Meta-analysis of Tonifying-Kindney and Soothing-Liver traditional Chinese medicine method in the treatment of polycystic ovary syndrome

Background:To systematically evaluate the clinical efficacy of Tonifying-Kindney and Soothing-Liver method in the treatment of polycystic ovary syndrome(PCOS).Methods:The literatures of randomized controlled trials(RCTs)on the treatment of PCOS with traditional Chinese medicine(TCM)published at home and abroad until March 2020 were retrieved,and RCTs on the treatment of PCOS with Tonifying-Kindney and Soothing-Liver method were collected.According to the systematic evaluation method of the Cochrane Collaboration Network,RevMan5.3 software was used to perform quality evaluation and data extraction for meta-analysis of tests that met the inclusion criteria.Results:A total of 30 eligible RCTs were included,including 2244 patients.Meta-analysis results show that the method of tonifying the kidney and Soothing-Liver has certain advantages in the treatment of PCOS.Compared with Western medicine alone group,tonifying the kidney and Soothing-Liver TCM method alone or combined with Western medicine could improve the total effective rate[OR=3.52,95%CI(2.67,4.63),I2=0%,P<0.00001].It is superior to the control group in improving ovulation rate[OR=2.01,95%CI(1.46,2.78),I2=0%,P<0.0001],pregnancy rate[OR=2.82,95%CI(2.28,3.49),I2=0%,P<0.00001],reducing LH[MD=-2.65,95%CI(-3.43,-1.88),I2=92%,P<0.00001]and ovarian stimulating hormone levels[MD=-0.52,95%CI(-0.85,-0.18),I2=94%,P=0.002].There was no statistical difference in reducing serum testosterone levels[SMD=-0.56,95%CI(-1.22,0.09),I2=96%,P=0.09]and improving TCM symptoms[MD=-0.09,95%CI(-4.75,4.56),I2=97%,P=0.97].Conclusion:The method of tonifying the kidney and Soothing-Liver has a certain effect in treating polycystic ovary syndrome,but the evidence is still very limited,and a large sample of high-quality randomized controlled studies is still needed in order to make a more rigorous evaluation.

Effect of soothing-liver and nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset for depressive disorder and related indicators of neuroimmunology:a randomized controlled clinical trial

OBJECTIVE:To observe the effect of soothing-liver and nourishing-heart acupuncture on selective serotonin reuptake inhibitor(SSRIs) treatment effect onset in patients with depressive disorder and related indicators of neuroimmunology.METHODS:Overall,126 patients with depressive disorder were randomly divided into a medicine and acupuncture-medicine group using a random number table.Patients were treated for 6 consecutive weeks.The two groups were evaluated by the Montgomery-Asberg Depression Rating Scale(MADRS) and Side Effects Rating Scale(SERS) to assess the effect of the soothing-liver and nourishing-heart acupuncture method on early onset of SSRI treatment effect.Changes in serum 5-hydroxytryptamine(5-HT) and inflammatory cytokines before and after treatment were recorded and compared between the medicine group and the acupuncture-medicine group.RESULTS:The acupuncture-medicine group had significantly lower MADRS scores at weeks 1,2,4,and 6 after treatment compared with the medicine group(P < 0.01).The acupuncture group had significantly lower SERS scores at weeks 1,2,4,and 6 after treatment compared with the medicine group(P < 0.01).At 6 weeks after treatment,serum 5-HT in the acupuncture-medicine group was significantly higher compared with the medicine group(P <0.01).lnterleukin-6(IL-6) in the acupuncture-medicine group was significantly lower than that in the medicine group(P < 0.01),whereas there was no significant difference in IL-1(3 between the groups(P > 0.05).Anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in the acupuncture-medicine group compared with the medicine group(P < 0.01,P < 0.05,respectively).CONCLUSION:The soothing-liver and nourishing-heart acupuncture method can effectively accelerate the onset of SSRI effects when treating depressive disorder and can significantly reduce the adverse reactions of SSRIs.Moreover,acupuncture can enhance serum 5-HT and regulate the balance of pro-inflammatory cytokines and anti-inflammatory cytokines.