Journal of Traditional Chinese Medical Sciences (Oct 2023)
Systematic review of randomized controlled trials on Gong Liu Ning as a complimentary therapy in the treatment of uterine fibroids
Abstract
Objective: To systematically evaluate the efficacy and safety of Gong Liu Ning as a complimentary therapy in treatment for uterine fibroids. Methods: Randomized controlled trials on Gong Liu Ning for uterine fibroids from China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, PubMed, Cochrane Library, Embase, Web of Science, Chinese Clinical Trial Registry, and ClinicalTrials.gov were retrieved from inception to March 20, 2023. The risk of bias tool was used to evaluate the quality of the selected studies after they met inclusion and exclusion criteria. The GRADE tool was used to evaluate the quality of evidence, and the RevMan5.3 software was used for data analysis. Results: Twenty studies with 1907 patients were analyzed. The meta-analysis results of 15 studies showed that Gong Liu Ning combined with mifepristone was more efficacious than those observed in controls taking only Western medicine (risk ratio [RR] = 1.22, 95% confidence interval [CI] = [1.11, 1.33], P < .001). Owing to the large heterogeneity, a random-effects model was used to merge the included studies. Gong Liu Ning combined with mifepristone was better in reducing the volume of uterine fibroids (mean difference [MD] = −4.09 cm3, 95%CI [−5.16, −3.02], P < .001), uterine volume (MD = −23.22 cm3, 95%CI [−29.10, −17.33], P < .001), and the levels of female hormones, including progesterone, estrogen, follicle-stimulating hormone, and luteinizing hormone (all P < .001). Ten studies reported adverse events. The methodological quality of the included studies was not high, and a moderate risk of bias was observed. Conclusion: Compared with conventional Western medicine alone, the combined use of Gong Liu Ning has certain advantages in improving efficacy. It shows a certain advanced tendency to reduce the volume of uterine fibroids, uterine volume, and female hormones; however, more high-quality and rigorously designed studies are required for validation.
