Zhang Yang, Ma Hongzhao, Nan Tao, Li Yongqiang, Zheng Wei, Zhou Zhihui, Gong Xiaoyong
Shaanxi University of Chinese Medicine, Xianyang, China.
The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China.
Front Pharmacol. 2021 May 10;12:649470. doi: 10.3389/fphar.2021.649470. eCollection 2021.
Oral Chinese patent medicine (OCPM) combined with western medicine (WM) are believed to be effective for the therapy of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with sexual dysfunction (SD). These western medicines mainly involve antibiotics, phosphodiesterase type-5 inhibitor (PDE-5i), α-blockers. But there is no randomized controlled trial (RCT) that directly compares the efficacy of different OCPM. Hence, we operated a network meta-analysis (NMA) to contrast the efficacy of different OCPM for CP/CPPS with SD. Relevant studies were searched in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. All of the RCTs concentrated on the use of OCPM to cure CP/CPPS with SD from the inception of the databases to November 2020. We appraised the risk of bias under the Cochrane Handbook and CONSORT statement. The data were statistically analyzed STATA 13.0 and WinBUGS 1.4.3 instrument. Altogether, 30 pieces of literature with 2,996 participants containing 11 oral Chinese patent medicine and 11 interventions were included in the NMA. In terms of The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), Qianlie Shutong Capsules (QLSTC) + WM had the most possible of being the optimal treatment. In the light of the International Index of Erectile Function (IIEF-5), Congrong Yishen Granules (CRYSG) + WM had the most possible of being the optimal treatment. Shugan Yiyang Capsules (SGYYC) + WM performed the highest likelihood efficacy under cluster rank graph combined NIH-CPSI and IIEF-5. Liuwei Dihuang Pills/Yougui capsules (LWDHP/YGC) + WM had highly possible to be the optimal treatment not only for the clinical effective rate of CP/CPPS but also for the clinical effective rate of SD. Considering four outcomes, QLSTC, CRYSG, SGYYC, LWDHP/YGC, Qianlie Beixi Capsules (QLBXC) plus WM were the best therapy approach for CP/CPPS with SD, especially LWDHP/YGC + WM and QLBXC + WM. Based on the NMA, QLSTC, CRYSG, SGYYC, LWDHP/YGC, QLBXC plus WM demonstrated the maximum probability of being the optimal therapies. Owing to the limitations of this research, these results should be confirmed by elaborate RCTs. [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021224060].
口服中成药（OCPM）联合西药（WM）被认为对治疗伴有性功能障碍（SD）的慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）有效。这些西药主要包括抗生素、5型磷酸二酯酶抑制剂（PDE-5i）、α受体阻滞剂。但尚无直接比较不同口服中成药疗效的随机对照试验（RCT）。因此，我们进行了一项网络荟萃分析（NMA），以对比不同口服中成药治疗伴有SD的CP/CPPS的疗效。在PubMed、Cochrane图书馆、科学网、Embase、中国知网（CNKI）、中文科技期刊数据库（维普）和万方数据库中检索相关研究。所有RCT均聚焦于从各数据库建库至2020年11月期间使用口服中成药治疗伴有SD的CP/CPPS。我们根据Cochrane手册和CONSORT声明评估偏倚风险。数据采用STATA 13.0和WinBUGS 1.4.3软件进行统计分析。NMA共纳入30篇文献，2996名参与者，包含11种口服中成药和11种干预措施。就美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）而言，前列舒通胶囊（QLSTC）+西药最有可能是最佳治疗方法。根据国际勃起功能指数（IIEF-5），苁蓉益肾颗粒（CRYSG）+西药最有可能是最佳治疗方法。疏肝益阳胶囊（SGYYC）+西药在结合NIH-CPSI和IIEF-5的聚类排序图下疗效可能性最高。六味地黄丸/右归丸（LWDHP/YGC）+西药不仅对CP/CPPS的临床有效率，而且对SD的临床有效率都极有可能是最佳治疗方法。综合四项结果，QLSTC、CRYSG、SGYYC、LWDHP/YGC、前列倍喜胶囊（QLBXC）加西药是治疗伴有SD的CP/CPPS的最佳治疗方法，尤其是LWDHP/YGC+西药和QLBXC+西药。基于NMA，QLSTC、CRYSG、SGYYC、LWDHP/YGC、QLBXC加西药成为最佳治疗方法的概率最大。由于本研究存在局限性，这些结果应通过精心设计的RCT加以证实。[https://www.crd.york.ac.uk/prospero/]，标识符[CRD42021224060]
