Meta Analysis For The Treatment Of Ovarian Chocolate Cyst With Chinese Herbal Medicine

Objectives:To assess the effectives and safety of Chinese herbal medicine(CHM) in the treatment of ovarian chocolate cyst with meta analysis, which reflects the characteristics of CHM in treatment of ovarian chocolate cyst. This will provide a basis for further research and lay the foundation for the treatment of ovarian chocolate cyst.Methods:Using the method of evidence-based medicine (EBM),combined with a comprehensive search of domestic and abroad randomized controlled research literature on CHM treatment of ovarian chocolate cyst. We evaluate the quality of the selected literatures, do the meta-analysis with Revman5.2.1software, and then choose the corresponding effect model according to heterogeneity test results. The effect index is risk ratio or mean differences, which was shown by95%confidence interval (CI).Outcomes:A total of31RCTs involving2630patients were included.1.Postoperative combined with Chinese medicine and western medicine treatment group compared with the western medicine controlled group(RR:1.14,95%CI:1.03,~1.25), postoperative combined with Chinese medicine treatment group compared with blank controlled group(RR:1.13,95%CI:1.04,1.22), the two groups shown statistically significant difference in improving clinical symptoms.2. Postoperative combined with CHM therapy compared with placebo (RR:-3.80;95%CI:-4.83~-2.77), postoperative combined with CHM compared with blank controlled group (RR:-3.90;95%CI:-5.96~-1.84), the two groups shown statistically significant difference in the treatment of dysmenorrhea;3.CHM compared with western medicine (RR:-0.85,95%CI:-1.18~-0.12), CHM compared with other treatments (RR:-0.65,95% CI:-0.96~-0.344), CHM combined with western medicine compared with western medicine group (RR:-0.13,95%CI:-0.26~-0.,11), the three groups shown statistically significant differences in narrowing the ectopic cyst;4. Postoperative combined with CHM and western medicine compared with the western medicine controlled group (RR:1.72,95%CI:1.28~2.31), postoperative combined with CHM treatment group compared with blank controlled group (RR:68,95%CI:1.03~2.75),shown statistically significant differences in CA125negative conversion ratio;5.CHM treatment group compared with the western medicine group (RR:0.18,95%CI:0.0,7~0.44), postoperative combined with CHM treatment group compared with blank controlled group (RR:0.18,95%CI:0.04~0.74), western medicine combined withCHM and enema in treatment group compared with CHM combined with western medicine controlled group (RR:0.11;95%CI:0.02~0.57), postoperative combined with CHM compared with the placebo group (RR:0.36;95%CI:0.14~0.98), postoperative combined with CHM compared with other treatments (RR:0.16,95%CI:0.04~0.68), postoperative combined with CHM and western medicine treatment group compared with the western medicine controlled group (RR:0.39,95%CI:0.2,1~0.73), these six groups shown statistically significant differences in the prevention of cyst recurrent;6.Postoperative combined with CHM treatment group compared with western medicine controlled group (RR:1.75,95%CI:1.13~2.70), postoperative combined with CHM treatment group compared with blank controlled group (RR:1.84;95%CI:1.23~2.74),the two groups shown statistically significant differences in improving the conception rates.7.Postoperative CHM treatment group compared with the western medicine controlled group (RR:0.12,95%CI:0.05~0.26), CHM treatment group compared with western medicine controlled group (RR:0.05,95%CI:0.01~0.26), CHM cooperate with other treatments (RR:0.04;95%CI:0.00~0.65), CHM combined with western medicine and enema treatment group compared with the CHM combined with western medicine controlled group (RR:0.05;95%CI:0.00~0.77), these three groups shown statistically significant differences in adverse events.Conclusions:1. CHM has curative effects in the treatment of ovarian chocolate cyst.Side effects of CHM were obviously lower than that of western medicine. This research can provide certain reference for the treatment of ovarian chocolate cyst with traditional Chinese medicine.2. Due to the bias in the literature and its’low quality, we should improve the quality of the research, which will provide strong evidence to guide clinical practice. Further well designed multicenter, large-scale and double-blind randomized controlled trials are still need at the same time.3.At present, Chinese herbal medicine therapy of ovarian chocolate cyst is not standard, which affect the quality of research seriously.The treatment of ovarian chocolate cyst with Chinese herbal medicine need to be standardized so as to provide a higher level evidence-based study basis for the clinical application.4. Due to ovarian chocolate cyst has the potential of malignant transformation, we need to alert to the occurrence of malignant transformation.