Chinese Herbal Medicine in Treatment of Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Spinal cord injury (SCI) is a catastrophic disease associated with damaged neurological structures and has become a significant social and economic burden for the health care system and patients’ families. The use of Chinese Herbal Medicine (CHM) to treat SCI has been increasing in recent years. This meta-analysis aimed to investigate the effectiveness of CHM for patients with SCI. Therefore, we included randomized controlled trials (RCTs) of CHM for SCI in seven databases. A total of 26 studies involving 1961 participants were included in this study. No serious heterogeneity or publication bias was observed across each study. The results showed that significant improvements of the American Spinal Injury Association (ASIA)-grading improvement rate ([Formula: see text], [Formula: see text]), clinical effective rate ([Formula: see text], [Formula: see text]), ASIA motor score ([Formula: see text], [Formula: see text]), ASIA sensory score (total) ([Formula: see text], [Formula: see text]), ASIA sensory score (light touch) ([Formula: see text], [Formula: see text]), ASIA sensory score (pinprick) ([Formula: see text], [Formula: see text]), and activities of daily living (ADL) score ([Formula: see text], [Formula: see text]) in CHM group compared with the control group. Among the CHM groups, Buyang Huanwu decoction was the most frequently prescribed herbal formula, while Astragalus membranaceus was the most commonly used single herb. In addition, there were no serious and permanent adverse effects in the two groups. The methodological quality of the most included RCTs was poor and the quality of evidence for the main outcomes was from very low to moderate according to the GRADE system. Current evidence suggests that CHM is an effective and safe treatment for SCI and could be treated as a complementary and alternative option with few side effects. However, considering the low quality, small size, and high risk of the studies identified in this meta-analysis, higher methodological quality, rigorously designed RCTs with large sample sizes are needed to confirm the results.