Lai Bao-Yong, Jia Li-Yan, Yu Bo-Wen, Liang Shi-Bing, Chu Ai-Jing, Cao Hui-Juan, Liu Jian-Ping, Pei Xiao-Hua
Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China.
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Integr Med Res. 2021 Jun;10(2):100491. doi: 10.1016/j.imr.2020.100491. Epub 2020 Jul 31.
Breast pain is one of the most common breast disorders, affecting 41%-69% women in the clinical populations. Chinese herbal medicine (Rupi Sanjie, RPSJ) capsule has been recommended to be commonly used for breast pain in China. This review aimed to systematically collect latest evidence and critically evaluate the eff ;ectiveness and safety of RPSJ capsule for breast pain.
We searched 6 databases from their inception to June 1, 2020 for randomized clinical trials (RCTs) comparing RPSJ capsule with conventional drug therapies, placebo or no treatment. Primary outcomes were breast pain relief, reduction of breast mass and clinical cure rate.
Seventeen RCTs were included in total, involving 2899 participants with breast pain. RPSJ capsule showed a significant effects in shortening duration of the breast pain (MD-6.51 days, 95%CI [-8.57, -4.45], n = 82, 1 trial), shortening the duration of breast mass (MD-5.17 days, 95%CI [-7.56, -2.78], n = 82, 1 trial), improving clinical cure rate (RR 1.55, 95% CI [1.21, 2.00], = 64%, n = 1398, 10 trials) and total effective rate (RR 1.08, 95% CI [1.03, 1.14], = 71%, n = 2170, 14 trials) compared to Tamoxifen (TAM). The meta-analysis showed that the incidence of total adverse events was higher in TAM group than the RPSJ capsule group (RR 0.30, 95%CI [0.21, 0.42], = 49%, n = 2122, 13 trials).
RPSJ capsule appears to be a potentially effective in treating breast pain and seems generally safe for clinical application. However, this potential benefit is inconclusive due to generally weak evidence, and the findings should be further confirmed in large and rigorous trials.
乳房疼痛是最常见的乳腺疾病之一,在临床人群中,有41%-69%的女性受其影响。在中国,中药(乳癖散结,RPSJ)胶囊已被推荐用于治疗乳房疼痛。本综述旨在系统收集最新证据,并严格评估RPSJ胶囊治疗乳房疼痛的有效性和安全性。
我们检索了6个数据库自建库至2020年6月1日期间,比较RPSJ胶囊与传统药物治疗、安慰剂或不治疗的随机临床试验(RCT)。主要结局指标为乳房疼痛缓解情况、乳房肿块缩小情况及临床治愈率。
共纳入17项RCT,涉及2899名乳房疼痛患者。与他莫昔芬(TAM)相比,RPSJ胶囊在缩短乳房疼痛持续时间(MD=-6.51天,95%CI[-8.57,-4.45],n=82,1项试验)、缩短乳房肿块持续时间(MD=-5.17天,95%CI[-7.56,-2.78],n=82,1项试验)、提高临床治愈率(RR=1.55,95%CI[1.21,2.00],I²=64%,n=1398,10项试验)和总有效率(RR=1.08,95%CI[1.03,1.14],I²=71%,n=2170,14项试验)方面显示出显著效果。荟萃分析表明,TAM组总不良事件发生率高于RPSJ胶囊组(RR=0.30,95%CI[0.21,0.42],I²=49%,n=2122,13项试验)。
RPSJ胶囊似乎是一种治疗乳房疼痛的潜在有效药物,临床应用总体上似乎是安全的。然而,由于证据普遍薄弱,这种潜在益处尚无定论,研究结果应在大规模、严格的试验中进一步得到证实。