A systematic review and Meta-Analysis on the effect of Cotoneaster manna on Neonatal Jaundice

Document Type: Review article

Authors

1 Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Clinical Research Development Center, "the Persian Gulf Martyrs" Hospital, Bushehr University of Medical Sciences, Bushehr, Iran

Abstract

Background & Aim: The manna of Cotoneaster nummularia (purgative manna) has been traditionally used in the Persian medicine for the treatment of neonatal jaundice. The effect of Cotoneaster manna on neonatal jaundice was investigated with systematic review and meta-analysis.
Experimental: This study intended to explore the clinical trials of the efficacy of Cotoneaster manna on neonatal jaundice. The aspects considered in this study included searching for relevant English and Persian data bases up to March 2016. The methodological quality was assessed using the Consort checklist for herbal interventions. Seven studies with low or moderate risk of bias involved 804 participants of which 410 cases versus 394 controls were selected for systematic review and meta-analysis with CMA software version 2.2.
Results: Total plasma bilirubin in 0, 12, 24, 36, 48 hours and the duration of hospital stay were checked and no adverse effect was reported. The Meta-analysis exhibited marked heterogeneity of the results (Q-value = 132.446, P< 0.0001, I2 = 87.165, τ = 0.998). However, it showed favorable effect of Cotoneaster manna on reducing neonatal jaundice (n= 804, OR = 0.242, 95% CI: 0.147 to 0.399, P< 0.0001). Also it was effective on reducing duration of hospital stay (n= 804, SMD= -1.154, 95% CI: -1.854 to -0.455, P< 0.001). However, the results obtained were heterogeneous (Q-value= 119.642, P< 0.0001, I2= 94.985, τ= 0.913).
Recommended applications/ industries: Although the meta-analysis of Cotoneaster manna showed positive effect on treatment of neonatal jaundice in these studies, it is warranted to carry out further multi-centre randomized clinical trials with larger samples and controlled risk factors, alongside comparison with phototherapy. 

Keywords


Article Title [Persian]

اثر شیر خشت بر زردی نوزادان یک مرور نظامند همراه با متا آنالیز

Authors [Persian]

  • علیرضا صالحی 1
  • محدثه استوار 2
  • مریم مرزبان 3
1 مرکز تحقیقات طب سنتی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
2 گروه طب سنتی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
3 مرکز توسعه پژوهش های بالینی، بیمارستان شهدای خلیج فارس، دانشگاه علوم پزشکی بوشهر، بوشهر، ایران
Abstract [Persian]

زمینه و هدف: در طب سنتی از شیر خشت به عنوان یک روش درمانی به صورت سنتی در طب ایرانی برای درمان زردی نوزادان استفاده میشود. با استفاده از متا آنالیز و مرور متون، اثر شیر خشت بر زردی نوزادان بررسی شد.
روش تحقیق: هدف از این مطالعه بررسی اثر کارآزمایی های  بالینی  انجام شده در مورد  شیرخشت بر زردی نوزادان است. شیوه اصلی که در این مطالعه استفاده شده شامل جستجو  مقالات انگلیسی و فارسی تا مارچ 2016 بوده است. کیفبت کارآزمایی های بالینی با استفاده از چک لیست کانسورت برای مداخلات دارویی بررسی شد. هفت مطالعه که دارای تورش پایین یا متوسط بوده اند با  804 شرکت کننده برابر با  410 مورد در برابر 394 شاهد برای ورود به مطالعه مروری و یا متا آنالیز با نرم افزار CMA نسخه 2.2 انتخاب شدند.
نتایج: مقدار کلی بیلی روبین پلاسما در 0، 12، 24 ، 36، 48 ساعت و طول دوره اقامت در بیمارستان کنترل شده و هیچگونه عارضه جانبی گزارش نشده است. متاآنالیز نشان دهنده هتروژنیتی برجسته ای از نتایج بوده است(Q-value = 132.446, P< 0.0001,   I2 = 87.165, τ = 0.998).  با این حال، اثرات موثر شیرخشت بر زردی نوزادان نشان داده شده است(n= 804, OR = 0.242, 95% CI:  0.147 to 0.399, P < 0.0001).  همچنین میتوان اذعان نمود که شیر خشت میتواند مدت اقامت در بیمارستان را نیز کاهش دهد(n= 804, SMD= -1.154, 95% CI:  -1.854 to -0.455, P< 0.001). با این حال نتایج به دست آمده هتروژن و ناهمگن بوده است(Q-value= 119.642, P< 0.0001,   I2= 94.985, τ= 0.913).
توصیه های کاربردی/ صنعتی: گرچه که متاآنالیز شیر خشت بر زردی نوزدان نشان دهنده اثر مثبت شیرخشت بر زردی نوزادان در این مطالعات بوده، با این حال انجام مطالعات چند مرکزی کارآزمایی بالینی با حجم نمونه بالاتر که برای عوامل خطر کنترل شده و مقایسه آن با روش درمان رایج که فتوتراپی می باشد توصیه می­شود. 

Keywords [Persian]

  • شیر خشت
  • زردی نوزادان
  • پرژک
  • بیلیناستر
  • طب سنتی ایرانی
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