A Systematic Review Of Chinese Patent Medicines In The Treatment Of Secondary Dysmenorrhea (endometriosis, Adenomyosis)

ObjectiveThrough the meta-analysis method,systematically evaluate the clinical efficacy of Chinese Patent Medicines alone or combined with western medicines in the treatment of secondary dysmenorrhea(EMs,AM)and provide evidence-based recommendations of the reasonable use of Chinese Patent Medicine.Method?determination of clinical problems:through the experts' questionnaire survey,determine the most need to be solved clinical problems about the Chinese Patent Medicines' treatment of secondary dysmenorrhea(EMs,AM)in eart2 study.?selecting o f Chinese Patent Medicine,by querying the Chinese Patent Medicines'instruction and China's food and drug administration website,collet the indications contained the treatment of dysmenorrhea such as the abdominal pain,menstrual period abdominal pain,etc.The list of 25 commonly used and recommended Chinese Patent Medicines for the treatment of secondary dysmenorrhea(EMs,AM)was determined by the gynaecology experts'questionnaire survey.?literature searching,screening,evaluate the methodology quality of literatures,data extraction and comprehensive analysis:Searched 4 Chinese databases(Wanfang,China National Knowledge Infrastructure,VIP database,Sinomed)and 2 English databases(MEDLINE,Cochrane library).Collected randomized controlled trials of Chinese Patent Medicine for the treatment of secondary dysmenorrhea(EMs,AM),screened the literatures according to the inclusion and exclusion criteria then evaluate the methodology quality of the literatures,reading the full text to pick up the final literatures,used the Revman 5.3.5 software provided by the Cochrane Collaboration Network for meta-analysis,and the final results of systematic review were carefully interpreted and reasonably discussed.Result 25 commonly used Chinese Patent Medicines in the treatment of secondary dysmenorrhea(EMs,AM)were determined by the experts' questionnaire.Literature searching was conducted on 25 Chinese Patent Medicines,and a total of 927 literatures were searched.After literature screening,78 randomized controlled trials were finally included.Sanjie Zhentong Capsule(27),Dane Fukang decocted extract(24),Guizhi Fuling Capsule/pill(18),Zhitong Huazheng capsule(5),Shaofu Zhuyu Capsule(1),Dingkundan(1)Tongjingling Granule(1),Honghua Ruyi Pill(1),a total of 8 Chinese Patent Medicines can get related literatures.Sanjie Zhentong Capsule,Dane Fukang decocted extract,Guizhi Fuling Capsule/pill,Zhitong Huazheng capsule all had multi-center randomized controlled trials with Large sample size,and the results of efficacy evaluation were more reliable.The invetentions were Chinese Patent Medicines compared with conventional western medicine alone or Chinese Patent Medicines combined with conventional western medicines compared with western medicines.Sanjie Zhentong Capsule can decrease the VAS score,reduce serum CA125,and improve the cure rate.It can basically achieve the same therapeutic effect of western medicines.Dane Fukang decocted extract can decrease the VAS score,NRS score and dysmenorrhea score2(refer to Chinese medicine new medicine clinical research guiding principles(trial))and decrease the serum CA125.It can basically achieve the therapeutic effect of western medicines.Combined with western medicines,Sanjie Zhentong Capsule,Dane Fukang decocted extract,Guizhi Fuling Capsule/pill,Zhitong Huazheng capsule all can decrease secondary dysmenorrhea(EMs,AM)patients' pain degree(VAS score,COX score,NRS score,dysmenorrhea score 1(refer to international general classification of chronic pain questionnaire),dysmenorrhea score 2 and other pain index),lower serum CA125,improve recovery rate.They can enhance the effectiveness of western medicines.In decreasing the ectopic lesion(pelvic mass,cyst diameter),we found only Guizhi Fuling pill combined with western medicines had synergistic effect.Shaofu Zhuyu Capsule,Dingkundan,Tongjingling Granule,Honghua Ruyi Pill all included only one RCT,with small sample size and incomplete methodology.There was no difference between the two groups in the cure rate of Honghua Ruyi Pill combined with western medicine,it showed no obvious clinical effect.Shaofu Zhuyu Capsule,Dingkundan,Tongjingling Granule all can achieve better clinical effects in reducing serum CA125 and improving the recovery rate of dysmenorrhea compared with western medicines,but their authenticity,reliability and evidence-based evidence were insufficient.The Tongjingbao Granule,Aifu Nuangong Pill,Tianqi Tongjing Capsule,Cuzhi Xiangfu Pill,Shixiaosan,Funv Tongjing Pill(Granule),Tongjing Pill,Yuhu Zhiteng Tablet,Bawei Tongjing Tablet,Tongjingning Granule,Tiaojing Huayu Pill,Tongjing Ointment,Wenjing Pill,Yuetai Stick navel piece,Shuerjing Granule(Capsule),Tiaojing Huoxue Capsule(Tablet),Tongjing Oral liquid,a total of 17 Chinese patent medicines were not systematically reviewed because no literature evidence conformed to the the inclusion criteria was found.Its curative effect has been confirmed by clinicians,but it lacks evidence-based evidences.Conclusion1.Sanjie Zhentong Capsule can decrease the VAS score,reduce serum CA125,and improve the cure rate.Dane Fukang decocted extract can decrease the VAS score,NRS score and dysmenorrhea score 2(refer to Chinese medicine new medicine clinical research guiding principles(trial))and decrease the serum CA125.They can basically achieve the therapeutic effect of western medicines.2.Combined with western medicines,Sanjie Zhentong Capsule,Dane Fukang decocted extract,Guizhi Fuling Capsule/pill,Zhitong Huazheng capsule all can decrease secondary dysmenorrhea(EMs,AM)patients' pain degree(VAS score,COX score,NRS score,dysmenorrhea score 1(refer to international general classification of chronic pain questionnaire),dysmenorrhea score 2 and other pain index),lower serum CA125,improve recovery rate.They can enhance the effectiveness of western medicines.In decreasing the ectopic lesion(pelvic mass,cyst diameter),we found only Guizhi Fuling pill combined with western medicine had synergistic effect.3.Honghua Ruyi Pill failed to improve the cure rate of western medicine compared with western medicine.The cure rate of Tongjingling Granule was higher than western medicine.Shaofu Zhuyu Capsule and Dingkundanl can achieve better clinical effects in reducing serum CA125 and improving the recovery rate of dysmenorrhea compared with western medicines.But their authenticity,reliability and evidence-based evidence were insufficient.4.Aifu Nuangong Pill,Cuzhi Xiangfu Pill,Yuhu Zhiteng Tablet,etc.a total of 17 Chinese patent medicines were not systematically reviewed because no literature evidence conformed to the the inclusion criteria was found.