Effects of Chinese Medicinal Herbs for Female Immune-caused Subfertility: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

HE Haojie ¹ , XU Liangzhi ² , LI Shangwei ² , LI Ping ²

1. Peking Union Medical College Hospital; Beijing 100037; China2. West China Second University Hospital; Chengdu; 610041;

Corresponding author：

Keywords：

Chinese herbs; Immune; Subfertility; Randomized controlled trials; Systematic review

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Objective 　To assess the effectiveness and safety of Chinese medicinal herbs for female immune-caused subfertility.
Methods 　Databases included: MEDLINE (1966-2002.2), EMBASE (1984-2002.2), CBM (1978-2002.2) and Cochrane Controlled Trial Register, CCTR (Issue 1, 2002). Reference lists of trials were handsearched. Published randomized controlled trials (RCTs) whether blind or unblind, any languages and length of follow up were included. Treatments included Chinese medicinal herbs (single or compound). Controls were placebo and western medicine, or no intervention. Data were extracted independently by two reviewers and analyzed with Revman 4.2.
Results 　Six RCTs were included, all of which were poor in methodological quality. Because of different therapies in the treatment and control groups, we did not perform meta-analysis. The No.1 anti-immune tablet was more effective than corticosteroid plus condom during intercourse both in the pregnancy rate (RR 3.75, 95%CI 1.61 to 8.75, P=0.002) and AsAb negative rate (RR 1.66, 95%CI 1.23 to 2.22, P=0.000 8). Bushen Xiezhuo Soup was more effective than antibiotic in the pregnancy rate (RR 2.97, 95%CI 1.60 to 5.50, P=0.000 6) and antisperm antibody (AsAb) negative rate (RR 2.33, 95%CI 1.54 to 3.54, P lt;0.000 1)。Zhenqi Zhuanyin Soup was as effective as IUI in pregnancy rate (RR 1.80, 95%CI 0.58 to 5.60, P＝0.31) but more effective than IUI in AsAb negative conversion rate (RR 9.61, 95%CI 3.22 to 28.67, P lt;0.000 1), Zhenqi Zhuanyin Soup combined with IUI was more effective than IUI in pregnancy rate (RR 3.60, 95%CI 1.32 to 9.85,P=0.01) and AsAb negative rate (RR 8.92, 95%CI 2.98 to 26.75, P lt;0.000 1).
Conclusions 　Some Chinese medicinal herbs may work well in subfertility treatment. However, the evidence is too weak to draw a conclusion for there are deficiencies in strict randomization, blinding and follow-up.More strictly designed, randomized, double-blind, placebo-controlled trials are required.

Citation： HE Haojie,XU Liangzhi,LI Shangwei,LI Ping. Effects of Chinese Medicinal Herbs for Female Immune-caused Subfertility: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2004, 04(9): 609-614. doi: Copy

1.	［1］Gao DL, Chen XF. Investigation of primary pregnancy rate and subfertility rate about 60 000 new married women[J].Chin J Obstet Gyneco ,1989; 24(4):234-235.
2.	高道利,陈霞飞. 六万新婚妇女初孕率和不孕率调查[J]. 中华妇产科杂志, 1989; 24(4):234～235.
3.	［2］Neville F. Hacker, J.George Moore. Essentials of obstetrics and gonaecology. See: David R. Meldrum: Infertility[M]. 3rd. Philadelphia: W.B. Saunders Company;1998. p. 610-611.
4.	［3］Zhao K. Clinical observation on the effect of applying NO.1 anti-immune tablet to females with positive antisperm antibody in serum[J]. Journal of Sichuan of Traditional Chinese Medicine, 2001;19(4):57-58.
5.	赵凯. 抗免一号片治疗女性血清抗精子抗体阳性不孕疗效观察[J]. 四川中医, 2001; 19(4):57～58.
6.	［4］Zhao R. Clinical Research on the treatment of immune subfertility with Traditional Chinese Medicine[J]. Research of Traditional Chinese Medicine, 2001; 17(3):14,41.
7.	赵瑞. 中药治疗免疫性不孕的临床研究[J]. 中医药研究,2001; 17(3):14,41.
8.	［5］Liang WZ. Bushen Xiezhuo Soup for 78 patients with immune subfertility[J]. New Journal of Traditional Chinese Medicine,1997; 30(4):44.
9.	梁文珍. 补肾泻浊汤治疗免疫性不孕症78例[J]. 新中医, 1997; 30(4):44.
10.	［6］Luo SP, Liang GZ, Zhang YZ, Luo YK. Clinical research on applying NO.1 and NO.2 improving pregnancy pills to patients with positive antisperm antibody in serum[J]. New Journal of Traditional Chinese Medicine,1996; 28(8):46-48.
11.	罗颂平,梁国珍, 张玉珍,罗元恺. 助孕一号、二号丸治疗血清抗精子抗体阳性患者的临床研究[J]. 新中医,1996; 28(8):46～48.
12.	［7］Lian F, Zhang N. Clinical observation on applying Zhenqi Zhuanyin Soup and IUI to females with positive antisperm antibody subfertility[J]. Chinese journal of integrated traditional and western medicine, 2002; 22(2):95-97.
13.	连方,张宁. 贞芪转阴汤配合宫腔内人工受精治疗女性抗精子抗体阳性脾肾两虚型不孕症的临床观察[J]. 中国中西医结合杂志, 2002; 22(2):95～97.
14.	［8］Liu RF. 26 Clinical Observation on the treatment of immune subfertility with integrated traditional and western medicine[J]. Chinese journal of integrated traditional and western medicine, 2002; 22(1):68-69.
15.	刘瑞芬.中西医结合治疗免疫性不孕26例临床观察[J]. 中国中西医结合杂志, 2002; 22(1):68～69.
16.	［9］Wang JL, Lin Z, Zhang YF, Pan BX, Tang CY, Wu ZZ, Ma DF. Clinical observation on the effect of applying Zhugunning to 136 patients with positive antisperm antibody[J]. Journal of Traditional Chinese Medicine, 2001; 42(11):667-669.
17.	王俊玲,林战,张永锋,潘柏轩,唐春艳,吴正治,马德芬. 助孕灵治疗抗精子抗体阳性患者136例临床疗效观察[J]. 中医杂志, 2001; 42(11):667～669.
18.	［10］Luo SP, Liang GZ, Zhang YZ. Clinical and laboratory study on immune natural abortion and immune subfertility[J]. Journal of Traditional Chinese Medicne,1997;38(6).
19.	罗颂平,梁国珍, 张玉珍. 免疫性自然流产与免疫性不孕的临床与实验研究[J]. 中医杂志, 1997; 38(6).
20.	［11］Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5):408-412.
21.	［12］Vickers A, Goyal N, Harland R, Rees R Do certain countries produce only positive results? A systematic reviews of controlled trials[J]. Control Clin Trials, 1998; 19(2): 159-166.

1. ［1］Gao DL, Chen XF. Investigation of primary pregnancy rate and subfertility rate about 60 000 new married women[J].Chin J Obstet Gyneco ,1989; 24(4):234-235.
2. 高道利,陈霞飞. 六万新婚妇女初孕率和不孕率调查[J]. 中华妇产科杂志, 1989; 24(4):234～235.
3. ［2］Neville F. Hacker, J.George Moore. Essentials of obstetrics and gonaecology. See: David R. Meldrum: Infertility[M]. 3rd. Philadelphia: W.B. Saunders Company;1998. p. 610-611.
4. ［3］Zhao K. Clinical observation on the effect of applying NO.1 anti-immune tablet to females with positive antisperm antibody in serum[J]. Journal of Sichuan of Traditional Chinese Medicine, 2001;19(4):57-58.
5. 赵凯. 抗免一号片治疗女性血清抗精子抗体阳性不孕疗效观察[J]. 四川中医, 2001; 19(4):57～58.
6. ［4］Zhao R. Clinical Research on the treatment of immune subfertility with Traditional Chinese Medicine[J]. Research of Traditional Chinese Medicine, 2001; 17(3):14,41.
7. 赵瑞. 中药治疗免疫性不孕的临床研究[J]. 中医药研究,2001; 17(3):14,41.
8. ［5］Liang WZ. Bushen Xiezhuo Soup for 78 patients with immune subfertility[J]. New Journal of Traditional Chinese Medicine,1997; 30(4):44.
9. 梁文珍. 补肾泻浊汤治疗免疫性不孕症78例[J]. 新中医, 1997; 30(4):44.
10. ［6］Luo SP, Liang GZ, Zhang YZ, Luo YK. Clinical research on applying NO.1 and NO.2 improving pregnancy pills to patients with positive antisperm antibody in serum[J]. New Journal of Traditional Chinese Medicine,1996; 28(8):46-48.
11. 罗颂平,梁国珍, 张玉珍,罗元恺. 助孕一号、二号丸治疗血清抗精子抗体阳性患者的临床研究[J]. 新中医,1996; 28(8):46～48.
12. ［7］Lian F, Zhang N. Clinical observation on applying Zhenqi Zhuanyin Soup and IUI to females with positive antisperm antibody subfertility[J]. Chinese journal of integrated traditional and western medicine, 2002; 22(2):95-97.
13. 连方,张宁. 贞芪转阴汤配合宫腔内人工受精治疗女性抗精子抗体阳性脾肾两虚型不孕症的临床观察[J]. 中国中西医结合杂志, 2002; 22(2):95～97.
14. ［8］Liu RF. 26 Clinical Observation on the treatment of immune subfertility with integrated traditional and western medicine[J]. Chinese journal of integrated traditional and western medicine, 2002; 22(1):68-69.
15. 刘瑞芬.中西医结合治疗免疫性不孕26例临床观察[J]. 中国中西医结合杂志, 2002; 22(1):68～69.
16. ［9］Wang JL, Lin Z, Zhang YF, Pan BX, Tang CY, Wu ZZ, Ma DF. Clinical observation on the effect of applying Zhugunning to 136 patients with positive antisperm antibody[J]. Journal of Traditional Chinese Medicine, 2001; 42(11):667-669.
17. 王俊玲,林战,张永锋,潘柏轩,唐春艳,吴正治,马德芬. 助孕灵治疗抗精子抗体阳性患者136例临床疗效观察[J]. 中医杂志, 2001; 42(11):667～669.
18. ［10］Luo SP, Liang GZ, Zhang YZ. Clinical and laboratory study on immune natural abortion and immune subfertility[J]. Journal of Traditional Chinese Medicne,1997;38(6).
19. 罗颂平,梁国珍, 张玉珍. 免疫性自然流产与免疫性不孕的临床与实验研究[J]. 中医杂志, 1997; 38(6).
20. ［11］Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5):408-412.
21. ［12］Vickers A, Goyal N, Harland R, Rees R Do certain countries produce only positive results? A systematic reviews of controlled trials[J]. Control Clin Trials, 1998; 19(2): 159-166.

Chinese Journal of Evidence-Based Medicine

Effects of Chinese Medicinal Herbs for Female Immune-caused Subfertility: A Systematic Review

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