Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review

Background: Squama Manitis (pangolin scale) has been used in traditional Chinese medicine for thousands of years. However, its efficacy has not been systematically reviewed. This review aims to fill the gap. Methods: We searched six electronic databases including PubMed, Embase, Cochrane Library, Ch...

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Main Authors: Xinyao Jin, Hui Zi Chua, Keyi Wang, Nan Li, Wenke Zheng, Wentai Pang, Fengwen Yang, Bo Pang, Mingyan Zhang, Junhua Zhang
Format: Article
Language:English
Published: Elsevier 2021-03-01
Series:Integrative Medicine Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213422020301189
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author Xinyao Jin
Hui Zi Chua
Keyi Wang
Nan Li
Wenke Zheng
Wentai Pang
Fengwen Yang
Bo Pang
Mingyan Zhang
Junhua Zhang
author_facet Xinyao Jin
Hui Zi Chua
Keyi Wang
Nan Li
Wenke Zheng
Wentai Pang
Fengwen Yang
Bo Pang
Mingyan Zhang
Junhua Zhang
author_sort Xinyao Jin
collection DOAJ
description Background: Squama Manitis (pangolin scale) has been used in traditional Chinese medicine for thousands of years. However, its efficacy has not been systematically reviewed. This review aims to fill the gap. Methods: We searched six electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database and SinoMed from inception to May 1, 2020. Search terms included “pangolin”, “Squama Manitis”, “Manis crassicaudata”, “Manis javanica”, “Malayan pangolins”, “Manis pentadactyla”, “Ling Li”, “Chuan Shan Jia”, “Shan Jia”, “Pao Jia Zhu”, “Jia Pian” and “Pao Shan Jia”. The Cochrane Risk of Bias (RoB) assessment tool and Newcastle-Ottawa Scale (NOS) were used to evaluate the risk of bias of the included randomized controlled trials (RCTs) and case control studies (CCSs). Results: After screening, 15 articles that met the inclusion criteria were finally included. There were 4 randomized controlled trials, 1 case control study, 3 case series and 7 case reports. A total of 15 different diseases were reported in these studies, thus the data could not be merged to generate powerful results. Two RCTs suggested that Squama Manitis combined with herbal decoction or antibiotics could bring additional benifit for treating postpartum hypogalactia and mesenteric lymphadenitis. However, this result was not reliable due to low methodological quality and irrational outcomes. The other two RCTs generated negative results. All the non-RCTs did not add any valuable evidence to the efficacy of Squama Manitis beacause of small samples, incomplete records, non-standardized outcome detection. In general, currently available evidence cannot support the clinical use of Squama Manitis. Conclusion: There is no reliable evidence that Squama Manitis has special medicinal value. The removal of Squama Manitis from Pharmacopoeia is rational.
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spelling doaj-art-c3062d89d8ad46eda75269890b8d3ab42025-08-20T03:04:51ZengElsevierIntegrative Medicine Research2213-42202021-03-0110110048610.1016/j.imr.2020.100486Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic reviewXinyao Jin0Hui Zi Chua1Keyi Wang2Nan Li3Wenke Zheng4Wentai Pang5Fengwen Yang6Bo Pang7Mingyan Zhang8Junhua Zhang9Evidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaCorresponding authors at: Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, No. 10 Poyanghu Road, Jinghai District, Tianjin 301617, China (W. Zheng); (J. Zhang).; Evidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaEvidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaCorresponding authors at: Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, No. 10 Poyanghu Road, Jinghai District, Tianjin 301617, China (W. Zheng); (J. Zhang).; Evidence-Based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaBackground: Squama Manitis (pangolin scale) has been used in traditional Chinese medicine for thousands of years. However, its efficacy has not been systematically reviewed. This review aims to fill the gap. Methods: We searched six electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database and SinoMed from inception to May 1, 2020. Search terms included “pangolin”, “Squama Manitis”, “Manis crassicaudata”, “Manis javanica”, “Malayan pangolins”, “Manis pentadactyla”, “Ling Li”, “Chuan Shan Jia”, “Shan Jia”, “Pao Jia Zhu”, “Jia Pian” and “Pao Shan Jia”. The Cochrane Risk of Bias (RoB) assessment tool and Newcastle-Ottawa Scale (NOS) were used to evaluate the risk of bias of the included randomized controlled trials (RCTs) and case control studies (CCSs). Results: After screening, 15 articles that met the inclusion criteria were finally included. There were 4 randomized controlled trials, 1 case control study, 3 case series and 7 case reports. A total of 15 different diseases were reported in these studies, thus the data could not be merged to generate powerful results. Two RCTs suggested that Squama Manitis combined with herbal decoction or antibiotics could bring additional benifit for treating postpartum hypogalactia and mesenteric lymphadenitis. However, this result was not reliable due to low methodological quality and irrational outcomes. The other two RCTs generated negative results. All the non-RCTs did not add any valuable evidence to the efficacy of Squama Manitis beacause of small samples, incomplete records, non-standardized outcome detection. In general, currently available evidence cannot support the clinical use of Squama Manitis. Conclusion: There is no reliable evidence that Squama Manitis has special medicinal value. The removal of Squama Manitis from Pharmacopoeia is rational.http://www.sciencedirect.com/science/article/pii/S2213422020301189PangolinSquama ManitisCoronavirus disease 2019Clinical efficacySystematic review
spellingShingle Xinyao Jin
Hui Zi Chua
Keyi Wang
Nan Li
Wenke Zheng
Wentai Pang
Fengwen Yang
Bo Pang
Mingyan Zhang
Junhua Zhang
Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
Integrative Medicine Research
Pangolin
Squama Manitis
Coronavirus disease 2019
Clinical efficacy
Systematic review
title Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
title_full Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
title_fullStr Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
title_full_unstemmed Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
title_short Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review
title_sort evidence for the medicinal value of squama manitis pangolin scale a systematic review
topic Pangolin
Squama Manitis
Coronavirus disease 2019
Clinical efficacy
Systematic review
url http://www.sciencedirect.com/science/article/pii/S2213422020301189
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