Meta-analysis Of The Efficacy Of Different Forms Of Guizhi Fuling Pill In The Treatment Of Chronic Pelvic Inflammatory Disease And A Case-sharing

Background and purpose:Chronic pelvic inflammatory disease is a common clinical disease,mostly occurring in women of childbearing age.It’s lingering and refractory nature,and recurrent attacks seriously affect the quality of patients’ life.However,western medicine has not found an obviously effective drug treatment method yet.Guizhi Fuling Pill is a kind of simple and effective drug.Early clinical studies have shown that Guizhi Fuling Pill can effectively treat chronic pelvic inflammation.In recent years,many researchers have used different forms of Guizhi Fuling Pill to treat chronic pelvic inflammatory disease,and further observed the changes of inflammatory index and hemorheological index of patients after medication.The purpose of this paper is to explore the clinical efficacy of Guizhi Fuling Pill in the treatment of chronic pelvic inflammation by Meta-analysis,and to observe the effect of it’s application on clinical detection indicators,so as to provide evidence for it’s clinical application.Method:All clinical randomized controlled trials of Guizhi Fuling Pills(including pills,decoctions and capsules)in the databases of CNKI,VIP,WF,Sinomed,Pub Med,The Cochrane Library and EMbase for the treatment of chronic pelvic inflammation were retrieved by keyword search.All the articles,up to October 24,2018,were screened according to inclusion and exclusion criteria,and 22 articles were included in the end.In these articles a total of 2143 patients were included,including 1116 in the experimental group and 1027 in the control group.Revman 5.3 was used to analyze the relevant data in the articles.Meanwhile,taking clinical cases as an example,we observed the effectiveness of Guizhi Fuling Decoction on chronic pelvic inflammation,and further studied the theory of syndrome differentiation and treatment,and homotherapy for heteropathy.Result:1.Effectiveness analysis of clinical treatment: 22 articles included were compared with the commonly used Western medicine.Among them,18 studies used Guizhi Fuling pills combined with Western medicine as experimental group.The results showed that the curative effect was better than that of single Western medicine[RR=1.23,95%CI(1.18,1.29)].4 studies used Guizhi Fuling decoction as experimental group,and the curative effect was better than that of Western medicine alone [RR=1.29,95% CI(1.18,1.42)].2.Clinical indicators analysis: Guizhi Fuling pills dosage-forms combined with western medicine treatment was better than the use of westernin medicine alone in reducing the level of CRP [MD=-2.84,95% CI(-3.47,-2.22)],TNF-α [SMD=-3.65,95% CI(-5.01,-2.29)],whole blood low shear viscosity [MD=-1.15,95% CI [-1.75,95% CI(-1.75,0.54)],whole blood high shear viscosity [MD=-0.38,95% CI(-0.55,-0.21],fibrinogen [MD=-2.33,95%CI(-4.53,-0.12)];it could also promote the expression of IL-2 [SMD = 2.05,95% CI(1.04,3.06)],IL-10 [MD = 6.70,95% CI(4.03,9.37)].There was no significant difference in reducing the expression of hs-CRP[MD=-1.70,95%CI(-3.48,0.08)],erythrocrit [MD=-2.40,95%CI(-4.81,0.01)],and plasma viscosity [MD=-0.32,95% CI(-0.68,0.04)] between the two groups.The clinical recurrence rate of traditional Chinese medicine combined with western medicine was lower [RR = 0.18,95% CI(0.10,0.34)].The results of sensitivity analysis of serum hs-CRP and plasma viscosity changed greatly,which indicated that the stability of the two results was not good,so the results should be treated objectively,but the stability of other results was good.Conclusion:The clinical efficacy of Guizhi Fuling Pill in combination with western medicine in treating chronic pelvic inflammatory disease was significantly higher than that of single western medicine,and the effect of Guizhi Fuling Decoction alone was also better than that of single western medicine.It also has the advantages of lower recurrence rate and lesser adverse reactions.After treatment with Guizhi Fuling Pill with Western medicine,the levels of CRP,TNF-a,IL-2 and IL-10 in serum of patients were significantly decreased,that is,the combination of traditional Chinese medicine and Western medicine can better promote the absorption of inflammation,regulate immune function and plasma viscosity.In conclusion,traditional Chinese medicine synthetically act on the body in many ways to alleviate or even cure diseases.