Zhang Li-Shuang, Yang Feng-Wen, Zhang Jun-Hua, Zheng Wen-Ke, Zhang Ming-Yan, Li Yue, Zhao Hong-Jie
Evidence Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.
Zhongguo Zhong Yao Za Zhi. 2017 Apr;42(8):1500-1509. doi: 10.19540/j.cnki.cjcmm.2017.0048.
This systematic review aims to systematically evaluate the efficacy and safety of Guizhi Fuling Capsule/Pill on the treatment of chronic pelvic inflammatory disease. We searched CNKI datebases,WanFang,SinoMed,PubMed,Embase,The Cochrane Library from the inception to February 2017,to collect randomized controlled trials(RCTs)of Guizhi Fuling Capsule/Pill in treating chronic pelvic inflammation disease.Two reviewers independently screened literature,extracted date and assessed the risk of bias of included studies.Then,the risk assessment of included references was evaluated according to criteria recommended by Cochrane Handbook 5.3.A total of 30 RCTs involving 3 586 patients were finally included.30 studies reported the clinical efficacy,the result of meta-analysis showed that:compared with the western medicine group,Guizhi Fuling (capsule,pill) combined with western medicine could significantly improve the clinical efficacy [RR=1.20,95%CI(1.16,1.23)];3 studies reported recurrence rate,the result of meta-analysis showed that:compared with the western medicine,Guizhi Fuling (capsule,pill) combined with western medicine could decrease the recurrence rate [RR=0.33,95%CI(0.18,0.62)]; Their secondary indicators mainly included hs-CRP, plasma viscosity ratio and tumor necrosis factor and fibrin,the result of meta-analysis showed that: Guizhi Fuling (capsule,pill) combined with western medicine was better than western medicine in terms of anti-inflammatory and improving blood circulation.17 studies reported adverse reactions,most of the adverse events were the irritation of gastrointestinal tract. The result showed that: compared with the western medicine group, the incidence of adverse reactions in Guizhi Fuling (capsule,pill) combined with western medicine group is low.Guizhi Fuling(capsule,pill) did not increase the adverse reactions. The available evidence suggests that: Guizhi Fuling(capsule, pill) compared with the western medicine group, Guizhi Fuling (capsule,pill) combined with western medicine was more effective than the western medicine group in terms of clinical efficacy, recurrence rate, anti-inflammatory and plasma viscosity.Due to the limited quality and quantity of included studies,more high quality RCTs are needed to verify the above conciusion.
本系统评价旨在系统评价桂枝茯苓胶囊/丸治疗慢性盆腔炎的有效性和安全性。我们检索了中国知网数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、考克兰图书馆,检索时间从建库至2017年2月,收集桂枝茯苓胶囊/丸治疗慢性盆腔炎的随机对照试验(RCT)。两名评价员独立筛选文献、提取数据并评估纳入研究的偏倚风险。然后,根据《考克兰手册5.3》推荐的标准对纳入参考文献进行风险评估。最终共纳入30项RCT,涉及3586例患者。30项研究报告了临床疗效,Meta分析结果显示:与西药组相比,桂枝茯苓(胶囊、丸)联合西药可显著提高临床疗效[RR = 1.20,95%CI(1.16,1.23)];3项研究报告了复发率,Meta分析结果显示:与西药相比,桂枝茯苓(胶囊、丸)联合西药可降低复发率[RR = 0.33,95%CI(0.18,0.62)];其次要指标主要包括超敏C反应蛋白、血浆黏度比、肿瘤坏死因子及纤维蛋白,Meta分析结果显示:桂枝茯苓(胶囊、丸)联合西药在抗炎及改善血液循环方面优于西药。17项研究报告了不良反应,多数不良事件为胃肠道刺激。结果显示:与西药组相比,桂枝茯苓(胶囊、丸)联合西药组不良反应发生率低。桂枝茯苓(胶囊、丸)未增加不良反应。现有证据表明:与西药组相比,桂枝茯苓(胶囊、丸)联合西药在临床疗效、复发率、抗炎及血浆黏度方面比西药组更有效。由于纳入研究的质量和数量有限,需要更多高质量的RCT来验证上述结论。