Meta-analysis Of Traditional Chinese Medicine For Vulvovaginal Candidiasis

Object:The meta-analysis was used to evaluate the curative effect of Traditional Chinese Medicine on Vulvovaginal Candidiasis,and summarized the syndromes and medications included in the literature,which will provide theoretical basis and reference for the future treatment of Vulvovaginal Candidiasis with Traditional Chinese Medicine.Method:Randomized controlled trials related to the treatment of Vulvovaginal Candidiasis with Traditional Chinese Medicine(TCM)or Intergrated Traditional Chinese and Western Medicine were conducted in search of four major academic databases:China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature database,VIP database,Pubmed,Cochrane library,from the establishment of the library to December 31,2019.All the retrieved documents were loaded into EndnoteX9 software for rechecking,and screening was performed according to the inclusion and exclusion criteria.Use Excel2019 software for data extraction,and use Revman5.3.5 software and Cochrane collaboration assessment risk of bias tool to conduct risk bias assessment for the included randomized controlled trials,perform heterogeneity and sensitivity analysis on the efficacy indicators,and compare afterobtaining the effect value.A funnel plot was used to evaluate publication bias for documents with more than 10 indicators.Results:A total of 29 randomized controlled trials,2777 study subjects were included,which had no significant publication bias.The overall efficacy of Chinese Medicine or Traditional Chinese Medicine combined with Western Medicine was superior to that of Western Medicine alone.(1)The difference of negative conversion rate of Candida [OR(95% CI)= 3.15(2.60,3.82),P <0.00001] is statistically significant;(2)The difference of total effective rate of TCM syndromes [OR(95% CI)= 4.42(3.32,5.87),P < 0.00001] is statistically significant;The total effective rate of TCM syndromes with damp-heat betting syndrome [OR(95% CI)= 4.39(3.04,6.34),P <0.00001],the total effective rate of TCM syndromes with heat-toxic accumulation syndrome [OR(95% CI)= 5.29(2.87,9.74),P <0.00001]and the total effective rate of TCM syndromes of spleen deficiency syndrome [OR(95% CI)= 3.56(1.81,7.00),P = 0.0002] were statistically significant.(3)After 3 months of treatment,the recurrence rate of the Chinese medicine group was lower than that of the Western medicine group [OR(95% CI)= 0.22(0.16,0.31),P <0.00001],the difference was statistically significant.(4)The reduction of TCM syndrome points is better than that of the Western medicine group [SMD(95% CI)= ? 1.23(?1.64,?0.83),P <0.00001],the difference is statistically significant.(5)The reduction of the total score of VVC symptoms was better than that of the Western medicine group [SMD(95% CI)= ? 1.00(?1.72,?0.27),P = 0.007],the difference was statistically significant.(6)Traditional Chinese Medicine reduces IL-4 [SMD(95% CI)=? 4.03(?5.64,?2.95),P < 0.00001],IL-6 [SMD(95% CI)= ?2.98(?4.02,?1.94),P <0.00001] level is better than Western medicine treatment,the difference is statistically significant.(7)There was no significant difference between the two groups in the incidence of adverse reactions [OR(95% CI)= 0.66(0.35,1.24),P = 0.20].(8)The syndrome types included in the literature are mainly damp-heat betting syndromes;the first three types of commonly used drugs are heat-clearing drugs,diuretic osmotic drugs and tonic drugs.For the treatment of vulvovaginal candidiasis,heat-clearing,tonifying deficiency,diuresis,dampness,compatibility with Jiepi,astringency,qi,humidification,blood circulation,blood stasis,insecticidal and antipruritic drugs are used.Conclusion:Meta analysis found that the overall efficacy of traditional Chinese medicine or traditional Chinese medicine combined with western medicine in treating vulvovaginal candidiasis is better than that of western medicine alone.Traditional Chinese medicine can improve the negative conversion rate of Candida,the total effective rate of TCM syndromes,can reduce the recurrence rate of VVC,TCM syndrome scores and clinical symptoms and signs scores,and reduce the levels of IL-4 and IL-6.But there is no significant advantage in the incidence of adverse reactions.By summarizing the literature types and traditional Chinese medicines,the main syndrome of vulvovaginal candidiasisis damp-heat injection,and the first three types of commonly used drugs are heat-clearing drugs,diuretic and dampening drugs and tonic drugs.For the treatment of vulvovaginal candidiasis,heat-clearing,tonifying deficiency,diuresis,dampness,compatibility with Jiepi,astringency,qi,humidification,blood circulation,blood stasis,insecticidal and antipruritic drugs are used.