Multiple traditional Chinese medicinal approaches in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs: A systematic review and meta-Analysis

Background: This review aimed to verify the clinical effects of traditional Chinese medicine in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs (LHIVD). Methods: The CENTRAL, EMBASE, MEDLINE/PubMed, JMAS, CNKI, and seven Korean databases were searched using pre-planned strategies. The risk of bias was assessed using the Cochrane Collaboration tool and a meta-Analysis was conducted accordingly. Results: Twenty-eight randomized controlled trials (RCTs) were included in this systematic review and meta-Analysis. All RCTs included 2746 participants. The experimental group showed more significant improvements in VAS (Mean differences (MD)-1.61, 95% Confidence Intervals (CI) [-2.44,-0.79]; I²= 98%), Oswestry Disability Index (ODI) (MD-8.52, 95% CI [-11.71,-5.34]; I²= 96%), and Japanese Orthopaedic Association (JOA) scores (MD 4.83, 95% CI [3.49, 6.17]; I²= 85%) than the control group. However, the difference in the incidence of adverse events between the experimental and control groups was not significant (Relative Risk (RR) 0.05, 95% CI [0.23, 1.10]; I²= 46%). Conclusion: Traditional Chinese medicine in collaboration with conservative conventional medicine can be used to relieve pain and facilitate better function of the lumbar spine in lumbar herniated intervertebral disc cases. However, this conclusion should be applied with caution in clinical practice owing to the low quality of the included studies.