A Systematic Review and Meta-analysis on Effectiveness of Cissus quadrangularis (Linn.) in Hemorrhoid Treatment
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Abstract
Introduction :Cissus quadrangularis L. (Vitaceae) is a medicinal herb used for hemorrhoid treatment, widely accepted in Thailand. However, efficacy of treating hemorrhoid by C quadrangularis is supported by limit evidence. Objectives: This study was to review literatures systematically and conduct the meta-analysis to confirm efficacy of C. quadrangularis in hemorrhoid treatment. Published and unpublished papers were searched from accessible database such as Pubmed, CENTRAL, Science-direct, SciSearch, and Thailis including a hand search. Specific keywords were assigned prior to the study. Study designed randomized controlled trial in human, written in English or Thai, and conducted before 2014 were recruited. Results: Three papers met inclusion criteria with high quality of methodology (Jadad’s score ≥3). The number of patients involved in the studies ranged 20 - 350. All of the studies were conducted in Thailand. Results showed no statistical difference for C. quadrangularis L. in reducing bleeding (RR=0.67, 95%CI =0.42, 1.06), pain (RR=1.01, 95%CI =0.67, 1.52) and prolapsed (RR=1.11, 95%CI =0.58, 2.12). No serious adverse events were reported. Conclusion: This study supports that therapeutic efficacy of C. quadrangularis L. was not different from the comparative conventional treatment. This suggests that C. quadrangularis L. can improve hemorrhoidal symptoms. However, a randomized control trial is still needed in order to confirm other clinical outcomes and safety of C. quadrangularis L.
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