ABSTRACT
Objective: To systematically evaluate the effectiveness of Kushen Gel in the treatment of cervical high-risk human papillomavirus (HR-HPV) infection. Methods: The Cochrane Library, PubMed, Embase, Medline, Wanfang, VIP, CNKI, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on Kushen Gel in the treatment of the cervical high-risk HPV infection from their inception to December 2019. Two researchers screened the articles, extracted the data, assessed the risk of bias of the eligble studies independently, and performed Meta-analysis with RevMan 5.3. Results: A total of 583 cases were included in five RCTs. The Meta-analysis showed that HR-HPV negative rate [RR = 1.38, 95% CI(1.20, 1.58), P 0.05). Conclusion: The therapeutic effect of applying Kushen Gel can increase the rate of clearance of HPV, reduce HPV-DNA load, and reduce postoperative complication. There is no evidence that the use of Kushen Gel after LEEP can reduce the recurrence rate of CIN2/CIN3. Due to the limitation of the quantity and quality of the included studies, the results need to be further verified and updated by more high-quality RCTs.
ABSTRACT
OBJECTIVE: To study the effects of Kushen gel on the growth of six common vaginal lactobacilli in vitro.METHODS: This study was conducted at Beijing Tsinghua Changgung Hospital from June 2018 to March 2019.Six different vaginal lactobacilli isolated from the healthy women of reproductive age in China were purified and cultured in vitro. The effect of different concentrations of Sophora flavescens alkaloid,which was the main active ingredient of Kushen gel,on the growth of various clinical lactobacillus isolates was observed by the agar dilution method.RESULTS: The minimum inhibitory concentration(MIC)of Sophora flavescens alkaloid to Lactobacillus rhamnosus was 40 mg/mL. The MICs for Lactobacillus crispatus,Lactobacillus jensenii,Lactobacillus gasseri and Lactobacillus reuteri were all 20 mg/mL. The MIC for Lactobacillus vaginalis was 10 mg/mL.When the concentration of Sophora flavescens alkaloid was lower than the MIC value,it had a certain effect on promoting proliferation of both Lactobacillus gasseri and Lactobacillus reuteri,but had no effect on Lactobacillus crispatus or Lactobacillus vaginalis.CONCLUSION: Under the clinical dosage,Kushen gel does not inhibit the growth of common vaginal lactobacilli,which is conducive to the recovery of the vaginal microecosystem.
ABSTRACT
Related randomly controlled trials about Kushen Gel and Metronidazole in recent 10 years were collected by various kinds of database according to strict inclusion and exclusion criteria. Valid data were extracted to conduct Meta-analysis by RevMan5.0. To evaluate the efficacy and safety of Kushen Gel and Metronidazole for bacterial and trichomonas vaginitis. A total of 63 articles were retrieved, but only four of them were finally included. Meta-analysis showed that the effective proportion of Kushen Gel was significantly higher than that of Metronidazole [RR=1.13, 95% CI (1.06 and 1.20), P < 0.01]. The incidence of adverse effects was significantly lower in Kushen group compared to the Metronidazole group [RR=0.29, 95% CI (0.15 and 0.56), P < 0.01]. Kushen Gel can improve symptoms of vaginitis more effectively than Metronidazole and tend to have lower incidence of adverse effects.