Efficacy and safety of yaobitong capsules for lumbar disc herniation: a systematic review and meta-analysis.

BACKGROUND

Lumbar disc herniation (LDH) is a major contributor to the global burden of low back pain. Yaobitong (YBT) capsules are a commercial Chinese polyherbal preparation that has been widely used to treat LDH. However, its efficacy and safety require comprehensive evaluation.

METHODS

A comprehensive search was conducted across eight databases, retrieving literature from the inception of each database up to 31 October 2025. Randomized controlled trials (RCTs) evaluating YBT alone or in combination with standard pharmacological therapy were included. Subgroup and sensitivity analyses explored outcome stability. Publication bias was assessed using funnel plots, Egger's test, and Begg's rank correlation test. Study quality was evaluated using the Cochrane Risk of Bias (RoB) tool, and evidence certainty was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis was performed using RevMan 5.3 and R software.

RESULTS

Seventeen RCTs involving 1,752 patients with LDH were included. Compared with standard pharmacological therapy, YBT capsules significantly improved VAS (MD = -1.37, 95% CI: -1.60 to -1.14), ODI (MD = -5.36, 95% CI: -6.56 to -4.16), and JOA scores (MD = 5.21, 95% CI: 3.66-6.75). Additionally, YBT capsules significantly reduced levels of inflammatory cytokines including IL-6, IL-8, and TNF-α, supporting potential anti-inflammatory effects. Adverse events were mild and less frequent in the YBT capsules group (RR = 0.34, 95% CI: 0.18-0.67). Subgroup and sensitivity analyses demonstrated consistent results across varying sample sizes, treatment periods, and regimens, supporting the robustness of the study findings.

CONCLUSION

YBT capsule-based therapy was associated with reduced pain, improved functional outcomes, and suppressed inflammatory responses in LDH, while exhibiting a favorable short-term safety profile. These findings support YBT capsules as a potentially effective adjunct to conventional therapy. However, most trials were small, single-center studies conducted in China. Large-scale, multicenter RCTs with standardized outcomes are needed to confirm long-term safety and clinical utility.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251232067, identifier CRD420251232067.