College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea.
J Ethnopharmacol. 2024 Jan 30;319(Pt 2):117258. doi: 10.1016/j.jep.2023.117258. Epub 2023 Sep 29.
Infertility is a global public health issue related to gynecological diseases and psychological disorders such as stress, depression, and fatigue. Prescriptions of various herbs in traditional East Asian medicine (TEAM) have recently gained attention among patients as a complementary alternative therapy for female infertility. However, studies on systemic analysis of the use of herbal medicines according to TEAM patterns or the therapeutic effects of herbal medicines on female infertility are limited.
We aimed to systematically investigate the single herb and TEAM patterns that are commonly used for treating female infertility using network analysis. Additionally, we performed a meta-analysis to assess the effect of herbal medicine on the pregnancy rate in women with infertility.
PubMed, EMBASE, Korean Studies Information Service System, Science ON, Research Information Sharing Service, and Oriental Medicine Advanced Searching Integrated System were searched for randomized controlled trials (RCTs) reporting the pregnancy rate of herbal medicine for infertility until July 2021. Following identifying the top three herbs used in treating female infertility, a network analysis was performed to reveal the TEAM pattern relationships between each herb. A meta-analysis was performed to evaluate the therapeutic effect of herbal medicine on pregnancy rate. Moreover, the methodological quality of RCTs was analyzed using Consolidated Standards of Reporting Trials (CONSORT) extension guidelines and the Risk of bias (RoB) tool.
Eighteen RCTs with 2,662 participants were included. Cuscuta chinensis Lam. (Tusizi) is the most commonly used herb for treating female infertility, followed by Angelica gigas Nakai (Danggui) and Cyperus rotundus L. (Xiangfuzi). These herbs were mainly used to treat patients with kidney deficiency or kidney deficiency combined with blood stasis or Phlegm-dampness on the TEAM pattern. The meta-analysis revealed that the effect of herbal medicine led to a significant increase in pregnancy rates compared to the placebo treatment. Adverse events in the included studies were generally mild and infrequent. The methodological quality of RCTs using CONSORT extension was poor, while the RoB of the included RCTs was generally low.
The findings of this review suggest that herbal medicine will be beneficial for treating female infertility by improving pregnancy rates. However, more carefully designed studies on herbal medicines are encouraged to improve the quality of herbal medicine research in the future.
不孕是一个与妇科疾病和心理障碍相关的全球公共健康问题，如压力、抑郁和疲劳。传统东亚医学（TEAM）中各种草药的处方最近受到患者的关注，作为一种补充替代疗法治疗女性不孕。然而，根据 TEAM 模式或草药对女性不孕的治疗效果对草药进行系统分析的研究有限。
我们旨在通过网络分析系统地研究治疗女性不孕常用的单一草药和 TEAM 模式。此外，我们进行了荟萃分析，以评估草药对不孕妇女妊娠率的影响。
检索了 PubMed、EMBASE、韩国研究信息服务系统、Science ON、研究信息共享服务和东方医学高级搜索综合系统，以获取截至 2021 年 7 月报告草药治疗不孕妊娠率的随机对照试验（RCT）。在确定治疗女性不孕的前三种最常用草药后，进行了网络分析以揭示每种草药之间的 TEAM 模式关系。进行荟萃分析以评估草药对妊娠率的治疗效果。此外，使用 CONSORT 扩展指南和风险偏倚（RoB）工具分析 RCT 的方法学质量。
纳入了 18 项 RCT，涉及 2662 名参与者。菟丝子（菟丝子）是治疗女性不孕最常用的草药，其次是当归（当归）和香附（香附）。这些草药主要用于治疗肾虚或肾虚合并血瘀或痰湿的患者。荟萃分析表明，与安慰剂治疗相比，草药治疗导致妊娠率显著增加。纳入研究中的不良事件通常较轻且不常见。使用 CONSORT 扩展的 RCT 的方法学质量较差，而纳入 RCT 的 RoB 通常较低。
本综述的结果表明，草药治疗可能通过提高妊娠率对治疗女性不孕有益。然而，鼓励未来进行更精心设计的草药研究，以提高草药研究的质量。
