Systematic Evalution Of Traditional Chinese Medicine For Dysfunctional Ovulatory Infertility

ObjectiveTo systematic evaluate effectiveness and safety of dysfunctional ovulatory infertility by Traditional Chinese Medicine(TCM),serch the best treatment options in the field of TCM, so as to provide reference for clinical.MedthodLiteratures related to TCM (traditional chinese medicine、acupuncture) for dysfunctional ovulatory acyesis were searched from Chinese Biomedical Literature Datebase (CBM)(January1978to January2012)、China Journals Full-text Datebase (CNKI)(January1979to January2012)、Weipu periodical datebase (VIP)(January1989to January2012)、PubMed (January1966to January2012)、Embase(January1966to January2012). We assessed the risk of bias of the include randomized controlled trial (RCT) or quasi-randomized controllde trial (qRCT) according to the Cochrane Handbook for Systematic Reviews of Interventions Version5.0.The Cochrane Collaboration’s sofaware Revman5.0was used for meta-analysis.Results1.We included23RCTs and qRCTs(n=3038):Chinese medicine versus Western medicine(15papers), Acupuncture versus Chinese medicine(0paper),Acupuncture versus Western medicine(2papers),Combined Chinese medicine an Acupuncture versus Western medicine(4papers), Combined Chinese medicine an Acupuncture versus Chinese medicine(2papers);2.Most of the included studies were of low quality with a high risk of bias.3.Meta-analysis:①Pregnancy rate:Chinese medicine had a higher rate than Western medicine (RR=1.57,95%CI1.32,1.87), Chinese medicine had a higher rate than CC (RR=1.54,95%CI1.20,1.99),Combined Chinese medicine and Acupuncture had a higher rate than CC (RR=2.03,95%CI1.39,2.96),Combined Chinese medicine an Acupuncture had a higher rate than Chinese medicine (RR=1.55,95%CI1.16,2.16);②Ovulation rate:Anovulatory infertility: Chinese medicine had a higher rate than CC (RR=1.07,95%CI0.99,1.16), Acupuncture had a lower rate than CC(RR=0.86,95%CI0.81,0.91),Combined Chinese medicine an Acupuncture had a higher rate than CC (RR=1.22,95%CI1.04,1.42);③BBasal body temperature:there was no significant difference between Chinese medicine and CC(RR=1.28,95%CI0.87,1.89);④Cervical mucus:Chinese medicine had a higher rate than CC(RR=1.84,95%CI1.18,2.89);⑤Spontaneous abortion rate:Chinese medicine groups had a lower rate than CC(RR=0.38,95%CI0.22,0.67), Acupuncture groups had a lower rate than CC (RR=0.35,95%CI0.13,0.95);⑥Safety:1study reported ovarian hypertimuiation syndrome and Ectopic pregnancy.The treatment groups had0 case,2cases(1.1%), however the control groups had2cases(6.67%),5cases(3.3%).There was no method to combination safety because no studies had reported adverse drug reactions and adverse outcomes.ConclustionThe existing studies have shown that Combined Chinese medicine and Acupuncture have a higher pregnancy rate than traditional Chinese medicine. Combined Chinese medicine and Acupuncture have a higher ovulation rate than traditional Chinese medicine and acupuncture.However,the results should be interpreted with caution because of the heterogeneity among the included studies and the high risk of bias.It is necessary to further development of high-quality,large sample,randomized clinical controlled trials to evaluate the efficacy and safety.