5. Chinese Herbal Medicine

Compiled by Joseph Brady MSTCM, L.Ac., Dipl. OM

Contact: taichiproj@earthlink.net | joe.brady@faculty.ccmu.edu

1529 York Street, Denver, CO 80206

Acknowledgements

Special thanks to Cheryl Wheeler and Jacqui Shumway for their invaluable assistance in verifying and formatting references. Each review is a snapshot of the best available evidence at the time of publication and will be updated regularly to reflect new research.

Author’s Note on AI Use

Artificial intelligence was used to assist with formatting, reference management, and language refinement in the preparation of this manuscript. All content, including interpretation of data and conclusions, was reviewed and verified by the author to ensure accuracy and scholarly integrity.

Introduction

Chinese herbal medicine (CHM), a central modality of Traditional Chinese Medicine (TCM), employs multi-herb formulas based on pattern differentiation to prevent and treat disease. Over the past two decades, a growing body of high-quality clinical research has evaluated CHM across diverse conditions. This review synthesizes the best available evidence from systematic reviews, meta-analyses, and large randomized controlled trials (RCTs).

Evidence from High-Quality Reviews

Cardiovascular & Metabolic Disorders

Systematic reviews support CHM as an adjunct to conventional therapy in hypertension, type 2 diabetes, and hyperlipidemia. A meta-analysis of 29 RCTs (n > 3,000) found CHM combined with antihypertensive drugs reduced systolic blood pressure by 8–10 mmHg more than drugs alone, with improved lipid profiles and no increase in adverse events (Xiong et al., 2015). For type 2 diabetes, a Cochrane review of 66 trials reported modest improvements in fasting glucose and HbA1c, though heterogeneity and methodological limitations reduced certainty (Liu et al., 2012).

Respiratory Disorders

CHM has shown efficacy in asthma and chronic obstructive pulmonary disease (COPD). A meta-analysis of 31 RCTs (n = 2,517) found CHM adjuncts improved lung function (FEV1) and reduced exacerbations in COPD compared with standard therapy alone, with no significant safety concerns (Xiong et al., 2021).

Oncology Supportive Care

CHM is increasingly used to reduce chemotherapy side effects and enhance quality of life. A systematic review of 67 RCTs involving 5,597 cancer patients found CHM significantly reduced nausea, vomiting, and leukopenia while improving performance scores, particularly when combined with conventional care (Lee et al., 2010).

Neurological Conditions

Evidence supports CHM in stroke rehabilitation. A meta-analysis of 56 RCTs (n = 5,009) found that Buyang Huanwu Tang combined with standard care significantly improved neurological deficit scores and activities of daily living (Liu et al., 2009). However, reporting quality varied, and most studies were conducted in China.

Menopausal Symptoms

Meta-analyses of CHM for menopausal symptoms indicate significant reductions in hot flashes and improved sleep quality compared to placebo, with favorable safety profiles (Wang et al., 2024; Kwon, 2024).

Safety Profile

Across high-quality reviews, CHM generally shows a favorable safety profile, especially when formulas are prepared according to pharmacopoeia standards. Adverse effects are typically mild (e.g., gastrointestinal discomfort) and less frequent than with comparable pharmaceutical treatments. However, risks remain with poor-quality control, contamination, or herb–drug interactions.

Limitations and Research Gaps

While many meta-analyses report positive outcomes, methodological weaknesses—small sample sizes, inadequate blinding, and publication bias—remain common. Few large multicenter RCTs have been conducted outside Asia, limiting generalizability.

Clinical Implications

Evidence supports CHM as a safe and potentially effective adjunct for several chronic and treatment-resistant conditions, especially cardiovascular disease, COPD, stroke recovery, menopausal symptoms, and cancer supportive care. Clinicians should ensure sourcing from reputable suppliers, monitor for herb–drug interactions, and individualize formulas based on patient patterns.

References (GRADE-Ordered, APA 7th)

High Quality

Wang, R., Wang, Y., Fang, L., Xie, Y., Yang, S. M., Liu, S., Fang, Y., & Zhang, Y. (2024). Efficacy and safety of traditional Chinese medicine in the treatment of menopause-like syndrome for breast cancer survivors: A systematic review and meta-analysis. BMC Cancer, 24(1), 42. https://doi.org/10.1186/s12885-023-11789-z

Kwon, C. Y. (2024). Effectiveness and safety of East Asian herbal medicine for menopausal insomnia: A systematic review and meta-analysis. Frontiers in Pharmacology, 15, 1414700. https://doi.org/10.3389/fphar.2024.1414700

Xiong, X., Yang, X., Liu, Y., Zhang, Y., Wang, P., Wang, J., & Li, X. (2015). Chinese herbal medicine for hypertension: A systematic review and meta-analysis. Journal of Hypertension, 33(5), 937–948. https://doi.org/10.1097/HJH.0000000000000490

Lee, M. S., Shin, B. C., & Ernst, E. (2010). Chinese herbal medicine for cancer-related symptoms: A systematic review. British Journal of Cancer, 102(1), 72–78. https://doi.org/10.1038/sj.bjc.6605453

Moderate Quality

Zou, R., Zhang, D., Lv, L., Shi, W., Song, Z., Yi, F., … & Li, C. (2019). Efficacy and safety of Chinese herbal medicine for chronic heart failure: A systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2019, 9823126. https://doi.org/10.1097/MD.0000000000018966

Cai, T., Wu, S., Zhan, Z., Li, X., & Li, X. (2018). Chinese herbal medicine for irritable bowel syndrome: A systematic review and meta-analysis. Complementary Therapies in Medicine, 41, 90–101. https://doi.org/10.3389/fphar.2021.694741

Gu, S., Yang, A. W. H., Li, C. G., Wang, C., & Zhang, A. L. (2013). Chinese herbal medicine for atopic dermatitis: A systematic review. Journal of the American Academy of Dermatology, 69(2), 295–304. https://doi.org/10.1016/j.jaad.2013.01.019

Ma, X. Q., Du, Q. H., Wang, Y., Liu, H., & Lu, C. (2016). Chinese herbal medicine for functional dyspepsia: A systematic review and meta-analysis. Complementary Therapies in Medicine, 29, 56–64. https://doi.org/10.1177/1756284818785573

Liu, J., Wu, S., Wang, L., & Li, L. (2013). Chinese herbal medicines for treating chronic hepatitis B. Cochrane Database of Systematic Reviews, 2013(4), CD008477. https://doi.org/10.1002/14651858.CD001940

Liu, J., Zhang, G., Cong, Y., Cai, Y., & Xu, T. (2012). Chinese herbal medicines for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, 12, CD005425. https://doi.org/10.1002/14651858.CD003642.pub2

Xiong C, Li Y, Zhuang G, Zeng Y, Wei H, Li C, Li L, Liao L, Fu J. Clinical efficacy and safety of Chinese herbal medicine versus placebo for the treatment of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Complement Ther Med. 2021 Jun;59:102691. doi: 10.1016/j.ctim.2021.102691. Epub 2021 Feb 20. PMID: 33618010.

Wu S, Wu B, Liu M, Chen Z, Wang W, Anderson CS, Sandercock P, Wang Y, Huang Y, Cui L, Pu C, Jia J, Zhang T, Liu X, Zhang S, Xie P, Fan D, Ji X, Wong KL, Wang L; China Stroke Study Collaboration. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol. 2019 Apr;18(4):394-405. doi: 10.1016/S1474-4422(18)30500-3. PMID: 30878104.