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Table 2 Effect of estimates of oral herbal medicine for intrahepatic cholestasis in pregnancy in 43 included trials

From: Oral herbal medicine for women with intrahepatic cholestasis in pregnancy: a systematic review of randomized controlled trials

Trials Intervention/Comparison Effect estimates
(95%CI)
Pvalue
1. The pruritus score of the pregnancy
 1.1 Herbal medicine vs. Conventional medicine
  Huang and Liu [34], 2004 Yinchenhao Decoction MD − 0.70 [− 0.93, − 0.47]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction MD − 0.55 [− 1.07, − 0.03]  
Subtotal (REM, I2 = 0%) MD − 0.68 [− 0.88, − 0.47] < 0.00001
 1.2 Herbal medicine plus Conventional medicine versus Conventional medicine
1.2.1 Herbal medicine plus SAMe versus SAMe
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction MD − 0.65 [− 1.02, − 0.28]  
  Wen et al. [44], 2014 Self prescribed prescription MD-1.27 [− 1.47, − 1.07]  
  Liu et al. [46], 2013 Yinchendanshao Decoction MD − 0.50 [− 1.16, 0.16]  
  Ding et al. [48], 2010 Qingganhuayu Decoction MD − 1.20 [− 1.57, − 0.83]  
  Liu et al. [70], 2019 Wuling pill MD − 1.02 [− 1.08, − 0.96]  
  Wang et al. [71], 2015 Yinchen Decoction MD − 0.70 [− 1.10, − 0.30]  
  Zhang [73], 2005 Dangguidihuang Decoction MD − 0.70 [− 0.86, − 0.54]  
1.2.2 Herbal medicine plus UDCA versus UDCA
  Wang and Lai [42], 2011 Yinchenlidan Decoction MD − 0.70 [− 1.01, − 0.39]  
  Yin [53], 2015 Bushenqingli Decoction MD − 0.70 [− 1.13, − 0.27]  
  Deng [59], 2015 Yinzhihuang oral liquid MD − 0.68 [− 0.91, − 0.45]  
  Gu et al. [66], 2014 Yinchen Decoction MD −0.32 [− 0.54, − 0.10]  
Subtotal (REM, I2 = 56%) MD − 0.58 [− 0.79, − 0.36] < 0.00001
1.2.3 Herbal medicine plus UDCA plus SAMe versus UDCA plus SAMe
  Zhou et al. [37], 2017 Yinchailishi Decoction MD −0.77 [− 1.01, − 0.53]  
  Lan et al. [51], 2016 Yinchenhao Decoction MD − 1.68 [− 1.99, − 1.37]  
Subtotal (REM, I2 = 95%) MD − 1.22 [− 2.11, − 0.33] < 0.00001
1.2.4 Herbal medicine plus dexamethasone versus dexamethasone
  Liu et al. [38], 2015 Yinchenlidan Decoction MD −0.70 [− 0.88, − 0.52]  
  Zhao [41], 2011 Qingyulidan Decoction MD −0.68 [− 0.83, − 0.53]  
Subtotal (FEM, I2 = 0%) MD − 0.69 [− 0.80, − 0.57] < 0.00001
2. Maternal serum TBA
 2.1 Herbal medicine vs. Conventional medicine
  Yang [32], 2015 Yinzhihuang oral liquid vs. UDCA MD − 4.74 [− 6.57, − 2.91]  
  Li et al. [14], 2015 Yinchenhao Decoction vs. UDCA+SAM MD 1.40 [− 0.45, 3.25]  
 2.2 Herbal medicine plus Conventional medicine versus Conventional medicine
2.2.1 Herbal medicine plus SAMe versus SAMe
  Liu et al. [46], 2013 Yinchendanshao Decoction MD −10.66 [− 19.08, − 2.24]  
  Zhang [52], 2015 Yinchenhao Decoction MD −8.20 [− 10.04, − 6.36]  
  Wang et al. [71], 2015 Yinchen Decoction MD − 6.00 [− 8.18, − 3.82]  
  Zhang [73], 2005 Dangguidihuang Decoction MD −7.20 [− 9.39, − 5.01]  
Subtotal (FEM, I2 = 0%) MD − 7.33 [− 8.50, − 6.15] < 0.00001
2.2.2 Herbal medicine plus UDCA versusUDCA
  Wang X et al. [39], 2016 Danyu Decoction MD − 6.44 [− 9.73, − 3.15]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction MD −4.33 [− 7.48, − 1.18]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction MD − 3.51 [− 4.88, − 2.14]  
  Yin [53], 2015 Bushenqingli Decoction MD −4.45 [− 5.76, − 3.14]  
  Shu [58], 2018 Qianyinlidan Decoction MD −3.94 [− 4.20, − 3.68]  
  Wei [63], 2016 Self prescribed prescription MD −5.00 [− 6.78, − 3.22]  
  Gu et al. [66], 2014 Yinchen Decoction MD −4.81 [− 7.25, − 2.37]  
Subtotal (FEM, I2 = 0%) MD-3.99 [− 4.24, − 3.74] < 0.00001
2.2.3 Herbal medicine plus UDCA plus SAMe versus UDCA plus SAMe
  Wang et al. [36], 2016 Yinzhihuang oral liquid MD − 2.30 [− 4.18, − 0.42]  
  Zhou et al. [37], 2017 Yinchailishi Decoction MD − 7.08 [− 9.88, − 4.28]  
  Liu et al. [38], 2015 Yinchenlidan Decoction MD − 8.13 [− 9.45, − 6.81]  
  Lan et al. [51], 2016 Yinchenhao Decoction MD − 1.77 [− 4.30, 0.76]  
  Su et al. [60], 2015 Lidan Decoction MD − 3.42 [− 6.32, − 0.52]  
  Mao and He [67], 2014 Qingganlidan Decoction MD −24.10 [− 26.05, − 22.15]  
  Zheng [65], 2019 Lidan Decoction MD −6.38 [− 7.69, − 5.07]  
Subtotal (REM, I2 = 98%) MD − 7.62 [− 12.97, − 2.27] 0.005
2.2.4 Herbal medicine plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone
  Zhao [41], 2011 Qingyulidan Decoction MD-3.57 [−4.74, − 2.40]  
  Shan et al. [50], 2016 Huashilidan Decoction MD-3.54 [− 5.33, − 1.75]  
  Li et al.,14 2015 Yinchenhao Decoction MD-5.00 [− 6.71, − 3.29]  
  Zhang et al. [57], 2016 Self prescribed prescription MD-3.37 [− 3.86, − 2.88]  
Subtotal (FEM, I2 = 8%) MD-3.50 [−3.93, − 3.08] < 0.00001
3. The number of fetal distress
 3.1 Herbal medicine vs. Conventional medicine
  Zhang [31], 2006 Self prescribed prescription vs SAMe+Reduced glutathione RR 0.93 [0.39,2.20]  
  Huang and Liu [34], 2004 Yinchenhao Decoction vs SAMe RR 0.86 [0.29, 2.50]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM RR 0.47 [0.13, 1.70]  
Subtotal (FEM, I2 = 0%) RR 0.77 [0.43, 1.39] 0.39
 3.2 Herbal medicine plus Conventional medicine versus Conventional medicine  
  Wang et al. [36], 2016 Yinzhihuang oral liquid plus UDCA and SAMe versus UDCA and SAMe RR 0.22 [0.05, 0.96]  
  Zhou et al. [37], 2017 Yinchailishi Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.33 [0.01, 7.87]  
  Liu et al. [38], 2015 Yinchenlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.31 [0.12, 0.81]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction plus UDCA versus UDCA RR 0.39 [0.08, 1.83]  
  Zhao [41], 2011 Qingyulidan Decoction plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone RR 0.25 [0.06, 1.13]  
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction plus SAMe versus SAMe RR 0.38 [0.11, 1.28]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction plus UDCA versus UDCA RR 0.29 [0.08, 1.02]  
  Tian et al. [47], 2016 Kangdanyu Decoction plus Reduced glutathione plus UDCA plus SAMe plus DXM versus Reduced glutathione plus UDCA plus SAMe RR 1.40 [0.71, 2.76]  
  Zhang et al. [49], 2014 Qingdanzhiyang Decoction plus SAMe, phenobarbital and DXM versus SAMe, phenobarbital and DXM RR 0.27 [0.08, 0.88]  
  Shan et al. [50], 2016 Huashilidan Decoction plusUDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone RR 0.40 [0.08, 1.96]  
  Lan et al. [51], 2016 Yinchenhao Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.54 [0.24, 1.21]  
  Yin [53], 2015 Bushenqingli Decoction plus UDCA versus UDCA RR 0.33 [0.10, 1.11]  
  Su et al. [60], 2015 Lidan Decoction plus UDCA, SAMe and
Magnesium isoglycyrrhizinate versus UDCA, SAMe and
Magnesium isoglycyrrhizinate
RR 0.67 [0.12, 3.76]  
  Wang et al. [62], 2018 Yinzhihuang granule plus UDCA, SAMe and DXM versus UDCA, SAMe and DXM RR 0.20 [0.05, 0.84]  
  Wei [63], 2016 Self prescribed prescription plus UDCA versus UDCA RR 0.21 [0.08, 0.55]  
  Zhang [64], 2017 Lidan Decoction plus UDCA versus UDCA RR 0.25 [0.03, 2.17]  
  Zheng [65], 2019 Yinchen Decoction plus UDCA, SAMe and Phenobarbital versus UDCA, SAMe and Phenobarbital RR 0.50 [0.05, 5.31]  
  Mao and He [67], 2014 Qingganlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.31 [0.12, 0.80]  
  Mao [68], 2016 Yinchenhao Decoction plus UDCA versus UDCA RR 0.97 [0.06, 15.02]  
  Zhu and Huang [69], 2008 Yinchenhao Decoction plus UDCA versus UDCA RR 0.86 [0.29, 2.50]  
  Liu et al. [70], 2019 Wuling pill plus SAMe versus SAMe RR 0.40 [0.08, 1.98]  
  Wang et al. [71], 2015 Yinchenhao Decoction plus SAMe versus SAMe Not estimable  
  Du and Li [72], 2014 Yiguanjian Decoction plus UDCA and DXM versus UDCA and DXM RR 0.35 [0.17, 0.75]  
  Zhang [73], 2005 Dangguidihuang Decoction plus SAMe versus SAMe RR 0.50 [0.21, 1.20]  
Overall (FEM, I2 = 0%) RR0.41 [0.32, 0.51] < 0.00001
4. The number of asphyxia neonatorum
 4.1 Herbal medicine vs. Conventional medicine
  Yang [32], 2015 Yinzhihuang oral liquid vs UDCA RR 1.00 [0.06,16.76] 1.00
 4.2 Herbal medicine plus Conventional medicine versus Conventional medicine
  Zhou et al. [37], 2017 Yinchailishi Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.33 [0.01, 7.87]  
  Wang X et al. [39], 2016 Danyu Decoction plus UDCA versus UDCA RR 0.33 [0.07, 1.58]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction plus UDCA versus UDCA RR 0.48 [0.05, 5.03]  
  Zhao [41], 2011 Qingyulidan Decoction plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone RR 0.25 [0.03, 2.17]  
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction plus SAMe versus SAMe RR 0.11 [0.01, 1.98]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction plus UDCA versus UDCA RR 0.29 [0.08, 1.02]  
  Tian et al. [47], 2016 Kangdanyu Decoction plus Reduced glutathione, UDCA, SAMe and DXM versus Reduced glutathione, UDCA and SAMe RR 0.85 [0.43, 1.65]  
  Ding et al. [48], 2010 Qingganhuayu Decoction plus SAMe versus SAMe RR 0.33 [0.13, 0.88]  
  Zhang et al. [49], 2014 Qingdanzhiyang Decoction plus SAMe, phenobarbital and DXM versus SAMe, phenobarbital and DXM RR 0.13 [0.02, 0.94]  
  Shan et al. [50], 2016 Huashilidan Decoction plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone RR 0.20 [0.01, 4.06]  
  Lan et al. [51], 2016 Yinchenhao Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.50 [0.19, 1.33]  
  Zhang [52], 2015 Yinchenhao Decoction plus SAMe versus SAMe RR 0.25 [0.06, 1.11]  
  Yin [53], 2015 Bushenqingli Decoction plus UDCA versus UDCA RR 0.13 [0.02, 0.94]  
  Ma [56], 2010 Self prescribed prescription plus UDCA versus UDCA RR 0.38 [0.11, 1.30]  
  Wang [61], 2014 Kangyudan Decoction plus UDCA versus UDCA RR 0.40 [0.08, 1.93]  
  Zheng [65], 2019 Yinchen Decoction plus UDCA, SAMe and Phenobarbital versus UDCA, SAMe and Phenobarbital RR 0.33 [0.01, 7.96]  
  Mao and He [67], 2014 Qingganlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.23 [0.07, 0.77]  
  Wang et al. [71], 2015 Yinchenhao Decoction plus SAMe versus SAMe Not estimable  
Overall (FEM, I2 = 0%) RR0.35 [0.25, 0.49] < 0.00001
5. The number of cesarean section
 5.1 Herbal medicine vs. Conventional medicine
  Zhang [31], 2006 Self prescribed prescription vs SAMe and Reduced glutathione RR 0.93 [0.56, 1.55]  
  Li et al. [14], 2015 Yinchenhao Decoction vs. UDCA and SAM RR 1.07 [0.85, 1.37]  
  Huang and Liu [34], 2004 Yinchenhao Decoction vs SAMe RR 0.93 [0.56, 1.55]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM RR 0.58 [0.22, 1.58]  
Overall (FEM, I2 = 0%) RR 0.97 [0.80,1.18] 0.78
 5.2 Herbal medicine plus Conventional medicine versus Conventional medicine
  Wang et al. [36], 2016 Yinzhihuang oral liquid plus UDCA and SAMe versus UDCA and SAMe RR 0.27 [0.08, 0.90]  
  Zhou et al. [37], 2017 Yinchailishi Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.69 [0.53, 0.90]  
  Liu et al. [38], 2015 Yinchenlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.71 [0.51, 0.99]  
  Wang X et al. [39], 2016 Danyu Decoction plus UDCA versus UDCA RR 0.38 [0.23, 0.62]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction plus UDCA versus UDCA RR 0.57 [0.32, 1.02]  
  Zhao [41], 2011 Qingyulidan Decoction plus UDCA, SAMe and dexamethasone versus UDCA, SAMe and dexamethasone RR 0.95 [0.73, 1.24]  
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction plus SAMe versus SAMe RR 0.91 [0.67, 1.24]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction plus UDCA versus UDCA RR 0.53 [0.28, 1.00]  
  Tian et al. [47], 2016 Kangdanyu Decoction plus Reduced glutathione, UDCA, SAMe and DXM versus Reduced glutathione, UDCA and SAMe RR 0.52 [0.30, 0.89]  
  Ding et al. [48], 2010 Qingganhuayu Decoction plus SAMe versus SAMe RR 1.03 [0.89, 1.19]  
  Li et al. [14], 2015 Yinchenhao Decoction plus UDCA andSAMe versus UDCA and SAMe RR 0.80 [0.59, 1.08]  
  Yin [53], 2015 Bushenqingli Decoction plus UDCA versus UDCA RR 0.50 [0.14, 1.82]  
  Chen and Mo [55], 2005 Self prescribed prescription plus DXM and VK3 versus DXM and VK3 RR 1.08 [0.83, 1.39]  
  Ma [56], 2010 Self prescribed prescription plus UDCA versus UDCA RR 1.11 [0.72, 1.71]  
  Wang [61], 2014 Kangyudan Decoction plus UDCA versus UDCA RR 0.67 [0.46, 0.97]  
  Wei [63], 2016 Self prescribed prescription plus UDCA versus UDCA RR 0.50 [0.19, 1.29]  
  Zhang [64], 2017 Lidan Decoction plus UDCA versus UDCA RR 0.27 [0.08, 0.93]  
  Mao and He [67], 2014 Qingganlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.80 [0.57, 1.13]  
  Zhu and Huang [69], 2008 Yinchenhao Decoction plus UDCA versus UDCA RR 0.93 [0.56, 1.55]  
  Liu et al. [70], 2019 Wuling pill plus SAMe versus SAMe RR 0.17 [0.02, 1.34]  
  Du and Li [72], 2014 Yiguanjian Decoction plus UDCA and DXM versus UDCA and DXM RR 0.39 [0.20, 0.77]  
  Zhang [73], 2005 Dangguidihuang Decoction plus SAMe versus SAMe RR 0.95 [0.61, 1.49]  
Overall (REM, I2 = 65%) RR 0.73 [0.63, 0.85] < 0.0001
6. The number of postpartum haemorrhage
 6.1 Herbal medicine plus versus Conventional medicine
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM RR 0.47 [0.09, 2.36] 0.36
 6.2 Herbal medicine plus Conventional medicine versus Conventional medicine
  Wang X et al. [39], 2016 Danyu Decoction plus UDCA versus UDCA RR 0.50 [0.05, 5.36]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction plus UDCA versus UDCA RR 0.48 [0.05, 5.03]  
  Zhao [41], 2011 Qingyulidan Decoction plus UDCA, SAMe and dexamethasone versus UDCA, SAMe and dexamethasone RR 2.00 [0.19, 21.47]  
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction plus SAMe versus SAMe RR 2.00 [0.19, 20.90]  
  Tian et al. [47], 2016 Kangdanyu Decoction plus Reduced glutathione, UDCA, SAMe and DXM versus Reduced glutathione, UDCA and SAMe RR 0.25 [0.06, 1.10]  
  Shan et al. [50], 2016 Huashilidan Decoction plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone RR 0.50 [0.05, 5.33]  
  Yin [53], 2015 Bushenqingli Decoction plus UDCA versus UDCA Not estimable  
  Chen and Mo [55], 2005 Self prescribed prescription plus DXM and VK3 versus DXM and VK3 RR 0.67 [0.12, 3.75]  
  Su et al. [60], 2015 Lidan Decoction plus UDCA, SAMe and
Magnesium isoglycyrrhizinate versus UDCA, SAMe and
Magnesium isoglycyrrhizinate
RR 0.50 [0.05, 5.28]  
  Wang [61], 2014 Kangyudan Decoction plus UDCA versus UDCA RR 1.00 [0.07, 15.38]  
  Zheng [65], 2019 Yinchen Decoction plus UDCA, SAMe and Phenobarbital versus UDCA, SAMe and Phenobarbital RR 0.33 [0.04, 3.08]  
  Mao [68], 2016 Yinchenhao Decoction plus UDCA versus UDCA RR 0.16 [0.02, 1.29]  
  Liu et al. [70], 2019 Wuling pill plus SAMe versus SAMe RR 0.40 [0.08, 1.98]  
  Du and Li [72], 2014 Yiguanjian Decoction plus UDCA and DXM versus UDCA and DXM RR 0.38 [0.16, 0.92]  
Overall (FEM, I2 = 0%) RR 0.45 [0.28, 0.72] 0.0009
7. The serum ALT values
 7.1 Herbal medicine vs. Conventional medicine
  Yang [32], 2015 Yinzhihuang oral liquid vs. UDCA MD − 1.54 [− 2.46, − 0.62]  
  Li et al. [14], 2015 Yinchenhao Decoction vs. UDCA and SAM MD 5.70 [0.50,10.90]  
  Huang and Liu [34], 2004 Yinchenhao Decoction vs SAMe MD 3.40 [− 12.37, 19.17]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM MD − 18.31 [− 46.10, 9.48]  
Subtotal (REM, I2 = 67%) MD 0.90 [− 5.10, 6.90] 0.77
 7.2 Herbal medicine plus Conventional medicine versus Conventional medicine
7.2.1 Herbal medicine plus SAMe versus SAMe
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction MD − 11.50 [− 16.78, − 6.22]  
  Liu et al. [46], 2013 Yinchendanshao Decoction MD 2.97 [− 3.73, 9.67]  
  Zhang [52], 2015 Yinchenhao Decoction MD − 13.60 [− 19.20, − 8.00]  
  Liu et al. [70], 2019 Wuling pill MD − 43.86 [− 47.04, − 40.68]  
  Wang et al. [71], 2015 Yinchenhao Decoction MD − 10.20 [− 17.59, − 2.81]  
  Zhang [73], 2005 Dangguidihuang Decoction plus SAMe versus SAMe MD −14.02 [− 19.04, − 9.00]  
7.2.2 Herbal medicine plus UDCA versus UDCA
  Wang X et al. [39], 2016 Danyu Decoction MD-26.10 [− 50.18, − 2.02]  
  Wang and Lai [42], 2011 Yinchenlidan Decoction MD − 72.00 [− 75.85, − 68.15]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction MD − 13.00 [− 17.50, − 8.50]  
  Yin [53], 2015 Bushenqingli Decoction MD − 19.07 [− 24.70, − 13.44]  
  Shu [58], 2018 Qianyinlidan Decoction MD − 16.98 [− 18.89, − 15.07]  
  Deng [59], 2015 Yinzhihuang oral liquid MD − 10.40 [− 16.37, − 4.43]  
  Wei [63], 2016 Self prescribed prescription MD − 11.67 [− 17.33, − 6.01]  
  Gu et al. [66], 2014 Yinchenhao Decoction MD − 1.37 [− 5.07, 2.33]  
  Zhu and Huang [69], 2008 Yinchenhao Decoction MD − 8.60 [− 24.25, 7.05]  
7.2.3 Herbal medicine plus UDCA and SAMe versus UDCA and SAMe
  Wang et al. [36], 2016 Danyu Decoction MD − 14.85 [− 18.88, − 10.82]  
  Li et al. [14], 2015 Yinchenhao Decoction MD − 21.00 [− 25.60, − 16.40]  
  Su et al. [60], 2015 Lidan Decoction MD − 18.40 [− 23.56, − 13.24]  
  Zheng [65], 2019 Yinchen Decoction MD − 19.11 [− 20.98, − 17.24]  
  Mao and He [67], 2014 Qingganlidan Decoction MD − 21.10 [− 24.86, − 17.34]  
Subtotal (REM, I2 = 34%) MD-18.94 [− 20.91, − 16.97] < 0.0001
7.2.4 Herbal medicine plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone
  Shan et al. [50], 2016 Huashilidan Decoction MD-8.69 [− 13.16, − 4.22] 0.0001
7.2.5 Herbal medicine plus dexamethasone versus dexamethasone
  Liu et al. [38], 2015 Yinchenlidan Decoction MD-13.33 [− 17.34, − 9.32]  
  Zhao [41], 2011 Qingyulidan Decoction MD-10.13 [− 13.93, − 6.33]  
  Zhang [54], 2008 Self prescribed prescription MD-19.10 [− 23.90, − 14.30]  
  Chen and Mo [55], 2005 Self prescribed prescription MD-20.03 [− 27.91, − 12.15]  
Subtotal (REM, I2 = 72%) MD-15.05 [− 19.59, − 10.51] < 0.0001
8. The serum AST values
 8.1 Herbal medicine vs. Conventional medicine
  Li et al. [14], 2015 Yinchenhao Decoction vs UDCA and SAM MD 11.20 [7.86,14.54]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM MD −12.90 [− 37.51, 11.71]  
Overall (REM, I2 = 72%) MD 2.36 [− 20.40, 25.12] 0.84
 8.2 Herbal medicine plus Conventional medicine versus Conventional medicine
8.2.1 Herbal medicine plus SAMe versus SAMe
  Liu et al. [46], 2013 Yinchendanshao Decoction MD-3.07 [− 7.69, 1.55]  
  Zhang [52], 2015 Yinchenhao Decoction MD-17.60 [− 26.96, − 8.24]  
  Liu et al. [70], 2019 Wuling pill MD − 35.30 [− 38.82, − 31.78]  
  Wang et al. [71], 2015 Yinchenhao Decoction MD − 6.10 [− 9.83, − 2.37]  
8.2.2 Herbal medicine plus UDCA versus UDCA
  Yin [53], 2015 Bushenqingli Decoction MD − 20.23 [− 25.21, − 15.25]  
  Ma [56], 2010 Self prescribed prescription MD − 6.60 [− 15.02, 1.82]  
  Shu [58], 2018 Qianyinlidan Decoction MD − 29.83 [− 32.37, − 27.29]  
  Wei [63], 2016 Self prescribed prescription MD 8.00 [2.00, 14.00]  
  Gu et al. [66], 2014 Yinchenhao Decoction MD −1.76 [− 4.51, 0.99]  
8.2.3 Herbal medicine plus UDCA and SAMe versus UDCA and SAMe
  Wang et al. [36], 2016 Danyu Decoction MD −27.30 [− 51.21, − 3.39]  
  Li et al. [14], 2015 Yinchenhao Decoction MD −19.00 [− 22.74, − 15.26]  
  Su et al. [60], 2015 Lidan Decoction MD − 14.85 [− 21.51, − 8.19]  
  Zheng [65], 2019 Yinchen Decoction MD − 18.79 [− 20.85, − 16.73]  
  Mao and He [67], 2014 Qingganlidan Decoction MD −11.20 [− 14.27, − 8.13]  
8.2.4 Herbal medicine plus UDCA, SAMe and dexamethasone versusUDCA, SAMe and dexamethasone
  Shan et al. [50], 2016 Huashilidan Decoction MD-2.19 [− 6.05, 1.67] 0.27
8.2.5 Herbal medicine plus dexamethasone versus dexamethasone  
  Liu et al. [38], 2015 Yinchenlidan Decoction MD-17.48 [−24.21, − 10.75]  
  Zhao [41], 2011 Qingyulidan Decoction MD-4.65 [− 8.58, − 0.72]  
  Chen and Mo [55], 2005 Self prescribed prescription MD-6.54 [− 12.97, − 0.11]  
9. The average gestational age of the newborn
 9.1 Herbal medicine vs. Conventional medicine
  Zhang [31], 2006 Self prescribed prescription vs. SAMe and Reduced glutathione MD 1.80 [1.04,2.56]  
  Li et al. [14], 2015 Yinchenhao Decoction vs. UDCA and SAMe MD − 0.50 [− 1.31,0.31]  
  Huang and Liu [34], 2004 Yinchenhao Decoction vs SAMe MD 0.70 [− 0.35, 1.75]  
 9.2 Herbal medicine plus Conventional medicine versus Conventional medicine
  Li et al. [14], 2015 Yinchenhao Decoctionplus UDCA plus SAMe versus UDCA plus SAMe MD 0.40 [− 0.37, 1.17]  
  Gu et al. [66], 2014 Yinchenhao Decoction plus UDCA and SAMe versus UDCA and SAMe MD 0.46 [− 0.29, 1.21]  
  Zhu and Huang [69], 2008 Yinchenhao Decoction plus UDCA versus UDCA MD 0.70 [− 0.35, 1.75]  
Overall (FEM, I2 = 0%) MD 0.49 [0.01, 0.97] 0.05
10. The number of premature birth
 10.1 Herbal medicine vs. Conventional medicine
  Yang [32], 2015 Yinzhihuang oral liquid vs UDCA RR 0.33 [0.04, 3.03]  
  Zhang et al. [35], 2006 Jiaweiyinchen Decoction vs DXM RR 0.23 [0.03, 1.97]  
Overall (FEM, I2 = 0%) RR 0.28 [0.06, 1.27] 0.10
 10.2 Herbal medicine plus Conventional medicine versus Conventional medicine
  Wang et al. [36], 2016 Yinzhihuang oral liquid plus UDCA and SAMe versus UDCA and SAMe RR 0.27 [0.08, 0.90]  
  Zhou et al. [37], 2017 Yinchailishi Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.13 [0.02, 0.94]  
  Wang X et al. [39], 2016 Danyu Decoction plus UDCA versus UDCA RR 0.30 [0.09, 1.03]  
  Yu [40], 2017 Yinzhijiangdansuan Decoction plus UDCA versus UDCA RR 0.32 [0.04, 2.91]  
  Zhao [41], 2011 Qingyulidan Decoctionplus DXM, SAMe and phenobarbital versus DXM, SAMe plus phenobarbital RR 0.45 [0.15, 1.42]  
  Shen and Tao [43], 2009 Tuihuangguyuan Decoction plus SAMe versus SAMe RR 0.50 [0.18, 1.38]  
  Wen et al. [44], 2014 Self prescribed prescription plus SAMe versus SAMe RR 0.47 [0.22, 1.01]  
  Lu [45], 2013 Yinchenzhuyedihuang Decoction plus UDCA versus UDCA RR 0.26 [0.07, 0.99]  
  Tian et al. [47], 2016 Kangdanyu Decoction plus Reduced glutathione, UDCA, SAMe and DXM versus Reduced glutathione, UDCA and SAMe RR 1.50 [0.84, 2.68]  
  Ding et al. [48], 2010 Qingganhuayu Decoction plus SAMe versus SAMe RR 0.51 [0.32, 0.82]  
  Shan et al. [50], 2016 Huashilidan Decoction plus UDCA, SAMe and dexamethasone versus UDCA, SAMe and dexamethasone RR 0.33 [0.07, 1.57]  
  Lan et al. [51], 2016 Yinchenhao Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.42 [0.16, 1.07]  
  Zhang [52], 2015 Yinchenhao Decoction plus SAMe versus SAMe RR 0.29 [0.10, 0.79]  
  Yin [53], 2015 Bushenqingli Decoction plus UDCA versus UDCA RR 0.25 [0.06, 1.08]  
  Ma [56], 2010 Self prescribed prescription plus UDCA versus UDCA RR 0.36 [0.13, 1.03]  
  Su et al. [60], 2015 Lidan Decoction plus UDCA, SAMe and
Magnesium isoglycyrrhizinate versus UDCA, SAMe and
Magnesium isoglycyrrhizinate
RR 0.33 [0.04, 3.06]  
  Wang et al. [62], 2018 Yinzhihuang granule plus UDCA, SAMe and DXM versus UDCA, SAMe and DXM RR 0.18 [0.04, 0.75]  
  Wei [63], 2016 Self prescribed prescription plus UDCA versus UDCA RR 0.33 [0.07, 1.52]  
  Zhang [64], 2017 Lidan Decoction plus UDCA versus UDCA RR 0.29 [0.06, 1.32]  
  Zheng [65], 2019 Yinchen Decoction plus UDCA, SAMe and Phenobarbital versus UDCA, SAMe and Phenobarbital RR 0.20 [0.01, 4.04]  
  Mao and He [67], 2014 Qingganlidan Decoction plus UDCA and SAMe versus UDCA and SAMe RR 0.23 [0.07, 0.77]  
  Mao [68], 2016 Yinchenhao Decoction plus UDCA versus UDCA RR 0.49 [0.05, 5.15]  
  Liu et al. [70], 2019 Wuling pill plus SAMe versus SAMe RR 0.43 [0.12, 1.58]  
  Wang et al. [71], 2015 Yinchenhao Decoction plus SAMe versus SAMe RR 0.60 [0.17, 2.18]  
  Du and Li [72], 2014 Yiguanjian Decoction plus UDCA and DXM versus UDCA and DXM RR 0.31 [0.12, 0.82]  
Overall (FEM, I2 = 7%) RR 0.41 [0.34, 0.51] < 0.00001
  1. UDCA Ursodesoxycholic acid, SAMe S-adenosylmethionine, DXM Dexamethasone, VK3 Vitamin K3, MD Mean Difference, RR Risk Ratio, FEM Fixed effect model, REM Random effect model