The effect of Zhizi Qinggan decoction in treating hyperthyroidism: A systematic review and meta-analysis

Background: This study aims to systematically assess the efficacy of Zhizi Qinggan Decoction combined with methimidazole tablets for the treatment of hyperthyroidism through a systematic review and meta-analysis, to provide evidence for clinical practice. Methods: A computer search of both Chinese and English databases, including CNKI, WangFang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science, was conducted. The search period was from the establishment of the database to August 2024. Randomized controlled trials (RCTs) related to the treatment of hyperthyroidism with Zhizi Qinggan Decoction were collected. Two independent researchers conducted the literature search, selection, and quality assessment. A meta-analysis was conducted using Stata 14.0 software to evaluate various outcome indicators, including thyroid hormone levels, clinical effectiveness, and traditional Chinese medicine syndrome scores. Results: A total of 16 RCTs were included, involving 1320 patients with hyperthyroidism with an average age of 39.3 years. The meta-analysis results indicated that Zhizi Qinggan Decoction combined with Western medicine significantly improved outcomes in the treatment of hyperthyroidism compared to Western medicine alone. Specifically, the results for free triiodothyronine (standardized mean difference [SMD] = –0.79; 95% confidence interval [CI]: –1.11, –0.47; P < .0001), free thyroxine (SMD = –2.09; 95% CI: –2.91, –1.28; P < .0001), thyroid-stimulating hormone (SMD = 1.99; 95% CI: 1.00, 2.99; P < .0001), thyroid volume (SMD = –1.22; 95% CI: –1.84, –0.60; P < .001), clinical efficacy (odds ratio = 6.05; 95% CI: 3.85, 9.51; P < .0001), adverse reactions (odds ratio = 2.61; 95% CI: 1.52, 4.45; P < 0.001), and traditional Chinese medicine syndrome score (SMD = –1.85; 95% CI: –2.41, –1.28; P < .001) all showed statistically significant improvements (P < .001). Conclusion: Current evidence suggests that the combination of Zhizi Qinggan Decoction and methimazole tablets provides good clinical therapeutic outcomes. However, further efforts are needed to strengthen the evidence supporting its clinical application through rigorous large-sample RCTs.