A Meta-analysis Of The Efficacy And Safety Of Traditional Chinese Medicine Combined With Hysteroscopy In The Treatment Of Endometrial Polyps

Objective:Through an in-depth analysis of the RCT study on the application of traditional Chinese medicine after EPs hysteroscopic surgery,systematic evaluation of the clinical efficacy of traditional Chinese medicine combined with hysteroscopic surgery for EPs,and its drug safety.Provide a theoretical basis for the prevention and treatment of EPs after TCRP,and provide evidence-based medical evidence for follow-up prospective studies of postoperative traditional Chinese medicine treatment of EPs.Methods:Search all related documents from the establishment of the database to February 28,2021 by searching the Chinese and foreign language databases,foreignlanguagedatabasesinclude Pubmed/Embase/EBSCO/Cochrane Library/OVID/Web of Science/JAMA Network/NEJM,and Chinese databases include China National Knowledge Infrastructure(CNKI),Wan Fang Database(WF),VIP Database for Chinese Technical Periodicals(VIP),and China Biology Medicine disc(CBM).Firstly,preliminary screening of the study by reading the titles and abstracts of the study.Then obtain and read the full text of the initially included study in detail,screen again,exclude irrelevant study,and include the final.Finally,extract the final included literature data,evaluate the quality of the final included literature,and assess its risk of bias.Perform a Meta analysis of the extracted and summarized outcome indicators,and draw a forest diagram and a funnel diagram,and use the funnel diagram to identify the publication bias of the included literature(≥10 articles).The main outcome indicators in this study are recurrence rate and adverse reaction rate,and the secondary outcome indicators are total effective rate and TCM syndrome score.Result:A total of 36 RCT articles were included,and the total sample size was 3238.The recurrence rate was divided into 6 subgroups for analysis,which were 3 months,6 months,9 months,12 months,18 months and 24months after surgery.Adverse reaction rates were divided into three subgroups:traditional Chinese medicine VS blank,traditional Chinese medicine VS western medicine,and traditional Chinese medicine+western medicine VS western medicine for analysis.The sources of the included literature are biased,the methodological quality is low,and there is a certain possibility of bias.1.Recurrence rate included 28 articles in total,and the studies were homogeneous(I~2=0%).The results of Meta-analysis showed that in the 5subgroups of 3 months(P<0.05),6 months(P<0.01),9 months(P<0.01),12months(P<0.01)and 18 months(P<0.01)after surgery,the recurrence rate of the test group was significantly lower than that of the control group,and the difference was statistically significant;There is only one article in the 24months after surgery subgroup,which is of no analytical significance;The funnel chart indicates that the included literature may have publication bias.2.Total effective rate included 9 articles in total,and the heterogeneity between the studies is negligible(I~2=8%).The Meta-analysis results show that the total effective rate of the test group is significantly higher than that of the control group(P<0.01),and the difference was statistically significant.3.TCM syndrome scores included 9 articles in total,and there is a non-negligible heterogeneity between the studies(I~2=91%),which is of no analytical significance.Through sensitivity analysis,3 documents that have a greater impact on heterogeneity are excluded.The remaining 6 studies have low heterogeneity(I~2=32%).The Meta-analysis results show that the improvement of TCM symptoms in the test group after treatment is significantly better than that in the control group(p<0.01),and the difference was statistically significant.4.The adverse reaction rate included 9 articles in total,and there was moderate heterogeneity among the studies(I~2=41%).The Meta-analysis results showed that the adverse reaction rate of the test group was significantly lower than that of the control group(P<0.05),and the difference was statistically significant.The results of the subgroup analysis of the adverse reaction rate showed that the two subgroups of traditional Chinese medicine VS blank and traditional Chinese medicine VS western medicine are less included in the literature and have no analytical significance;traditional Chinese medicine+western medicine VS western medicine subgroups have homogeneity among the studies(I~2=0%).The adverse reaction rate of the traditional Chinese medicine+western medicine group was lower than that of the western medicine group(P>0.05),but the difference was not statistically significant.Conclusion:1.Traditional Chinese medicine treatment can effectively prevent the recurrence of endometrial polyps after hysteroscopic resection of endometrial polyps.2.Traditional Chinese medicine treatment can effectively improve the clinical symptoms and TCM symptoms of patients after hysteroscopic resection of endometrial polyps.3.The application of traditional Chinese medicine after hysteroscopic resection of endometrial polyps has a low adverse reaction rate and a certain degree of safety.