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The trial duration ranged from 2?weeks to 3?months. All included studies were RCTs. Overall, the methodological quality of the included studies was low to moderate. Two studies were performed in Hong Kong [16, 17] and Taiwan [18, 19], and one in China [20], Australia [21], and Korea [22] (Fig.?1). Therefore, seven clinical trials of CHM treating PAR were included in the meta-analysis. The included trials were learn more reviewed by two independent investigators (W SJ and T QF). The characteristics of included trials, along with details on adopted herbal preparations, are listed in Table?1. Nasal symptom scores Serum IgE levelVisual analog scaleSkin prick testsQoL Nasal symptom scores Serum IgE levelLTC4, PGE2 productionCOX-2 mRNA Nasal symptom scores Nasal airflow resistanceNostril dissection areaSerum IgE antibodies Radix Astragalus seu Hedysari, 20g; Radix Ledebouriellae, 10g; Rhizoma Atractylodes Macrocephalae, 10g; Herba Asari, 3g; Ramulus Cinnamomi, 6g; Fructus Schisandrae, 6g; Radix Paeoniae Alba, 6g; Herba Ephedrae, 3g; Fructus Mume, 6g; Fructus Chebulae, 6g; Radix Glycyrrhizae, 6g. (Above herb decocte into 100?ml, two times a day.) (Each BMP tablet contained 0.4?g of dried herbal extract) Nasal symptom scores Serum IgE level Decreased nasal symptom scores and serum IgE level. There was significant difference between active and placebo treatments (P?flupentixol ranged from 2 to 6 points. All of the trials were described as randomized but only three of the 7 trials gave details of the method used. Among included studies, 6 [16-20, 22] evaluated nasal symptom score: of 453 patients, 263 were assigned to the treatment groups, whereas 190 were assigned to the control groups. Their total nasal symptom scores were evaluated. The heterogeneity was significant (��2?=?137.98, I2?=?96%), so we used the random-effect model method. The results showed that CHM reduced the total nasal symptom scores compared to placebo (SMD, ?1.82; 95% OSI-906 in vitro CI, ?3.03 to ?0.62; P?=?0.003). The follow-up studies showed that the nasal symptoms remained controlled after the completion of CHM treatment, whereas the symptoms did not improve in the placebo group [16, 19] (Fig.?2). Three included studies [18, 20, 22] reported total serum IgE in such a way that the data could be used in meta-analysis. In another study [21], the data could not be incorporated because it reported the total serum IgE with means and SD values, but only reported the outcomes as medians. The study by Zhao et?al. [17] did not report the raw data on total serum IgE and reported that between-group changes were not significant. Hence, meta-analysis of the total serum IgE level was performed in the three included studies.