Evaluation Of TCM In Treating Climacteric Syndrome

The Background:The climacteric syndrome is a common and polidisease in the gynecology. Most of the foreign medical adopt the hormone replacement therapeusis , but long-term taking medicine can result to the increasing incidence rate of the cancer of the wormb , the ovary and the breast. In the ancient and modern literature, it has been regarded and reported that the Chinese traditional medicine is sure effect to the climacteric period . So the systematic evaluation of these treatment is very important. Now the clinical investigation does not think highly of the methodology and affects the extence of the investigative conclusion and the admittance of the western medical.The method and result of the Evidence Based Medicine and systermatic analysis has been admitted and thought highly of by the international-medicine and the medical-decision department day by day. To utilize the Evidence-based medicine and the method of systematic analysis. The Meta-analysis of the multipdate of the literature can lead the Chinese Traditional to the world, to the modern. The Objective:The purpose of the article is to use the systematic reviews Meta analysis to evaluate the clinical effect of the TCM that it helps the climacteric syndrome.The Methods:The matched-control literatures are those published in the civil. To investigate the clinical effect of TCM that it helps the climacteric syndrome. Literature-retrieved data: CNKI WEB and CQVIP, during 1994-2004 years. Inclusion criteria: (l)The corrent of the article hints the report of the clinical investigation of theclimacteric period. (2) The grouping of the article appears the word of "random" . It has the good balance between groups and comparance. (3)The article should do statistic analysis to some samples. Based on the principle and the method of DME, formulat the Systematic Review Table of the treatment article of TCM to the climacteric period. It has made statistic analysis from 9 lines. Such as randomization the balance of groups. The inclusion and exclusion criteria,. control, sample size, blind-method, statistics method, objects sdandardization, the effect judgement standardization, etc. Calculate the percentage of all kinds of states and evaluate the quality. Then utilize the RevMan to procee Meta analysis of random effect model . I have made sensitivity analysis to different inclusion criteria results and analized publication bias using funnel plots.The Conclusion:I have recalled the literatures about climacteric syndrome therapeusis 625 pieces in all, only 43 randomized controlled trials in line with the inclusion criteria. The whole randomized quality is rather low. There are only 7pieces are randomization perfectly. The balance between groups which posses comparance are 43 pieces. There are 10 trials adopt the TCM treatment with syndrome differentia and foreign medical diagonosion. The criteria percentage is 23.26%.There are 8 pieces adopt TCM treatment with syndrome differentiation. The criteria percentage is 18. 60%. There are 15 pieces adopt the foreign diagonosion criteria. The percentage is 34. 88%.There are 1 pieces have clear inclusion-creteria. The percentage is 23. 26. There are 17 pieces have clear inclusion-creteria. It is 39. 53%. The sample definition is discompact. There are no artictes explain the analysis of the calculation method of sample size, latent allocation and conation therapeusis; The articles that apply blind method are very few, only 4 pieces, (the double blind method is 1, the single blind method is 3). The most articles have statistical test. For example: There is 1 statistical method is wrong. It is 2.33%. There are22 statistical method are generally right, about 51.16%. There are 20 pieces don' t make any interpretation about statistical method, about 46. 51%. The 43 articles evaluate from many lines, such as: The TCM therapeusis, the Standardizatiaon of the experimental medicine, the medicine conformation, the medicine type, dose, usage, course, etc. I regard initially that the better standardization are 4 pieces, about 9. 30%, the good are 28 pieces, about 65.12%, the normal are 11 pieces, about 25. 58%, 41 pieces have effect judgement, about 95. 35%. There are 19 pieces that regard Chinese TCM to be control, about 44. 19%. 22 pieces regard western medicine to be control, about 51. 16%. 2 pieces regard the combination of TCM and western medicine to be control, about 4. 65%. 7 pieces reported adverse reaction, about 16. 28%. 9 pieces have flow-up. The titre of the TCM therapeusis 0R=0. 33(The rate of effect between experiment and control), 95% CI[0.22 0.48]Discussion: Because of the spreadout of DME among scientific research personel has gain well result. The TCM clinical scientific research has also gain much amelioration. There are many problems in practicing scientific research personnel has gain well result. The TCM clinical scientific research has also gain much amelioration. There are many problems in practicing scientific research with RCT which need the most demonstration intensity. Such as: allocation method, sample size etc. So, we should procee strict, multicentric randomized double blind control trail, to provide more reasonable proof. The choice of effect judgement marker, the observation of omitted and observed reaction, the normalization of the clinical trial report etc. The quantity of inclusion is low, and the quality is not high. So the demonstration intensity is weak. We need much more high quality trail to add the demonstration intensity.Conclusion:Via the Meta analysis result ,there are some effect of TCM treating climacteric syndrome. But if there were more high quality article about TCM treating climacteric syndrome, the causality of this...