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Effectiveness of herbal medicine for lumbar herniated intervertebral disc with active controls: a systematic review and meta-analysis
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DOI：10.1016/j.hermed.2026.101092.png)
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Abstract
En 中文
Background: Lumbar herniated intervertebral disc (LHIVD) is a common global condition, with a lifetime prevalence of up to 40%. Herbal medicine (HM), a representative treatment in complementary and alternative medicine, is considered effective and safe. This study systematically reviewed the effects of HM in alleviating pain and improving functional outcomes in patients with LHIVD. Methods: This systematic review utilised domestic and international databases up to June 2024. Only randomised controlled trials (RCTs) involving adult patients with LHIVD were included. Two independent reviewers screened studies; a meta-analysis was performed to evaluate the efficacy and safety of HM decoctions. Results: Overall, 23 RCTs involving Chinese HMs were included (HM monotherapy, 5; HM+traditional Chinese medicine, 12; and HM+usual care, 6). For pain reduction, HM+usual care showed an improvement on visual analogue scale scores (standardised mean difference: -2.00; 95% confidence interval [CI], -2.86 to-1.15). Functional improvement was the most notable in the HM+traditional Chinese medicine group (standardised mean difference: 1.58; 95% CI, 1.20-1.96). HM add-on therapy significantly improved the total effective rate (risk ratio: 1.20; 95% CI, 1.16-1.25). Among the few studies reporting safety, no severe adverse events were associated with HM, although the evidence was insufficient for firm safety-related conclusions. Conclusion: HM add-on therapy may alleviate pain and improve function in patients with LHIVD, with a relatively low incidence of adverse events, indicating its potential efficacy and acceptable safety profile. However, rigorous large-scale RCTs are necessary to validate HM clinical efficacy. Protocol registration: PROSPERO (CRD42023415800)
Keywords:
Herbal medicine
Lumbar herniated intervertebral disc
Meta-analysis
Systematic review
Traditional Chinese medicine
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J
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1.9
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45
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