| Objective To objectively evaluate the clinical related indexes of Chinese traditional medicine pre scriptions for tonifying kidney and promoting blood circulation in the treatment of BP H by Meta-analysis,so as to provide objective basis for the clinical application of Ch inese traditional medicine prescriptions for tonifying kidney and promoting blood circul ation in the treatment of BPH.Methods Search CNKI,VIP,Wanfang,PUBMED,Cochrane,SCI databases.The Chinese langua ge takes " tonifying kidney and promoting blood circulation"," tonifying kidney and promoting blood circulation"," warming kidney and promoting blood circulation"," n ourishing kidney and promoting blood circulation"," nourishing kidney and promoting blood circulation"," prostatic hyperplasia"," prostatic hypertrophy" and " combination of traditional Chinese and western medicine" as retrieval words.In English,"Bushen Huoxue","Yishen Huoxue","Yangshen Huoxue","Gushen Huoxue","Wenshen Huoxue","Zi shen Huoxue","reinforcing the kidney and activating the blood","Lower urinary tract sy ndrome","Luts","Benign prostatic hyperplasia","BPH" are the search terms.According t o the inclusion criteria and exclusion criteria,the two individuals respectively screened,extracted,evaluated and analyzed the retrieved articles.Results A total of 46 studies were retrieved.A total of4387 patients were enrolled,including 2382 in the experimental group and 2004 in the control group.Meta analysis results 1.Comparison of IPSS scores before and after treatment: WMD=-3.70,95%CI[-4.57,-2.83] for combined effects of various studies.After the studies were combined,the diffe rence between the experimental group and the control group was statistically significan t(Z=8.31,P<0.00001),which showed that the IPSS score of the experimental group was significantly better than that of the chemical group(control group)in reducing ip ss score.2.Comparison of QOL scores before and after treatment: WMD=-0.79,95%CI[-1.10,-0.47] in all studies.After the studies were combined,the difference between the experi mental group and the control group was statistically significant(Z=4.90,P<0.00001),s howing that the QOL score of the experimental group and the control group were sig nificantly better than that of the chemical group(the control group)in reducing QOL score.3.Comparison of maximum urinary flow rate before and after treatment: WMD=2.13,95%CI[1.40,2.86].After the studies were combined,the difference between the experi mental group and the control group was statistically significant(Z=5.69,P<0.00001),i ndicating that the single use of kidney-tonifying and blood-activating methods or the c ombination of kidney-tonifying and blood-activating methods and chemical drugs(experimental group)was significantly better than the single use of chemical drugs(control group)in reducing the maximum urine flow rate level.4.Comparison of bladder residual urine volume before and after treatment: WMD=-5.43,95%CI[-8.03,-2.82].After the studies were combined,the difference between the ex perimental group and the control group was statistically significant(Z=4.09,P<0.0001),indicating that the single use of kidney-tonifying and blood-activating methods or the combination of kidney-tonifying and blood-activating methods and chemical drugs(exp erimental group)was significantly better than the single use of chemical drugs(control group)in reducing the residual urine volume of bladder.5.Comparison of prostate volume before and after treatment: WMD=0.00,95%CI[-0.00,0.00].After the studies were combined,there was no significant difference between the experimental group and the control group(Z=0.61,P=0.54);Since the chemical 5?reductase inhibitor has the effect of inhibiting prostatic hyperplasia,subgroup analysis is carried out on whether the drugs in the control group contain 5? reductase inhibito r,and the combined effect amount is respectively studied.The 5? reductase inhibitor group shows WMD=0.00,95%CI[-0.00,0.00],Z=0.62,P=0.53,with no statistical differ ence;Non-5? reductase inhibitor group showed WMD=-1.87,95%CI[-2.82,-0.91],Z=3.84,P=0.0001,the difference was statistically significant.The results showed that there was no significant difference in reducing prostate volume between the treatment group and the 5? reductase inhibitor,but it was obviously better than the non-5? reductase i nhibitor.6.Comparison of clinical effective rates: OR= 3.25,95%CI[2.70,3.91].After all the studies were combined,the difference between the experimental group and the control group was statistically significant(Z=12.47,P<0.00001),indicating that the clinical eff ective rate of the single kidney-tonifying and blood-activating method or the kidney-to nifying and blood-activating method combined with chemical drugs(experimental grou p)was significantly better than that of the single chemical drug group(control group).7.Comparison of adverse reactions: OR=0.59,95%CI[0.34,1.02].After the studies w ere combined,there was no statistical difference between the experimental group and t he control group(Z=1.89,P=0.06),indicating that there was no statistical difference i n the incidence rate of clinical adverse reactions between the experimental group and the chemical group(control group)using only kidney-tonifying and blood-activating m ethods or kidney-tonifying and blood-activating methods combined with chemical drugs(experimental group).Conclusion The method of tonifying kidney and promoting blood circulation has obvious advantag es in treating BPH.Whether it is a traditional Chinese medicine prescription,proprieta ry Chinese medicine or a combination of traditional Chinese medicine and chemical m edicine for tonifying kidney and promoting blood circulation,it has obvious advantage s in effective rate,IPSS,QOL,maximum urine flow rate,bladder residual urine volu me,etc.compared with simple chemical medicine(mainly 5? reductase inhibitor and ? receptor blocker)for treating benign prostatic hyperplasia.However,in terms of affe cting prostate volume,there is a statistical difference compared with non-5? reductase inhibitors.However,there is no statistical difference compared with 5? reductase inhibitor.The method of tonifying kidney and promoting blood circulation for the treatment of BPH has not reported the occurrence of serious adverse reactions such as liver an d kidney function injury and hypersensitivity reaction in the clinical application proces s,has high safety,and is worthy of clinical popularization and application.The metho d of tonifying kidney and promoting blood circulation has a significant effective rate i n the treatment of benign prostatic hyperplasia and can be selected clinically.Howeve r,the quality of the included literature is relatively low and there are limitations.Mor e high-quality RCT research is needed to guide clinical practice.However,due to the limitations of this study,the accuracy and reliability of the research results have been reduced to a certain extent.Therefore,more large-sample,multi-center and high-quality randomized controlled trials are still needed for verification. |
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