Efficacy And Safety Of Kangfuyan Capsule Combined With Antibiotics In The Treatment Of Pelvic Inflammatory Disease A Systematic Review And Meta-analysis

Objective:Through searching and screening literatures,data extraction,risk assessment of literature bias,Meta-analysis and other methods,the systematic and comprehensive understanding of the efficacy and safety of Kangfuyan capsule in combination with antibiotics and single antibiotics for PID treatment. Methods: 1.Literature retrieval and screeningAccording to the standards of the Cochrane Systematic Review Manual,the VIP,CBM,CNKI,WAN-FANG DATA,Corchrane Library,Embase,pubmed and other English databases were searched by computer.Hand-searched textbooks,important academic conference papers on the clinical research literature about Kangfuyan capsule treatment of pelvic inflammatory disease,as well as published standardization documents and published related monographs were searched.The retrieval time is from the time of database construction to January 1,2018.2.Data ExtractionThere are two researchers who will independently evaluated the quality of literature research and extracted data,such as basic information included in the literature,design of research methods,research subjects,intervention control measures,outcome indicators,and results.Contact the original investigator for additional information if necessary.3.Literature bias risk assessmentUsing the risk assessment tools recommended by the Cochrane Collaborative Network for the evaluation of literature quality,including the generation of stochastic allocation schemes,the concealment of allocation schemes,the blinding of research subjects and researchers,the blinding of outcome reviewers,the integrity of outcome data,and the selectivity Report results,other biases and other seven aspects.Using “low risk”,“high risk”,“unclear risk” to express judgments,and commenting on the basis for judgment.When there is disagreement,we will resolve it by discussing,or submiting it to a third party for assistance in adjudication.4.Meta analysisUsing the RevMan 5.3 software provided by the Cochrane Collaboration,Meta-analysis was performed on the different outcomes of the treatment group and the control group,including clinical manifestation rate,changes in pain,changes in physical signs,and changes in pelvic inflammatory masses.For example,if the heterogeneity is large,subgroup analysis and sensitivity analysis are performed,and a study of publication bias is conducted using a funnel plot for studies containing ?10 articles.Result:1.A total of 2540 patients were enrolled in 20 randomized controlled trials.2.T he risk of bias was higher when the quality of literature was evaluated.3.The clinical effective rate of Kangfuyan capsule combined with antibiotics in the treatment of pelvic inflammatory diseases is higher than that of antibiotics alone(RR 1.33,95%CI 1.19~1.48,cases of 1338 patients,20 studies),.At the same time,it was superior to antibiotics alone in relieving pelvic pain(OR 2.59,95%CI 1.57~4.27,cases of 246 patients,3studies)and reducing the outcome of inflammatory mass(OR 6.18,95%CI 2.65~14.43,cases of 237 patients,5studies).In order to improve the outcome of physical signs,Kangfuyan capsule combined with antibiotics has the same effect as antibiotic alone(RR 3.19,95%CI 0.84~12.13,cases of 1338 patients,3studies).4.Three studies in this study reported adverse reactions.Only one report mentioned adverse reactions during the course of treatment.The adverse reaction rate was low and the drug safety was well.5.Excluding the larger weighted studies for sensitivity analysis,there is no significant effect compared with before deletion.6.Funnels are asymmetrical on both sides,considering there is publication bias.Conclusion :(1)Kangfuyan capsule combined with antibiotics has better efficacy than antibiotics alone on the improvement of clinical manifestation rate,improving pain symptoms,reducing pelvic inflammatory mass,treatment safety,but there is no significantly differences in reducing the signs.(2)The standardization of clinical research for the treatment of pelvic inflammatory diseases by Kangfuyan capsule needs to be further improved,more rigorous multi-center and large-sample randomized clinical studies are expected to further confirm its effectiveness and safety.