Systematic Review of Chinese Medicine for the Treatment of Dysfunctional Uterine Bleeding

Objectives: To evaluate the effectiveness of Chinese medicine in treating dysfunctional uterine bleeding via a systematic review and meta-analysis. Methods: Clinical trials of Chinese medicine treating dysfunctional uterine bleeding were retrieved with specific search strategy in the following databases: CNKI (from 1994 to December 2016), Wan Fang (from 1980 to December 2016), Pro Quest Medical Database (from 1980 to December 2016), MEDLINE (from 1950 to December 2016) and PUBMED (from 1980 to December 2016). Eligible randomized controlled trials (RCTS) were selected with the inclusion and exclusion criteria. The quality of trials was accessed by the risk of bias assessment tool. Data was extracted into Excel and analyzed by Software Rev Man 5.3. Result: A total of 21 RCTs were included with 2167 patients. The meta-analysis showed that the Chinese medicine group had higher recovery rate than that of the Western medicine group [OR=2.26, 95% CI (1.86, 2.74), P<0.00001]. The effectiveness of Chinese medicine was superior to the Western medicine [OR=3.93, 95% CI (2.99, 5.169), P<0.00001]. There were no significant difference in bleeding arrest in 3 days [OR=0.90, 95% CI (0.49, 1.63), P=0.73] and in 10 days [OR=1.40, 95% CI (0.80, 2.44), P=0.24] between Chinese medicine group and Western medicine group. Few side effects were observed in the Chinese medicine group [OR=0.04, 95% CI (0.01, 0.11), P<0.0001]. The Chinese medicine group also had a lower recurrence rate than that of Western medicine group [OR=0.16, 95% CI (0.06, 0.47), P=0.0008]. Conclusion: Chinese medicine appears to have better overall clinical effect in treating dysfunctional uterine bleeding with less side effects and lower chance of recurrence. However, the quality of the included studies needs to be improved; the findings should be interpreted with caution. Further large-scale, rigorously designed trials are warranted to confirm the findings.