ABSTRACT
OBJECTIVE：To systematically evaluate therapeutic efficacy of Gongliuqing capsules combined with mifepristone in the treatment of uterine leiomyoma ，in order to provide evidence-based reference for clinical medication. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CJFD，VIP，CBM and Wanfang database ，randomized controlled trials （RCTs）about Gongliuqing capsules combined with mifepristone （trial group ）versus mifepristone alone （control group ）in the treatment of uterine leiomyoma were collected. After literature screening and data extraction ，the quality of included literatures was evaluated with modified Jadad scale. Meta-analysis was conducted by using Stata 14.0 software，and trial sequential analysis （TSA）was performed by using TSA 0.9 software. RESULTS ：A total of 12 RCTs were included ，involving 1 210 patients. The results of Meta- analysis showed that the total response rate of trial group [RR ＝1.12，95％CI（1.00，1.26），P＜0.05] was significantly higher than that of control group ；maximum uterine leiomyoma volume after treatment [SMD ＝－1.08，95％CI（－1.21，－0.95），P＜0.05]，uterine volume after treatment [SMD ＝－0.80，95％CI（－1.14，－0.45）， P＜0.05]，follicle stimulating hormone （FSH）level [SMD ＝ － 0.28，95％ CI（－ 0.45，－ 0.19），P＜0.05]，luteinizing hormone（LH）level [SMD ＝－0.44，95％CI（－0.52，－0.12）， 020-38076311。E-mail：867203217@qq.com P＜0.05]，E2 level [SMD ＝－2.69，95％CI（－3.08，－1.49）， P＜0.05] and progesterone （P）level [SMD ＝－1.27，95％CI（－1.69，－0.71），P＜0.05] of trial group were significantly lower or better than those of control group. Results of subgroup analysis showed that except for the level of FSH in 5 and 10 mg mifepristone groups （P＞0.05），maximum uterine leiomyoma volume after treatment ，uterine volume after treatment ，the levels of FSH，LH，E2 and P in trial group were significantly lower than control group. The results of TSA showed that there were definite evidences for total response rate of Gongliuqing capsules combined with mifepristone being better in the treatment of hysteromyoma. CONCLUSIONS ：Total response rate of Gongliuqing capsules combined with mifepristone in the treatment of hysteromyoma is better than mifepristone alone ，which can effectively decrease the volume of maximum uterine leiomyoma volume and uterine vilume ，and reduce the level of serum hormone.
ABSTRACT
OBJECTIVE： To systematically evaluate the difference of therapeutic efficacy of Xianling gubao capsules combined with routine therapy for postmenopausal osteoporosis （PMOP）. METHODS： Retrieved from Cochrane Library， PubMed， Embase， ClinicalTrials， CNKI， VIP， Wanfang database and CBM， clinical randomized controlled trials （RCTs） about Xianling gubao capsules combined with placebo and routine treatment （trial group） versus placebo and routine treatment or Xianling gubao capsules （control group） alone in the treatment of PMOP were collected. After literature screening and data extraction， the quality of included literatures were evaluated with Cochrane system evaluator manual 5.3 recommend bias risk evaluation tool. Bayesian Network Meta-analysis was performed with Stata 14.0 software and Bayesian Markov Chain Monte Carlo. RESULTS： A total of 16 RCTs were included， involving a total of 1 360 patients and 3 intervention measures as Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment， routine treatment. Results of Meta-analysis showed that in respect of improving total response rate， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.28，95％CI（0.12， 0.64），P＜0.05]could significantly improve total response rate； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In terms of increasing bone mineral density （BMD）， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.45，95％CI（0.24， 0.84），P＜0.05] and Xianling gubao capsules alone [OR＝0.78， 95％CI（0.32， 0.84），P＜0.05] could significantly improve BMD； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In the term of improving serum calcium level， compared with Xianling gubao capsules alone [OR＝4.76，95％CI（2.14， 10.59），P＜0.05] and routine treatment [OR＝0.45， 95％CI（0.21， 0.99），P＜0.05]， Xianling gubao capsules combined with routine treatment could significantly improve serum calcium level； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞routine treatment＞Xianling gubao capsules alone. In the term of improving serum phosphorus level， compared with Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment [OR＝2.85，95％CI（1.81， 4.48），P＜0.05] and routine treatment [OR＝2.93，95％CI（1.76， 4.86），P＜0.05] could significantly improve serum phosphorus level； network Meta-analysis ranking showed that routine treatment＞Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone. CONCLUSIONS： Xianling gubao capsules combined with routine treatment can significantly improve therapeutic efficacy of PP patients， increase BMD and serum calcium level after treatment， but routine treatment is the best in improving serum phosphorous level.