Xinbin Wang , Zhongwen Zhang , Haorui Wang , Ruilin Ma , Lili Wang , Xianhui Zhang , Yi Zhang , Rong Wang
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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).</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusions</h3><p>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. 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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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Results</h3><p>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. 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引用次数: 0
摘要
引言原发性痛经(PD)是青少年和年轻女性常见的妇科疾病。中草药在中国已被广泛用于帕金森病的治疗。然而,不同CHM方案的相对优势仍不确定。本系统综述旨在使用网络荟萃分析比较不同中药治疗帕金森病的疗效和安全性。方法我们检索了PubMed、Embase、Web of Science、中国知识基础设施(CNKI)和中国生物医学文献数据库(CBM),从它们成立到2022年12月17日。随机对照试验(RCTs)将中药或中成药与前列腺素合成酶抑制剂(PGSI)进行比较。使用Cochrane偏倚风险工具评估偏倚风险。结果共纳入54例随机对照试验,5345例帕金森病患者。与PGSI相比,当归四逆汤(平均差[MD]=5.92,95%可信区间[CI]-8.64--3.20)和香附四物汤(MD=-4.63,95%CI-8.37--0.89)显著减轻疼痛。;当归四逆汤(危险比[RR]=1.31,95%CI 1.12至1.53)、当归烧药散(RR=1.23,95%CI 1.05至1.44)、四物汤(RR=1.32,95%CI 1.17至1.47)、桃红四物汤,温精汤可显著降低中医证候积分(MD=4.14,95%CI-6.84--1.44)。未观察到严重不良事件。在所有感兴趣的结果(P评分排名)方面,四物汤和文静汤是首选治疗方案。结论与常规治疗相比,sCHMs与PD患者的总有效率、疼痛减轻和症状减轻有关,没有观察到严重的不良事件。然而,由于缺乏高质量的试验,对结论的信心有限。
Chinese herbal medicine for primary dysmenorrhea: A systematic review and network meta-analysis of 54 randomized controlled trials
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.