10.1016/j.heliyon.2023.e15652

Clinical effect of wumei bolus on ulcerative colitis: A meta-analysis

Heliyon. 2023 Apr 26;9(5):e15652. doi: 10.1016/j.heliyon.2023.e15652. eCollection 2023 May.

Authors

Zepeng Chen^{1

2}, Linhai He^{1

2}, Wenwen Tang^{1

2}, Qinglong Gu^{1

2}, Yuji Wang^{1

2}, Kuiling Wang^{1

2}, Ruichao Chen³, Yugen Chen^{1

4

5

6}

Affiliations

¹ Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, PR China.
² No. 1 Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
³ Department of Anorectal Surgery, Xuzhou City Hospital of TCM, Xuzhou, Jiangsu 221000, PR China.
⁴ Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, PR China.
⁵ Jiangsu Province Key Laboratory of Tumor Systems Biology and Chinese Medicine,The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, PR China.
⁶ Jiangsu Collaborative Innovation Center of Chinese Medicine in Prevention and Treatment of Tumor,The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, PR China.

Abstract

Wumei Bolus is a traditional Chinese medicine prescription, first appeared in Shennong Bencao Jing. Modern pharmacology believes that Wumei Bolus has antibacterial, antitussive, sedative, antiviral and anti-tumor effects, and plays a therapeutic role by acting on multi-target/multi-pathway. Moreover, it has great advantages in digestive system diseases, such as repairing the damaged gastrointestinal mucosa and improving the inflammatory environment.

Aim of the study: This review aimed to evaluate the efficacy and safety of prescriptions based on the Wumei Bolus treating ulcerative colitis (UC).

Materials and methods: In this meta-analysis, we searched CNKI, Wanfang Database, VIP, Pubmed, Web of Science (WOS) with language restrictions of Chinese and English for articles published from the establishment of the database to Dec 2022. This meta-analysis controlled randomized controlled trials (RCTs) assessing the efficacy and safety of Wumei Bolus against ulcerative colitis and using RevMan 5.4 and Stata 15.0to analyze information from the compliant studies.

Results: The search incorporated 3145 results (1617 cases assigned into Wumei Bolus group and 1528 cases assigned into control group), from which 37 studies fulfilled our inclusion criteria and were included. The outcomes of this meta-analysis showed that compared to the control group, the Experiment group was significantly more effective (RR = 1.24，95%CI [1.20，1.28])and lower adverse reactions (RR = 0.32, 95%CI [0.20, 0.53]). According to the subgroup analysis, The results showed that the RR = 1.23 and 95%CI [1.16, 1.30] in the group treated with Wumei Bolus alone and the group treated with Western medicine with RR = 1.25 and 95%CI [1.20, 1.30], indicating that the efficacy of Wumei Bolus in the treatment of UC was better and the difference was statistically significant (P < 0.00001). The results showed that compared with the control group, the experimental group had more advantages in reducing inflammatory factors whether TNF-α or IL-8 (TNF-α:SMD = -4.44, 95%CI [-5.75, -3.14]; IL-8: SMD = -3.02, 95%CI [-4.06, -1.97]) and improving TCM symptoms and reduced TCM syndrome points (SMD = -3.82, 95%CI [-4.30, -3.34]). There was significant association of the basic treatment of Wumei Bolus improving clinical efficacy, reducing serum pro-inflammatory factors, improving symptoms, and reducing adverse reactions in UC patients. These results were statistically significant (P < 0.00001).

Conclusions: The prescriptions based on the Wumei Bolus is greatly related to reducing serum pro-inflammatory factors, improving symptoms, improving clinical efficacy and reducing adverse reactions in the treatment of UC compared to conventional western medicine and improve the total clinical effective rate.

Keywords: Ethnopharmacological relevance; Meta analysis; Randomized controlled trial; Total clinical response rate; Ulcerative colitis; Wumei bolus.