Wu Lizheng, Jing Shangwen, Li Na, Cao Dandan, Pei Fangli, Luo Yantong, Chen Xiaoxin, Huang Yingjie, Zeng Cheng
The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Front Pharmacol. 2025 Feb 3;16:1484325. doi: 10.3389/fphar.2025.1484325. eCollection 2025.
To systematically evaluate the differences in the efficacy of commonly used topical commercial Chinese polyherbal preparations (CCPPs) for vulvovaginal candidiasis (VVC), and to provide evidence-based reference for clinical drug regimens.
Computer searched major Chinese and English literature databases, and collected randomized controlled trials (RCTs) of external use of CCPPs combined with conventional treatment (CT, test group) versus CT alone (control group) in patients with VVC. After screening the literature, the quality of the included studies was assessed using the risk of bias assessment tool recommended in 5.3 of the Cochrane Handbook. Outcome data for each outcome measure were extracted and a network meta-analysis was performed using Stata 15.0.
A total of 74 RCTs with a total of 8,151 patients were included, nine interventions were involved. The results of network meta-analysis showed that, Fufang Shajiziyou suppository combined with CT was more effective in improving the negative conversion rate and controlling the recurrence rate of albicans. Kangfu gel combined with CT had the better effect in relieving pruritus. Baofukang suppository combined with CT was the most effective in reducing leukorrhea. Fufukang spray combined with CT had fewer adverse reactions.
The addition of CCPPs to CT may acquire a better curative effect in patients with VVC and external does not significantly increase the occurrence of adverse reactions. However, due to the low quality of the included literature, larger-scale, higher-quality clinical studies are still needed.
PROSPERO, NO: CRD42023410244.
系统评价常用外用中药复方制剂治疗外阴阴道假丝酵母菌病(VVC)的疗效差异,为临床用药方案提供循证参考。
计算机检索中英文主要文献数据库,收集外用中药复方制剂联合常规治疗(试验组)与单纯常规治疗(对照组)用于VVC患者的随机对照试验(RCT)。文献筛选后,采用Cochrane手册5.3推荐的偏倚风险评估工具对纳入研究的质量进行评估。提取各结局指标的结局数据,使用Stata 15.0进行网状Meta分析。
共纳入74项RCT,共计8151例患者,涉及9种干预措施。网状Meta分析结果显示,复方沙棘籽油栓联合常规治疗在提高白色念珠菌转阴率和控制复发率方面更有效。康复凝胶联合常规治疗在缓解瘙痒方面效果较好。保妇康栓联合常规治疗在减少白带方面最有效。妇肤康喷雾剂联合常规治疗不良反应较少。
VVC患者在常规治疗基础上加用中药复方制剂可能获得更好的疗效,且外用未显著增加不良反应的发生。然而,由于纳入文献质量较低,仍需要开展更大规模、更高质量的临床研究。
PROSPERO,编号:CRD42023410244。