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. 2007 Apr 18;2007(2):CD005450.
doi: 10.1002/14651858.CD005450.pub2.

Chinese herbal medicines for hyperthyroidism

X X Zen, Y Yuan, Y Liu, T X Wu, S Han

Chinese herbal medicines for hyperthyroidism

X X Zen et al. Cochrane Database Syst Rev. .

Abstract

Background: Hyperthyroidism is a disease in which excessive amounts of thyroid hormones circulate in the blood. Patients, among other things suffer from tachycardia, warm moist skin and raised body temperature. The treatment of hyperthyroidism includes symptom relief and therapy with antithyroid medications, radioiodine and thyroidectomy. Medicinal herbs are used alone or in combination with antithyroid agents to treat hyperthyroidism in China and some other countries.

Objectives: To assess the effects of Chinese herbal medicines for treating hyperthyroidism.

Search strategy: Studies were obtained from computerised searches of MEDLINE, EMBASE, The Cochrane Library, the Chinese Biomedical Database.

Selection criteria: Randomised controlled trials comparing the effects of Chinese herbal medicines alone with Chinese herbal medicines combined with antithyroid drugs, radioiodine or both.

Data collection and analysis: Three authors interviewed authors of all potentially relevant studies by telephone to verify randomisation procedures. One author entered data into a data extraction form and another author verified the results of this procedure.

Main results: Thirteen relevant trials with 1770 participants were included. All of them were of low quality. Fifty-two studies still need to be assessed because the original authors could not be interviewed. None of these trials analysed mortality, health related quality of life, economic outcomes or compliance. Compared to antithyroid drugs alone the results showed that Chinese herbal medicines combined with antithyroid drugs may offer benefits in lowering relapse rates, reducing the incidence of adverse effects, relieving symptoms, improving thyroid antibody status and thyroid function. Two trials investigated Chinese herbal medicine versus radioiodine and reported improvements in anxiety, tachycardia and heat intolerance. However, thyroid function - with the exception of restored thyroid stimulating hormone (TSH) - was not significantly altered.

Authors' conclusions: The results suggest that traditional Chinese herbal medicines added to other routine treatment have a therapeutic potential for people with hyperthyroidism. However, due to methodological limitations, we could not identify a well-designed trial to provide strong evidence for Chinese traditional herbal medicine in the treatment of hyperthyroidism. Thus, we currently cannot recommend any single preparation or formulation for clinical use.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Adapted QUOROM (quality of reporting of meta‐analyses) flow‐chart of study selection
1.1
1.1. Analysis
Comparison 1 Chinese herbs versus control, Outcome 1 Thyroid antibody status.
1.2
1.2. Analysis
Comparison 1 Chinese herbs versus control, Outcome 2 Relapse rates.
1.3
1.3. Analysis
Comparison 1 Chinese herbs versus control, Outcome 3 Thyroid function tests (dichotamous data).
1.4
1.4. Analysis
Comparison 1 Chinese herbs versus control, Outcome 4 Thyroid function tests (continuous data).
1.5
1.5. Analysis
Comparison 1 Chinese herbs versus control, Outcome 5 Thyroid antibody status.
1.6
1.6. Analysis
Comparison 1 Chinese herbs versus control, Outcome 6 Symptoms of hyperthyrodism.
1.7
1.7. Analysis
Comparison 1 Chinese herbs versus control, Outcome 7 Weight change (improvement).
1.8
1.8. Analysis
Comparison 1 Chinese herbs versus control, Outcome 8 Adverse effects.
1.9
1.9. Analysis
Comparison 1 Chinese herbs versus control, Outcome 9 Tachycardia.
1.10
1.10. Analysis
Comparison 1 Chinese herbs versus control, Outcome 10 Thyroid antibody status.
1.11
1.11. Analysis
Comparison 1 Chinese herbs versus control, Outcome 11 Improvement of ophthalmopathy.
1.12
1.12. Analysis
Comparison 1 Chinese herbs versus control, Outcome 12 Weight change ( weight index ).
1.13
1.13. Analysis
Comparison 1 Chinese herbs versus control, Outcome 13 Symptoms of hyperthyroidism.
2.1
2.1. Analysis
Comparison 2 Chinese herbs versus radioiodine, Outcome 1 Symptoms of hyperthyroidism.
2.2
2.2. Analysis
Comparison 2 Chinese herbs versus radioiodine, Outcome 2 Thyroid function tests.
2.3
2.3. Analysis
Comparison 2 Chinese herbs versus radioiodine, Outcome 3 Thyroid function tests.
2.4
2.4. Analysis
Comparison 2 Chinese herbs versus radioiodine, Outcome 4 Hypothyroidism.
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Update of

References

References to studies included in this review

Chen 2004 {published data only}
    1. Chen Y, Qiu L, Zhang CY, Zhang SS, Li WP. Combined treatment of Graves' disease with radioiodine and a Tratitional Chinese Medicine herb preparation Jiakangxin. Lin Chuang Hui Cui (Clinical Focus) 2004;19(18):1032,4.
Dai 2000 {published data only}
    1. Dai LY. Observation on Curative Effect of Treatment of TCM Combined with Western Medicien for Hyperthyroidism. Zhe Jiang Zhong Xi Yi Jie He Za Zhi (Zhejiang Journal of Integrated Traditional Chinese and Western Medicine) 2000;10(12):731. - PubMed
Ding 2001a {published data only}
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Ding 2001b {published data only}
    1. Ding YY, Zhang CX. Observation on Curative Effect of Treatment of TCM Combined with Western Medicine for Hyperthyroidism. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi (Chinese Journal of Information on Traditional Chinese Medicine) 2001;8(4):66.
Ding 2005 {published data only}
    1. Ding P, Huang QY. Treatment on 44 Cases of Hyperthyroidism with Jiakang Mianyi Jiaonang. Zhong YI Yan Jiu (Research of Traditional Chineses Medicine) 2005;18(10):31.
Fang 2003 {published data only}
    1. Fang XM, Ye WC. Treatment on 41 Cases of Diffuse Toxic Goiter with Methimazole and Huangqi Injection Treatment on 41 Cases of Diffuse toxic goiter methimazole Diffuse toxic goiter. Herald of Medicine 2003;22(4):254.
Huang 2003 {published data only}
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Qiu 2003 {published data only}
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Yan 1999 {published data only}
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Yu 2002a {published data only}
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Yu 2002b {published data only}
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Zhang 2003a {published data only}
    1. Zhang HW. Treatment of 52 Cases of Hyperthyroidism with Traditional Chinese Medicine Combined with Western Medicine. Nanjing Zhong Yi Yao Da Xue Xue Bao(Joural of Nanjing TCM University) 2003;19(6):369.
Zhu 2005 {published data only}
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References to studies excluded from this review

Du 2003 {published data only}
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Fei 2004 {published data only}
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Feng 1998 {published data only}
    1. Feng LH, Li WQ, Xiong YX, Jia JX, Li AL. Clinical Practical Research on Treatment of Hyperthyroidism with Jiakangshu plus Radioactive Iodine 131. Guang Xi Yi Xue (Guangxi Medical Journal) 1998;20(4):534.
Ge 2004 {published data only}
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Hu 2005 {published data only}
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Huang 2002 {published data only}
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Huang 2004 {published data only}
    1. Huang J. Chang XR, Wang C, Chen T, Zhao GW. Treatment on 36 Cases of Hyperthyroidism with Catgut Implantation at Acupoint plus Jiakangning Tang. Hu Nan Zhong Yi Za Zhi (Journal Of Hu Nan Traditional Chinese Medicine) 2004;20(2):28.
Huang 2005 {published data only}
    1. Huang JL. Clinical Observation on treatment of 30 cases of hyperthyroidism with Huangying Tang. Zhong Guo Zhong Yi Yao Ke Ji (Chinese Journal of Traditional Medical Science and Technology) 2005;12(4):242.
Li 2003a {published data only}
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Liang 2000 {published data only}
    1. Liang JG, Jiang NY, Lu B, Lu XP, Liu S. Clinical Observation on Treatment of Jiakangshu Combined with Radioactive Iodine 131 for Hyperthyroidism. Zhong Guo Zhong Xi Yi Jie He Za Zhi (Chinese Journal of Integrated Traditional and Western Medicine) 2000;20(10):774.
Liao 1999 {published data only}
    1. Liao SH, Huang YM, Lin CS. Clinical Research on Treatment of Jiakangxiao for Hyperthyroidism. Liao Ning Zhong Yi Za Zhi (Liaoning Journal of Traditional Chinese Medicine) 1999;26(9):416.
Liao 2000 {published data only}
    1. Liao SH, Huang YM, Li LX, Du QH, Liu QP. Clinical Observation on treatment of Jiayanxiao Combined with Tapazole for Hyperthyroidism. Zhong Guo Zhong Xi Yi Jie He Za Zhi (Chinese Journal of Integrated Traditional and Western Medicine) 2000;20(6):433. - PubMed
Lv 1997 {published data only}
    1. Lv WM. Clinical Observation of Agranulocytosis Caused by Thiourea Homologues Treated with TCM Combined with Western Medicine on 30 Cases of Hyperthyroidism. Gan Nan Yi Xue Yuan Xue Bao (Journal of Gannan Medical College) 1997;17(4):294.
Nie 1997 {published data only}
    1. Nei YZ, Zhao YM, Li ST. Observation of Curative Effect on Treatment of TCM combined with Western Medicine for Hyperthyroidism. Zhong Guo Yi Kan (Chinese Journal of Medicine) 1997;32(8):61.
Shi 2002 {published data only}
    1. Shi KW, Lin ZZ. Treatment of 40 Cases of Hyperthyroidism with Xuejie Combined with Tapazole. Fu Jian Yi Yao Za Zhi (Fujian Medical Journal) 2002;24(3):56.
Sun 1999 {published data only}
    1. Sun P. Treatment of 30 Cases of Grave's Disease with Agranulocytosis with Yiqishengbai Tang. Shan Xi Journal of Traditional Chinese Medicine 1999;15(4):28.
Tang 2003 {published data only}
    1. Tang L, Liao ZQ, Su K. Influence of Tripterygium Glycosides on Thyroid Gland Function and Autoantibody of Grave's Disease. Zhong Guo Zhong Xi Yi Jie He Za Zhi (Chinese Journal of Integrated Traditional and Western Medicine) 2003;23(4):294. - PubMed
Wang 1999a {published data only}
    1. Wang J, Wang ZL, Du H, Zhao M, Feng GB, Xu RJ. Comparision on Curative Effect of Treatment for Severe Hyperthyroidism with Tripterygium Wilfordii and Glucocorticoid. Yi Xue Yan Jiu Sheng Bao (Journal Of Medical Postgraduate) 1999;12(4):218.
Wang 2001a {published data only}
    1. Wang S. Clinical Observation on Treatment of Hyperthyroidism Combined with Agranulocytosis with Shenqi Pian. He Bei Zhong Yi (Hebei J TCM) 2001;23(1):61.
Wang 2004a {published data only}
    1. Wang YG, Wang W, Zhao WJ. Randomised Double Blinded Paralled Observation with Placebo on the effect of Diyushengbai Pian to Elevating WBC Level in Antithyroid Therapy for Patients with Grave's Disease. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi (Chinese Journal of Information on Traditional Chinese Medicine) 2004;11(2):158.
Xiao 2004 {published data only}
    1. Xiao L, Su B, He J, Zhou H. Treatment of 40 Cases of Refractory Hyperthyroidism with TCM Combined with Western Medicine. Ji Lin Zhong Yi Yao (Journal of Traditional Chinese Medicine and Chinese Materia Medica of Jilin) 2004;24(9):44.
Xing 2003 {published data only}
    1. Xing YX. Treatment of 41 Cases of Hyperthyroidism with TCM plus Tapazole. Shan Dong Yi Yao ( Shandong Medical Journal) 2003;43(4):72.
Xu 2003a {published data only}
    1. Xu ZB, Sun SF. Clinical Observation On Treatment Of Graves Disease With Yi Kang Wan plus Propylthiouracil. Zhong Guo Di Fang Bing Fang Zhi Za Zhi (Chinese Journal of Control of Endemic Disease) 2003;18(1):56.
Yang 2004a {published data only}
    1. Yang SJ, Fu WL. Clinical Research for self‐prepared Jiakangling Mixture in the treatment of 40 cases of Hyperthyroidism. Journal of Medicine & Pharmacy of Chinese Minorities 2004;S1:77‐8.
Yao 1997 {published data only}
    1. Yao DG, Zhu XH. Comparison of Curative Effect between Lithium Salt and TCM in Adjunctive Therapy for Hyperthyroidism. Zhe Jiang Zhong Xi Yi Jie He Za Zhi (Zhejiang Journal of Integrated Traditional Chinese and Western Medicine) 1997;7(2):79.
Yuan 2002 {published data only}
    1. Yuan Q. Clinical Observation on 53 Cases of Hyperthyroidism with TCM Combined with Western Medicine. Shi Zhen Guo YI Guo Yao (Lishizhen Medicine and Materia Medica Research) 2002;13(7):440.
Zeng 1998 {published data only}
    1. Zeng SF. Tripterygium Glycosides combined with Tapazole in the treatment of 89 cases of Grave's disease. Yi Xue Li Lun Yu Shi Jian (The Journal of Medical Therory and Practice ) 1998;11(11):502‐3.
Zhang 2000 {published data only}
    1. Zhang YX. Treatment on 34 Cases of Hyperthyroidism with Yiqiyangyin Huatanjiesan Tang. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi (Chinese Journal of Information on Traditional Chinese Medicine) 2000;7(6):58.
Zhang 2001 {published data only}
    1. Zhang LP, Zhao P, Liao SH. Observation of Ultrasound on Treatment for Hyperthyroidism with Jiakangling Jiaonang. Guang Zhou Zhong Yi Yao Da Xue Xue Bao (Journal of Guang Zhou University of Traditional Chinese Medicine) 2001;18(3):211.
Zhang 2002 {published data only}
    1. Zhang MS. Clinical Observation on Treatment of 129 Cases of Grave's Disease with TCM Combined with Wetern Medicine. Shan Xi Zhong Yi (SHANXI J OF TCM) 2002;18(2):36.
Zhang 2003b {published data only}
    1. Zhang XJ. Observation on Curative Effect of Treatment for Adult Grave's Disease with TCM Combined with Western Medicine. Chong Qing Yi Xue (Chongqing Medical Journal ) 2003;32(1):98.
Zhang 2004a {published data only}
    1. Zhang LQ, Cao S, Chen LL, Liu XJ, Huang QL. Clinical Observation On hyerthyroidism Complex Treated With TCM and Western Medicine. Hei Long Jiang Yi Xue (HEI LONG JIANG MEDICAL JOURNAL) 2004;28(7):491.
Zhang 2005 {published data only}
    1. Zhang J, Lu B, Zhuang QZ. Treatment on 60 Cases of Hyperthyroidism with Shenqi Wuweizi Pan Combined with Tapazole. Shan Dong Zhong Yi Za Zhi (Shandong Journal of Traditional Chinese Medicine) 2005;24(3):161.
Zhao 2001 {published data only}
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Zhao 2003 {published data only}
    1. Zhao LM. Observation on Curative Effect of Treatment with Acupuncture Combined with Medicine for Hyperthyroid Ophthalmopathy. Liao Ning Zhong Yi Za Zhi (Liaoning Journal of Traditional Chinese Medicine) 2003;30(10):848.
Zhao 2004a {published data only}
    1. Zhao LM. Treatment on 155 Cases of Hyperthyroid Cardiac Disease with Acupuncture Combined with Medicine. Zhen Jiu Lin Chuang Za Zhi (Journal of Clinical Acupuncture and Moxibustion) 2004;20(8):32.
Zhao 2004b {published data only}
    1. Zhao LM. Observation on Curative Effect of Treatment with Acupuncture Combined with Medicine for Hyperthyroidism. Liao Ning Zhong Yi Za Zhi (Liaoning Journal of Traditional Chinese Medicine) 2004;31(7):572.
Zhao 2005 {published data only}
    1. Zhao LM. Treatment for Chronic Hyperthyroidism Myopathy with Acupuncture Combined with Medicine. Zhen Jiu Lin Chuang Za Zhi (Journal of Clinical Acupuncture and Moxibustion) 2005;21(7):30.

References to studies awaiting assessment

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