Meta-analysis Of Traditional Chinese Medicine Decoction In The Treatment Of Menopausal Syndrome

Objective:To evaluate the efficacy and safety of traditional Chinese medicine decoction in the treatment of menopausal syndrome by Meta analysis of the published randomized controlled trials of traditional Chinese medicine decoction in the treatment of menopausal syndrome,so as to provide evidence-based medicine for clinical use of traditional Chinese medicine decoction in the treatment of menopausal syndrome.Methods:Pub Med,Embase,Cochrane Library,CNKI,CBM,VIP and Wanfang Data were searched from January 1,2013 to December 31,2022.The retrieved literature was managed and screened by Note Express,and the data was extracted and the literature quality was evaluated according to the report standard of Meta analysis and the method of Cochrane manual.Stata15.0 is used for merger analysis,and finally the data results are explained and discussed.Results:A total of 70 related studies were included in this Meta analysis,including5877 subjects,including 2995 in the experimental group and 2882 in the control group.The intervention measures of the experimental group were all traditional Chinese medicine decoction,and the control group were all hormone drugs,and the treatment methods were menopausal hormone therapy,including sequential estrogen and progesterone therapy,continuous estrogen and progesterone combination therapy,estrogen replacement therapy,and tibolone therapy.Included literature outcome indicators include:total effective rate,Kupperman Index score,sex hormone level,Chinese medical symptoms Scale,glucose and lipid metabolism level,bone mineral density,anxiety and depression score,recurrence rate,endometrial thickness,and adverse reactions.The results of Meta analysis are as follows:（1）The total effective rate:the clinical efficacy of traditional Chinese medicine decoction in the treat ment of menopausal syndrome is better than that of hormone drugs;in subgroup analysis,the curative effect of traditional Chinese medicine decoction is better than sequential therapy of estrogen and progesterone,continuous combination therapy of estrogen and progesterone,estrogen replacement therapy and tibolone treatment,the difference is statistically significant.（2）Kupperman score:the effect of traditional Chinese medicine decoction was better than that of hormone drugs in reducing Kupperman score,and in subgroup analysis,the effect of traditional Chinese medicine decoction was better than that of sequential therapy of estrogen and progesterone,continuous combination therapy of estrogen and progesterone,estrogen replacement therapy and tibolone treatment,the difference was statistically significant.（3）Sex hormone level:in reducing FSH and LH and increasing E₂,the effect of traditional Chinese medicine decoction was similar to that of hormone drugs,and the difference was not statistically significant;in the subgroup analysis,the effect of traditional Chinese medicine decoction was better than that of estrogen replacement therapy in reducing E₂ and increasing FSH,and the difference was statistically significant.（4）Chinese medical symptoms scale:the effect of traditional Chinese medicine decoction in reducing Chinese medical symptoms scale was better than that of hormone drugs;in subgroup analysis,the effect of traditional Chinese medicine decoction in reducing Chinese medical symptoms scale was better than that of estrogen and progesterone sequential therapy and tibolone treatment.the results were statistically significant,but the effect was similar to that of estrogen replacement therapy.（5）Lipid metabolism level:in reducing TC and TG,the effect of traditional Chinese medicine decoction was better than that of hormone drugs,and the difference was statistically significant;in increasing HDL-C,it was similar to that of hormone drugs;in reducing LDL-C,it was better than tibolone,the difference was statistically significant,but the effect was similar to that of estrogen and progesterone sequential therapy.（6）Glucose metabolism level:the effect of traditional Chinese medicine decoction on improving glucose metabolism level（FGB,FINS,HOMA-IR）was better than that of hormone drugs,and the difference was statistically significant.（7）Anxiety and depression score:the effect of traditional Chinese medicine decoction in reducing anxiety and depression score（SAS,SDS）was better than that of hormone drugs,and the difference was statistically significant.（8）Bone mineral density:traditional Chinese medicine decoction has the same effect as hormone drugs in improving the level of BMD.（9）Recurrence rate:the recurrence rate of traditional Chinese medicine decoction in the treatment of menopausal syndrome was lower than that of hormone drugs,and the difference was statistically significant.（10）Safety:compared with hormone drugs,traditional Chinese medicine decoction is not easy to thicken the endometrium and has fewer adverse reactions,the difference is statistically significant.Conclusions:1.The clinical effective rate of traditional Chinese medicine decoction in the treatment of menopausal syndrome is better than that of hormone drugs.2.The effect of traditional Chinese medicine decoction is better than that of hormone drugs in improving clinical symptoms and quality of life.3.Compared with hormone drugs,traditional Chinese medicine decoction is more effective in improving the level of glucose and lipid metabolism,but has the same effect in improving sex hormone level and bone mineral density.4.Compared with hormone drugs,traditional Chinese medicine decoction in the treatment of menopausal syndrome has better long-term effect,lower recurrence rate,less adverse reactions,not easy to thicken endometrium and higher clinical safety.