Lu Fan , Jiahui Hu , Mei Han , Guoyan Yang , Shibo Cong , Min Xiong , Ruiting Wang , Gansheng Zhong
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The GRADE tool was used to evaluate the quality of evidence, and the RevMan5.3 software was used for data analysis.</p></div><div><h3>Results</h3><p>Twenty studies with 1907 patients were analyzed. The meta-analysis results of 15 studies showed that Gong Liu Ning combined with mifepristone was more efficacious than those observed in controls taking only Western medicine (risk ratio [RR] = 1.22, 95% confidence interval [CI] = [1.11, 1.33], <em>P</em> < .001). Owing to the large heterogeneity, a random-effects model was used to merge the included studies. Gong Liu Ning combined with mifepristone was better in reducing the volume of uterine fibroids (mean difference [MD] = −4.09 cm<sup>3</sup>, 95%CI [−5.16, −3.02], <em>P</em> < .001), uterine volume (MD = −23.22 cm<sup>3</sup>, 95%CI [−29.10, −17.33], <em>P</em> < .001), and the levels of female hormones, including progesterone, estrogen, follicle-stimulating hormone, and luteinizing hormone (all <em>P</em> < .001). Ten studies reported adverse events. The methodological quality of the included studies was not high, and a moderate risk of bias was observed.</p></div><div><h3>Conclusion</h3><p>Compared with conventional Western medicine alone, the combined use of Gong Liu Ning has certain advantages in improving efficacy. It shows a certain advanced tendency to reduce the volume of uterine fibroids, uterine volume, and female hormones; however, more high-quality and rigorously designed studies are required for validation.</p></div>","PeriodicalId":36624,"journal":{"name":"Journal of Traditional Chinese Medical Sciences","volume":"10 4","pages":"Pages 415-426"},"PeriodicalIF":0.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systematic review of randomized controlled trials on Gong Liu Ning as a complimentary therapy in the treatment of uterine fibroids\",\"authors\":\"Lu Fan , Jiahui Hu , Mei Han , Guoyan Yang , Shibo Cong , Min Xiong , Ruiting Wang , Gansheng Zhong\",\"doi\":\"10.1016/j.jtcms.2023.09.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To systematically evaluate the efficacy and safety of Gong Liu Ning as a complimentary therapy in treatment for uterine fibroids.</p></div><div><h3>Methods</h3><p>Randomized controlled trials on Gong Liu Ning for uterine fibroids from China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, PubMed, Cochrane Library, Embase, Web of Science, Chinese Clinical Trial Registry, and <span>ClinicalTrials.gov</span><svg><path></path></svg> were retrieved from inception to March 20, 2023. The risk of bias tool was used to evaluate the quality of the selected studies after they met inclusion and exclusion criteria. The GRADE tool was used to evaluate the quality of evidence, and the RevMan5.3 software was used for data analysis.</p></div><div><h3>Results</h3><p>Twenty studies with 1907 patients were analyzed. The meta-analysis results of 15 studies showed that Gong Liu Ning combined with mifepristone was more efficacious than those observed in controls taking only Western medicine (risk ratio [RR] = 1.22, 95% confidence interval [CI] = [1.11, 1.33], <em>P</em> < .001). Owing to the large heterogeneity, a random-effects model was used to merge the included studies. Gong Liu Ning combined with mifepristone was better in reducing the volume of uterine fibroids (mean difference [MD] = −4.09 cm<sup>3</sup>, 95%CI [−5.16, −3.02], <em>P</em> < .001), uterine volume (MD = −23.22 cm<sup>3</sup>, 95%CI [−29.10, −17.33], <em>P</em> < .001), and the levels of female hormones, including progesterone, estrogen, follicle-stimulating hormone, and luteinizing hormone (all <em>P</em> < .001). Ten studies reported adverse events. The methodological quality of the included studies was not high, and a moderate risk of bias was observed.</p></div><div><h3>Conclusion</h3><p>Compared with conventional Western medicine alone, the combined use of Gong Liu Ning has certain advantages in improving efficacy. 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引用次数: 0
摘要
目的系统评价宫刘宁辅助治疗子宫肌瘤的疗效和安全性。方法从中国国家知识基础设施、万方、中国科技期刊数据库、PubMed、Cochrane Library、Embase、Web of Science、中国临床试验注册中心和ClinicalTrials.gov检索龚刘宁治疗子宫肌瘤的随机对照试验。在符合纳入和排除标准后，使用偏倚风险工具来评估所选研究的质量。GRADE工具用于评估证据质量，RevMan5.3软件用于数据分析。结果对1907例患者的20项研究进行了分析。对15项研究的荟萃分析结果表明，宫刘宁联合米非司酮比仅服用西药的对照组更有效（风险比[RR]=1.22，95%置信区间[CI]=[1.11,3]，P<；.001）。由于异质性大，采用随机效应模型合并纳入的研究。宫刘宁联合米非司酮治疗子宫肌瘤体积（平均差[MD]=-4.09cm3，95%CI[-5.16,-3.02]，P<；.001）、子宫体积（MD=-23.22cm3，95%CI[-29.10,-17.3]，P>；.001）及女性激素水平（包括孕酮、雌激素、促卵泡激素，和促黄体生成素（均P＜0.001）。10项研究报告了不良事件。纳入研究的方法学质量不高，观察到中度偏倚风险。结论宫六宁与传统西药单用相比，在提高疗效方面有一定的优势。它表现出一定的晚期倾向，减少子宫肌瘤体积、子宫体积和女性激素；然而，需要更高质量和严格设计的研究来进行验证。
Systematic review of randomized controlled trials on Gong Liu Ning as a complimentary therapy in the treatment of uterine fibroids
Objective
To systematically evaluate the efficacy and safety of Gong Liu Ning as a complimentary therapy in treatment for uterine fibroids.
Methods
Randomized controlled trials on Gong Liu Ning for uterine fibroids from China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, PubMed, Cochrane Library, Embase, Web of Science, Chinese Clinical Trial Registry, and ClinicalTrials.gov were retrieved from inception to March 20, 2023. The risk of bias tool was used to evaluate the quality of the selected studies after they met inclusion and exclusion criteria. The GRADE tool was used to evaluate the quality of evidence, and the RevMan5.3 software was used for data analysis.
Results
Twenty studies with 1907 patients were analyzed. The meta-analysis results of 15 studies showed that Gong Liu Ning combined with mifepristone was more efficacious than those observed in controls taking only Western medicine (risk ratio [RR] = 1.22, 95% confidence interval [CI] = [1.11, 1.33], P < .001). Owing to the large heterogeneity, a random-effects model was used to merge the included studies. Gong Liu Ning combined with mifepristone was better in reducing the volume of uterine fibroids (mean difference [MD] = −4.09 cm3, 95%CI [−5.16, −3.02], P < .001), uterine volume (MD = −23.22 cm3, 95%CI [−29.10, −17.33], P < .001), and the levels of female hormones, including progesterone, estrogen, follicle-stimulating hormone, and luteinizing hormone (all P < .001). Ten studies reported adverse events. The methodological quality of the included studies was not high, and a moderate risk of bias was observed.
Conclusion
Compared with conventional Western medicine alone, the combined use of Gong Liu Ning has certain advantages in improving efficacy. It shows a certain advanced tendency to reduce the volume of uterine fibroids, uterine volume, and female hormones; however, more high-quality and rigorously designed studies are required for validation.
期刊介绍：
Production and Hosting by Elsevier B.V. on behalf of Beijing University of Chinese Medicine Peer review under the responsibility of Beijing University of Chinese Medicine. Journal of Traditional Chinese Medical Sciences is an international, peer-reviewed publication featuring advanced scientific research in Traditional Chinese medicine (TCM). The journal is sponsored by Beijing University of Chinese Medicine and Tsinghua University Press, and supervised by the Ministry of Education of China. The goal of the journal is to serve as an authoritative platform to present state-of-the-art research results. The journal is published quarterly. We welcome submissions of original papers on experimental and clinical studies on TCM, herbs and acupuncture that apply modern scientific research methods. The journal also publishes case reports, reviews, and articles on TCM theory and policy.
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