Kim Eun-Jin, Shim Young-Shin, Sung Hyun-Kyung, Min Sang-Yeon
Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Seongnam-si 13601, Gyeonggi-do, Republic of Korea.
Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Seoul 04620, Republic of Korea.
Pharmaceuticals (Basel). 2025 Jun 4;18(6):843. doi: 10.3390/ph18060843.
Adenomyosis (AM) is a hormone-dependent gynecological disorder that negatively impacts the quality of life and fertility of reproductive-age women. This study aimed to evaluate the effectiveness of herbal medicine (HM) as a post-treatment strategy following high-intensity focused ultrasound (HIFU) therapy. : English, Chinese, and Korean databases were systematically searched up to 24 March 2025. Eligible randomized controlled trials (RCTs) compared HM administration after HIFU therapy with HIFU therapy alone. Statistical analyses included mean difference (MD), standardized mean difference (SMD), and risk ratio (RR) with 95% confidence intervals (CIs). Evidence quality was assessed using GRADE approach. The protocol was registered with INPLASY (No.: INPLASY202530088). : Fourteen RCTs involving 1259 patients were included in the review. HM administration after HIFU therapy showed superior efficacy over HIFU therapy alone in reducing uterine volume (MD = -11.84, 95% CI: -13.74 to -9.95; < 0.00001), adenomyotic lesion volume (MD = -2.86, 95% CI: -3.29 to -2.43; < 0.00001), serum CA125 levels (SMD = -1.49, 95% CI: -2.41 to -0.58; < 0.00001), serum estradiol (E2) levels (SMD = -1.28, 95% CI: -1.54 to -1.03; < 0.0001), and improvements in dysmenorrhea (MD = -0.54, 95% CI: -1.06 to -0.02; < 0.00001) : HM may be an effective and safe adjunct to HIFU for managing AM. However, further high-quality RCTs with long-term follow-up are needed to validate these findings.
子宫腺肌病（AM）是一种激素依赖性妇科疾病，对育龄期女性的生活质量和生育能力产生负面影响。本研究旨在评估中药（HM）作为高强度聚焦超声（HIFU）治疗后辅助治疗策略的有效性。截至2025年3月24日，系统检索了英文、中文和韩文数据库。符合条件的随机对照试验（RCT）将HIFU治疗后给予HM与单纯HIFU治疗进行了比较。统计分析包括平均差（MD）、标准化平均差（SMD）和风险比（RR）以及95%置信区间（CI）。采用GRADE方法评估证据质量。该方案已在INPLASY注册（编号：INPLASY202530088）。本综述纳入了14项涉及1259例患者的RCT。HIFU治疗后给予HM在减少子宫体积（MD = -11.84，95% CI：-13.74至-9.95；P < 0.00001）、腺肌病病灶体积（MD = -2.86，95% CI：-3.29至-2.43；P < 0.00001）、血清CA125水平（SMD = -1.49，95% CI：-2.41至-0.58；P < 0.00001）、血清雌二醇（E₂）水平（SMD = -1.28，95% CI：-1.54至-1.03；P < 0.0001）以及改善痛经方面（MD = -0.54，95% CI：-1.06至-0.02；P < 0.00001）显示出比单纯HIFU治疗更优的疗效。中药可能是HIFU治疗子宫腺肌病的一种有效且安全的辅助治疗方法。然而，需要进一步开展长期随访的高质量RCT来验证这些结果。
