中药足浴作为痛经辅助治疗的有效性和安全性：一项系统评价与Meta分析
Effectiveness and safety of Chinese herbal footbaths as an adjuvant therapy for dysmenorrhea: a systematic review and meta-analysis.
作者信息
Tian Xiaoping, Wei Jingwen, Zhuang Yijia, Lin Xiaoding, Liu Liu, Xia Jun, Huai Wenying, Xiong Ying, Chen Yunhui
机构信息
CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
出版信息
Front Pharmacol. 2024 Aug 5;15:1397359. doi: 10.3389/fphar.2024.1397359. eCollection 2024.
OBJECTIVES
To evaluate the effectiveness and safety of Chinese herbal footbaths (CHF) as an adjunctive therapy in managing dysmenorrhea.
METHODS
Ten electronic databases were searched to identify eligible randomized clinical trials (RCTs) from inception until June 2023. Outcome measurements encompassed the total effective rate, visual analog scale (VAS) score of pain intensity, Cox menstrual symptom scale (CMSS) score, symptom score, Traditional Chinese Medicine (TCM) syndrome scale, and any reported adverse events. The methodological quality of the included studies was assessed with the Cochrane collaboration tool. Review Manager 5.3 software was employed for quantitative synthesis, and funnel plots were utilized to evaluate potential reporting bias.
RESULTS
Eighteen RCTs with 1,484 dysmenorrhea patients were included. The aggregated results suggested that the adjunctive CHF could significantly ameliorate dysmenorrhea, as evident from the improved total effective rate [risk ratio (RR) 1.18, 95% confidence interval (CI): 1.12 to 1.23, < 0.00001], VAS (MD 0.88, 95% CI: 0.68 to 1.09, < 0.00001), CMSS (MD 3.61, 95% CI: 2.73 to 4.49, < 0.00001), symptom score (SMD 1.09, 95% CI: 0.64 to 1.53, < 0.00001), and TCM syndrome scale (MD 3.76, 95% CI: 2.53 to 4.99, < 0.0001). In addition, CHF presented fewer adverse events with a better long-term effect (RR 1.34, 95% CI: 1.11 to 1.63, < 0.01) and diminished recurrence rate (RR 0.19, 95% CI: 0.09 to 0.39, < 0.0001).
CONCLUSION
Current evidence implies that CHF may be an effective and safe adjunctive therapy for patients with dysmenorrhea. However, the methodological quality of the studies included was undesirable, necessitating further verification with more well-designed and high-quality multicenter RCTs.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256, identifier registration number.
目的
评估中药足浴作为痛经辅助治疗方法的有效性和安全性。
方法
检索了10个电子数据库，以识别从数据库建立至2023年6月的合格随机临床试验（RCT）。结局指标包括总有效率、疼痛强度视觉模拟量表（VAS）评分、考克斯月经症状量表（CMSS）评分、症状评分、中医证候量表以及任何报告的不良事件。使用Cochrane协作工具评估纳入研究的方法学质量。采用Review Manager 5.3软件进行定量合成，并利用漏斗图评估潜在的报告偏倚。
结果
纳入了18项RCT，共1484例痛经患者。汇总结果表明，中药足浴辅助治疗可显著改善痛经，总有效率提高[风险比（RR）1.18，95%置信区间（CI）：1.12至1.23，P<0.00001]、VAS评分（平均差（MD）0.88，95%CI：0.68至1.09，P<0.00001）、CMSS评分（MD 3.61，95%CI：2.73至4.49，P<0.00001）、症状评分（标准化均数差（SMD）1.09，95%CI：0.64至1.53，P<0.00001）以及中医证候量表评分（MD 3.76，95%CI：2.53至4.99，P<0.0001）均有体现。此外，中药足浴不良事件较少，长期效果更好（RR 1.34，95%CI：1.11至1.63，P<0.01）且复发率降低（RR 0.19，95%CI：0.09至0.39，P<0.0001）。
结论
现有证据表明，中药足浴可能是痛经患者一种有效且安全的辅助治疗方法。然而，纳入研究的方法学质量不理想，需要更多设计良好的高质量多中心RCT进一步验证。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256，标识符注册号。
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