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Background: Dachaihu decoction (Dachaihu tang) plays a crucial role in treating acute illnesses. Recently, a significant number of clinical studies on Dachaihu decoction for acute cholecystitis (AC) have been published. This study was conducted to assess the efficacy and safety of Dachaihu decoction in patients with this condition. Methods: To identify relevant randomized controlled trials (RCTs), eight databases and three clinical trial registries were searched from inception to 30 June 2024. Two researchers independently screened and extracted data from eligible studies using EndNote X9 and Microsoft Office Excel 2019. RoB 2.0 was used to assess the risk of bias in the included studies. Stata 17.0 was used for data analysis. Publication bias and its impact on result stability were evaluated using a funnel plot and the "trim-and-fill" method. The quality of evidence was graded using the GRADE assessment system. Results: Thirty-three RCTs involving 2,851 participants were included. The treatment group demonstrated improved clinical efficacy (RR = 1.18; 95% CI = 1.13 to 1.24), significantly reduced length of hospital stay (MD = −1.78 days; 95% CI = –2.02 to −1.53), and the incidence of adverse events (RR = 0.31; 95% CI = 0.20 to 0.48). Additionally, there appeared to be reductions in the time for abdominal pain to resolve (MD = −1.92 days; 95% CI = –2.33 to −1.51), fever to disappear (MD = −1.52 days; 95% CI = –1.90 to −1.14), white blood cell count to return to normal (MD = −2.89 days; 95% CI = –3.32 to −2.46), alanine aminotransferase (ALT) levels (MD = −11.88 U/L; 95% CI = –15.29 to −8.47), aspartate aminotransferase (AST) levels (MD = −8.74 U/L; 95% CI = –9.76 to −7.72), neutrophil percentage (MD = −9.68; 95% CI = –11.33 to −8.03), TNF-α levels (SMD = −2.10 pg/L; 95% CI = –2.43 to −2.78), and certainty of evidence (moderate-to-low certainty). Conclusion: Dachaihu decoction may be an effective botanical formula for managing AC and a lower incidence of adverse events. However, due to the substantial risk of bias and heterogeneity across the included studies, these findings should be interpreted with caution and require further validation through well-designed, high-quality trials. Systematic Review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=573332. [ABSTRACT FROM AUTHOR]

The aim of the study was to understand healthcare professionals, pharmacists, and patients perspectives and experiences on clinical practice of herb-drug interactions (HDIs). A systematic review of qualitative studies was conduct. 10 electronic databases were searched from inception through September 2023. Qualitative studies, mixed-method studies, and unstructured or semi-structured cross-sectional surveys focused on healthcare professionals, pharmacists and patients' perspectives, attitudes, clinical practice behaviors, and information needs regarding HDI were included. Thematic synthesis employed Nvivo 12 software. Of 6655 studies identified, 1267 full-text articles were retrieved. Of these, 18 studies conducted in 11 countries/regions were eligible for inclusion, involving 1273 patients, 302 healthcare professionals, and 230 pharmacists. Five over-arching explanatory themes were identified: perspectives, attitudes, practices, experiences, expectations, and information needs. Complementary and alternative (CAM) physicians, pharmacists, and general practitioners were considered by patients to possess the ability or responsibility to assess potential HDIs. Pharmacists yet encountered difficulties due to conflicting information sources and inadequate training. Healthcare professionals, including pharmacists, usually only assessed HDIs when they were deemed to cause serious adverse effects. Regarding expectations and information needs, patients were particularly concerned about the risk of adverse HDIs, the severity of HDIs, and the appropriate intervals between drug doses. They would like to receive relevant HDI alerts. Results suggest that government, policy makers, healthcare professionals, and the education system should give attention to HDIs and improve health professional-patient communication. Further research should also be conducted on the understanding and practices of CAM practitioners in China. Trial Registration: CRD42022324777 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails)., (© 2024 The Author(s). Phytotherapy Research published by John Wiley & Sons Ltd.)

Introduction: Acupuncture and related acupoint therapies have been widely used for smoking cessation. Some relevant systematic reviews (SRs) have been published. There is a need to summarize and update the evidence to inform practice and decision-making., Methods: Eight databases were searched from their inception to December 2023. SRs, any randomized controlled trials (RCTs) comparing acupuncture therapies with sham acupuncture, pharmacotherapy, behavioral therapy, or no treatment, were included. The primary outcome was the abstinence rate. AMSTAR-2 was employed to assess the quality of SRs. An updated meta-analysis was conducted based on SRs and RCTs. Data were synthesized using risk ratios (RR) with 95% confidence intervals (CIs). The GRADE approach was employed to assess the certainty of the updated evidence., Results: Thirteen SRs and 20 RCTs outside of the SRs were identified. The SRs were of low or very low quality by AMSTAR-2. Sixteen (80%) RCTs were at high risk of performance bias. Eight acupuncture and related acupoint therapies were involved. The short-term (≤6 months) abstinence rate outcome was summarized as follows. Most SRs suggested that filiform needle acupuncture or acupressure had a better effect than sham acupuncture, but the findings were inconsistent. The updated meta-analysis also suggested that filiform needle acupuncture was more effective than sham acupuncture (RR=1.44; 95% CI: 1.02-2.02; I 2 = 66%; low certainty; 9 RCTs, n=1358). Filiform needle acupuncture combined with acupressure was comparable to nicotine patches (RR=0.99; 95% CI: 0.74-1.32; low certainty; 6 RCTs, n= 524). Acupressure was superior to counseling (RR=1.46; 95% CI: 1.14-1.87; I 2 =5%; low certainty; 8 RCTs, n=595). No serious adverse events were reported in these SRs or RCTs., Conclusions: Low certainty evidence suggests that filiform needle acupuncture and auricular acupressure appear to be safe and effective in achieving short-term smoking cessation. However, long-term follow-up data are needed., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2024 Zhang Y.Y. et al.)