| Objective By analyzing the literature,this paper systematically evaluates the clinical efficacy and medication law of the combination of traditional Chinese medicine(TCM)and western medicine in the treatment of non-gonococcal urethritis(NGU),and provides more objective and reliable theoretical basis for the clinical application of the combination of TCM and western medicine in the treatment of NGU.Content According to the theme of treating NGU with integrated traditional Chinese and western medicine,a reasonable research scheme was formulated.Searches were conducted in major databases according to the proposed search strategy,and retrieved articles were screened according to exclusion and inclusion criteria.Basic information and data of included articles were extracted,and the obtained data were summarized and analyzed by statistical software.To discuss the obtained results and evaluate the effectiveness,safety and medication regularity of integrative TCM and western medicine in the treatment of NGU.Methods First,according to the established retrieval strategy,the literature was retrieved in the database.The articles were published in both Chinese and English from the date of establishment of the database to October30,2022,regarding the randomized controlled clinical trials of treatment of NGU with the integration of TCM and Western medicine.In addition,relevant reviews and literature references were read for potential articles that met the inclusion criteria.According to the inclusion and exclusion criteria,the articles that met the requirements of this study were screened,and the effective data extraction was conducted for the included articles.Then,the basic characteristics of the subjects,intervention measures and other information were summarized into a table for easy browsing and research,and the medication rules of TCM and western medicine in the treatment of NGU were found.Finally,the Jadad scale,bias risk assessment tool,and Review Manager5.4 software were used to objectively evaluate the literature.Results 1.A total of 474 related articles were obtained according to the search strategy,and 25 articles were finally included.The total included cases were 2680,including 1436 cases in the experimental group and 1244 cases in the control group.2.The top four prescriptions in terms of frequency of use were: Bixifenqing Decoction,Bazheng Powder,Wandai Decoction and Xiaolin Decoction.The top ten Chinese herbs with the highest frequency of use were:Semen Plantaginis,Cortex Phellodendri,Rhizoma Dioscoreae Septemlobae,Radix Glycyrrhizae,Rhizoma Smilacis Glabrae,Rhizoma Atractylodis Macrocephalae,Herba Lysimachiae,Herba plantaginis,Herba Taraxaci,and Fructus Gardeniae.3.The results of Jadad scale showed that 19 articles were of low quality and 6 articles were of high quality.The results of risk bias evaluation showed that the overall risk of literature bias was medium and low.4.The results of the meta-analysis showed that the treatment of NGU with the integration of TCM and western medicine was superior to the treatment of simple western medicine,which was mainly reflected in:(1)The total effective rate was improved(OR=4.15,95%CI=[3.20,5.37],P<0.00001).The results of sensitivity analysis were stable,and the funnel plot results were free of publication bias.(2)The cure rate was improved(OR=2.59,95%CI=[2.05,3.26],P<0.00001),the sensitivity analysis results were stable,and the funnel chart results were not biased.(3)The pathogen clearance(negative conversion)rate was improved(OR=5.16,95%CI=[2.99,8.90],P<0.00001).(4)Relieve the symptoms of frequent micturition(MD=-0.38,95%CI=[-0.47,-0.28],P<0.00001),dysuria,(MD=-0.19,95%CI=[-0.27,-0.11],P<0.00001),urethral itching(MD=-0.30,95%CI=[0.37,-0.23],P<0.00001)),yellow urine(MD=-0.20,95%CI=[-0.27,-0.13],P<0.00001),and secretion at the urethral orifice(MD=-0.29,95%CI=[-0.36,-0.22],P<0.00001).(5)To reduce the recurrence rate(OR=0.42,95%CI=[0.25,0.70],P=0.0009)(6)To not increase the adverse reaction(OR=0.33,95%CI=[0.12,0.96],P=0.04).Conclusion This study found that the treatment of NGU was mainly based on Chinese herbs that clear heat and remove dampness,and the medication rule was roughly consistent with the thinking of clinical medication.The integrative TCM and western medicine treatment of NGU in improving the total effective rate,cure rate,negative conversion rate and reduce the incidence of adverse reactions,recurrence rate has a good effect,can effectively improve the urinary frequency,urinary pain,urethral itching,urine yellow and urethral meatus secretion symptoms.Finally,the design of the study was not described in detail in most of the articles included in this study.The overall quality of the literature was general,and the risk of bias was medium to low.Hence,more high-quality relevant studies were needed to provide more reliable evidence. |
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