Medicine, Chinese traditional,Letrozole,Polycystic ovary syndrome,Meta-analysis," /> Medicine, Chinese traditional,Letrozole,Polycystic ovary syndrome,Meta-analysis,"/> Effectiveness of co-treatment with traditional Chinese medicine and letrozole for polycystic ovary syndrome: A meta-analysis
Search JIM Advanced Search

Journal of Integrative Medicine ›› 2017, Vol. 15 ›› Issue (2): 95-101.doi: 10.1016/S2095-4964(17)60320-0

Special Issue: Traditional Chinese Medicine

• Systematic Review • Previous Articles     Next Articles

Effectiveness of co-treatment with traditional Chinese medicine and letrozole for polycystic ovary syndrome: A meta-analysis

Qian-wen Maa,b, Yong Tana   

  1. aThe First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China 
    b Department of Gynecology, Zhenjiang Hospital of Traditional Chinese Medicine, Zhenjiang 212003,Jiangsu Province, China
  • Received:2016-09-03 Accepted:2016-11-15 Online:2017-03-15 Published:2017-03-15
  • Contact: Yong Tan; E-mail: nzyszy@163.com
  • Supported by:
    This research was supported by the Natural Science Foundation of China (No. 81373683).

Background

Polycystic ovary syndrome (PCOS) is an endocrine disease that affects gynecological health. Treatment of PCOS remains a big challenge for clinicians.

Objective

This meta-analysis was developed to compare the efficacy of co-treatment with traditional Chinese medicine (TCM) and letrozole against letrozole monotherapy in the treatment of PCOS.

Search strategy

Randomized controlled trials (RCTs) were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software (The Cochrane Collaboration, Copenhagen, Denmark).

Inclusion criteria

We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources.

Data extraction and analysis

Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias.

Results

Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups.

Conclusion

Available evidence showed that co-treatment with TCM and letrozole was more effective than letrozole monotherapy in the treatment of PCOS.

Key words: Medicine, Chinese traditional, Letrozole, Polycystic ovary syndrome, Meta-analysis

1 Misso ML, Costello MF, Garrubba M, Wong J, Hart R, Rombauts L, Melder AM, Norman RJ, Teede HJ.Metformin versus clomiphene citrate for infertility in non-obese women with polycystic ovary syndrome: a systematic review and meta-analysis.Hum Reprod Update. 2013; 19(1): 2-11.
2 Birch Petersen K, Pedersen NG, Pedersen AT, Lauritsen MP, la Cour Freiesleben N. Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction.Reprod Biomed Online. 2016; 32(6): 563-583.
3 He D, Jiang F.Meta-analysis of letrozole versus clomiphene citrate in polycystic ovary syndrome.Reprod Biomed Online. 2011; 23(1): 91-96.
4 Palihawadana TS, Wijesinghe PS, Seneviratne HR.A comparison of endometrial thickness following augmentation of ovulation with clomifene citrate or letrozole in women with ovulatory infertility.Ceylon Med J. 2015; 60(2): 48-52.
5 Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Casson P, Christman GM, Huang H, Yan Q, Alvero R, Haisenleder DJ, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Trussell JC, Krawetz SA, Snyder P, Ohl D, Santoro N, Eisenberg E, Zhang H; NICHD Reproductive Medicine Network. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome.N Engl J Med. 2014; 371(2): 119-129.
6 Hussain NHN, Ismail M, Zain MM, Yeu PC, Ramli R, Mohammad WMZW.Randomized controlled trial of letrozole versus clomiphene citrate for induction of ovulation in polycystic ovarian syndrome (PCOS): a Malaysian experience.Open J Obstet Gynecol. 2013; 3: 11-17.
7 Tan WJ, Han WW. Observation on letrozole combined with traditional Chinese medicine sequential therapy for the treatment of infertility caused by polycystic ovary syndrome. Zhong Yi Yao Lin Chuang Za Zhi.2015; 27(1): 65-67. Chinese with abstract in English.
8 Wang CL. Clinical observation of Nuan Chao Bao combination with letrozole in the treatment with infertility of ovulation dysfunction for polycystic ovary syndrome (kidney defi ciency). Changsha: Hunan Un iversity of Chinese Medicine. 2014: 1-72. Chinese with abstract in English.
9 Zhang L. Clinical observation of Yang Pao Soup with letrozole in the treatment with spleen and kidney defi ciency syndrome of polycystic ovary syndrome. Changsha: Hunan University of Chinese Medicine. 2013: 1-61. Chinese with abstract in English.
10 Yu L, Li DJ. Clinical research of traditional Chinese medicine combined with Western medicine in the treatment of infertility caused by polycystic ovary syndrome. Shi Yong Zhong Yi Yao Za Zhi.2015; 31(1): 23-25. Chinese.
11 Jin Y. Clinical observation of traditional Chinese medicine combined with Western medicine in the treatment with infertility of kidney deficiency and liver depression syndrome for polycystic ovarian syndrome. Hefei: Anhui University of Chinese Medicine. 2014: 1-67. Chinese with abstract in English.
12 Cui HX. Traditional Chinese medicine combined with letrozole in the treatment of 45 cases of infertility caused by polycystic ovary syndrome. Zhongguo Zhong Yi Yao Ke Ji.2013; 20(3): 307. Chinese.
13 Li GZ, Li X, Ayinuer K, Yang L. Clinical observation of traditional Chinese medicine with letrozole cycle therapy in the treatment of hebephrenic polycystic ovary syndrome. Zhong Yi Yao Dao Bao.2015; 21(16): 78-81. Chinese.
14 Wang QD, Yu YM, Cao J, Zhang XX, Du ZY. Clinical observation of Yi Qi Hua Shi Qu Zhuo Tang in the treatment of obesity of polycystic ovary syndrome. Zhongguo Bao Jian Ying Yang.2015; 9(2): 36-37. Chinese.
15 15 The Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions version 5.1.0. (2011-03). [2016-09]. www.cochrane.org/training /cochrane-handbook.
[1] Ming-min Xu, Pei Guo, Qing-yu Ma, Xuan Zhou, Yu-long Wei, Lu Wang, Yue Chen, Yu Guo. Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis. Journal of Integrative Medicine, 2022, 20(4): 305-320.
[2] Ting-ting Lu, Cun-cun Lu, Mei-xuan Li, Li-xin Ke, Hui Cai, Ke-hu Yang. Reporting and methodological quality of meta-analyses of acupuncture for patients with migraine: A methodological investigation with evidence map. Journal of Integrative Medicine, 2022, 20(3): 213-220.
[3] Deng-chao Wang, Miao Yu, Wen-xian Xie, Li-yan Huang, Jian Wei, Yue-hua Lei. Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019. Journal of Integrative Medicine, 2022, 20(1): 26-33.
[4] Jun-peng Yao, Li-ping Chen, Xian-jun Xiao, Ting-hui Hou, Si-yuan Zhou, Ming-min Xu, Kai Wang, Yu-jun Hou, Lin Zhang, Ying Li. Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews. Journal of Integrative Medicine, 2022, 20(1): 13-25.
[5] Yang-hao-tian Wu, Wen-bo He, Yin-yan Gao, Xue-mei Han. Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 493-502.
[6] Yi Yuan, Rui-Ting Wang, Jun Xia, Hui-Juan Cao. Interventions for preventing influenza: an overview of Cochrane systematic reviews and a Bayesian network meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 503-514.
[7] Qiu-yu Tong, Ran Liu, Kun Zhang, Yuan Gao, Guang-wei Cui, Wei-dong Shen. Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(1): 20-28.
[8] Liang Dai, Ka Kei Chan, Jian-chun Mao, Yu Tian, Jun-hua Gu, Jun Zhou, Linda L.D. Zhong. Modified Zhibai Dihuang pill, a traditional Chinese medicine formula, on steroid withdrawal in systemic lupus erythematosus: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(6): 478-491.
[9] Arthur Yin Fan, Sherman Gu, Sarah Faggert Alemi, Research Group for Evidence-based Chinese Medicine. Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(5): 385-394.
[10] Xian-jun Xiao, Lei-xiao Zhang, Yun-zhou Shi, Jun-peng Yao, Wei Cao, Ying Liu, Zi-hao Zou, Si-yuan Zhou, Ming-ling Chen, Chun-xiao Li, Qian-hua Zheng, Ying Li. Cupping therapy for patients with chronic urticaria: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(4): 303-312.
[11] Esmaeil Yousefi Rad, Behzad Nazarian, Somayeh Saboori, Ebrahim Falahi, Azita Hekmatdoost. Effects of L-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials. Journal of Integrative Medicine, 2020, 18(4): 284-291.
[12] Dong-dong Yu, Liang-zhen You, Wan-qiu Huang, Hui Cao, Fan-jing Wang, Xiu-qin Tang, Zhao-hui Fang, Guo-ming Shen, Yu-xiang Guan. Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(4): 292-302.
[13] Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[14] Jia Xu, Fu-qing Zhang, Jian Pei, Jun Ji . Acupuncture for migraine without aura: A systematic review and meta-analysis. Journal of Integrative Medicine, 2018, 16(5): 312-321.
[15] Jin Yu, Chao-qin Yu, Qi Cao, Li Wang, Wen-jun Wang, Li-rong Zhou, Jing Li, Qiao-hong Qian. Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft). Journal of Integrative Medicine, 2017, 15(2): 102-109.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239