Xinbin Wang , Zhongwen Zhang , Haorui Wang , Ruilin Ma , Lili Wang , Xianhui Zhang , Yi Zhang , Rong Wang
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引用次数: 0
Abstract
Introduction
Primary dysmenorrhea (PD) is a common gynecological complaint among adolescents and young women. Chinese herbal medicines (CHMs) have been widely used for PD treatment in China. However, the relative advantages of different CHM regimens remain uncertain. This systematic review aimed to compare the efficacy and safety of different CHMs for the treatment of PD using network meta-analysis.
Methods
We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature Database (CBM) from their inception to December 17, 2022. Randomized controlled trials (RCTs) comparing CHM or Chinese patent drugs with Prostaglandin Synthetase Inhibitors (PGSIs) were included. Risk of bias was assessed using the Cochrane risk of bias tool. A frequentist framework network meta-analysis was performed using R (4.2.2).
Results
A total of 54 RCTs with 5,345 PD patients were included. Compared with PGSIs, Danggui Sini decoction (mean difference [MD] = -5.92, 95% confidence interval [CI] -8.64 to -3.20) and Xiangfu Siwu Decoction (MD = -4.63, 95%CI -8.37 to -0.89) reduced pain significantly.; Danggui Sini decoction (risk ratio[RR] = 1.31, 95%CI 1.12 to 1.53), Danggui shaoyao san (RR = 1.23, 95%CI 1.05 to 1.44), Siwu decoction (RR = 1.32, 95%CI 1.17 to 1.47), Taohong Siwu Decoction (RR = 1.35, 95%CI 1.14 to 1.61), and Wenjing decoction (RR = 1.33, 95%CI 1.19 to 1.52) showed significantly higher overall response rates, and Wenjing decoction could significantly reduce TCM syndrome scores (MD = -4.14, 95%CI -6.84 to -1.44), compared with PGSIs. No serious adverse events were observed. Siwu decoction and Wenjing decoction ranked as the top treatment options in terms of all outcomes of interest (P-score ranking).
Conclusions
CHMs were associated with improved overall response rate, pain reduction, and alleviation of symptoms compared to conventional treatments for patients with PD, and no serious adverse events were observed. However, the confidence in the conclusions is limited because of the lack of high-quality trials.
期刊介绍:
The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education.
EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians.
The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.