Meta-analysis Of Traditional Chinese Medicine Treatment Of Polycystic Ovary Syndrome

Purpose:This study objectively evaluated the efficacy and safety of traditional Chinese medicine and western medicine in the treatment of polycystic ovary syndrome through Meta analysis,with a view to objectively evaluating the efficacy of traditional Chinese medicine in the treatment of polycystic ovary syndrome,providing evidence-based evidence for clinical decision-making and further in-depth research.Method:Query Chinese databases via computer network: China Knowledge Network(CNKI),Wanfang Database,China Biomedical Literature Database(CBM),VIP(VIP),and foreign language databases: PubMed,Embase,Cochrane Library from January 2010 As of December 31,2019,randomized controlled trials related to the treatment of PCOS with traditional Chinese medicine.Load the retrieved documents into the Endnote X9 software to remove duplicates,remove duplicate documents,and then filter according to the inclusion and exclusion criteria.Use Endnote X9,Excel2016 software for data extraction,while using Reviews Manger5.3 software and Cochrane bias risk assessment tool to evaluate the risk of bias in the included randomized controlled trials;heterogeneity,effect value combination,and sensitivity of efficacy indicators And funnel chart analysis.Result:A total of 43 clinical randomized controlled trials were included,including 1,571 subjects in the Chinese medicine group and 1,485 subjects in the Western medicine group.The overall quality of the included literature is good and the credibility is high;and there is no significant publication bias.Meta analysis results showed that the overall efficacy of the Chinese medicine group after treatment was better than Western medicine.1.Clinical efficacy total effective rate [RR=1.26,95%CI(1.20,1.32),P<0.00001],cure rate [RR=1.92,95%CI(1.56,2.36),P<0.00001],apparent efficiency[RR= The difference of 1.35,95% CI(1.19,1.55),P <0.00001] was statisticallysignificant;the difference of effective [RR = 1.01,95% CI(0.90,1.12),P = 0.90] was not statistically significant.2.The difference of curative effect of TCM syndromes [RR=1.40,95%CI(1.26,1.56),P<0.00001],cure rate [RR=1.83,95%CI(1.19,2.84),P=0.006] has statistical significance;There was no statistically significant difference in significant efficiency[RR=1.29,95%CI(0.74,2.24),P=0.37],and effective [RR=1.17,95%CI(0.90,1.52),P=0.25].3.Chinese medicine has a statistically significant difference in improving pregnancy rate [RR=1.94,95%CI(1.14,3.29),P=0.01].4.Chinese medicine has a good effect on adjusting menstruation [RR=1.40,95%CI(1.13,1.73),P=0.002],and the difference is statistically significant.5.Traditional Chinese medicine is superior to western medicine in improving the basal body temperature in two phases [RR=1.65,95%CI(1.14,2.40),P=0.009],and the difference is statistically significant.6.The TCM syndrome score was significantly lower than that of Western medicine treatment [SMD =-1.36,95% CI(-1.65,-0.83),P <0.00001],the difference was statistically significant.7.In terms of improvement in body mass index [SMD =-0.14,95% CI(-0.49,-0.21),P <0.43],the difference between the two groups had no statistical significance.8.Comparing the acne score [SMD =-0.11,95% CI(-0.75,0.52),P = 0.73],the difference between the two groups was not statistically significant.9.The improvement of hormone level by traditional Chinese medicine treatment,including LH [SMD =-0.38,95% CI(-0.59,-0.16),P = 0.0005],LH/FSH [SMD =-0.39,95% CI(-0.60,-0.19),P = 0.0001],T [SMD =-0.40,95% CI(-0.65,-0.15),P =0.001] and other hormone levels improved,the difference was statistically significant;FSH [SMD = 0.01,95% CI(-0.22,-0.25),P = 0.93],PRL [SMD =-0.36,95% CI(-0.90,0.18),P = 0.19] improvement was not statistically significant;E2 [SMD = 0.29,95% The level of CI(0.06,0.53),P = 0.01] is statistically significant,and the effect of Western medicine is more obvious.10.Chinese medicine in the average volume of ovaries [SMD =-0.80,95% CI(-1.29,-0.32),P = 0.001] shrinkage,the number of follicles [SMD =-1.84,95% CI(-2.94,-0.74),P=0.001] is superior to Western medicine in the reduction,and the difference is statistically significant.11.Chinese medicine in fasting insulin [SMD = 0.01,95% CI(-0.18,0.39),P =0.47],fasting blood glucose [SMD =-0.21,95% CI(0.62,0.19),P = 0.3],insulin resistance index(HOMA-IR)[SMD = 0.04,95% CI(-0.17,0.25),P = 0.71],improvement of triglycerides [SMD =-0.37,95% CI(-1.00,0.25),P = 0.24] Above,the difference between the two groups was not statistically significant.12.The incidence of adverse reactions was lower in the Chinese medicine group than in the Western medicine group [RR=0.12,95%CI(0.06,0.25),P<0.00001],the difference was statistically significant.13.Meta analysis results suggest that LH [SMD =-2.46,95% CI(-4.52,-0.41),P= 0.02],LH/FSH [SMD =-1.33,95% CI(-2.55,-0.11),P = 0.03],improvement of T[SMD =-0.91,95% CI(-1.38,-0.45),P = 0.0001],ovarian volume [SMD =-2.36,95% CI(-4.28,-0.44),P = 0.02] Chinese medicine is superior to Western medicine in terms of reduction,and the difference is statistically significant;while there is no significant difference in comparison of other indicators.Conclusion:Meta analysis results show that the Chinese medicine group has better clinical efficacy in treating polycystic ovary syndrome than the Western medicine group;Chinese medicine treatment can improve the clinical cure rate and obvious efficiency,and the Chinese medicine syndrome has always effective and obvious efficiency,reducing TCM syndrome.Phenomenon points can promote normal menstrual recovery,which further shows that the clinical effect of traditional Chinese medicine in the treatment of polycystic ovary syndrome is accurate.Chinese medicine can reduce the average volume of ovaries to a certain extent,reduce the number of immature follicles,increase the basal body temperature biphasic rate,improve hormone levels(LH,LH/FSH,T),promote ovarian recovery to normal function,increase ovulation,and increase pregnancy rate.Hormone levels(LH,LH/FSH,T)were still lower after treatment withdrawal than before treatment.TheWestern medicine group recovered significantly,and the average ovarian volume was smaller than before treatment.The difference between the two groups after treatment withdrawal indicated that the traditional Chinese medicine had a long-lasting effect.Traditional Chinese medicine has the curative effect and advantages in the treatment of polycystic ovary syndrome,and it is relatively safe,which is worthy of further standardized promotion and application in clinic.