Abstract
Background: Endometriosis is an estrogen-dependent gynecological inflammatory condition that may lead to infertility and recurrent pelvic pain. The purpose of this research was to determine the efficacy and safety of Salvia miltiorrhiza-containing Chinese herbal medicine (CHM) combined with gonadotropin-releasing hormone agonist (GnRH-a) for postoperative endometriosis management. Methods:Eight databases were systematically searched before October 2021, including PubMed, Embase, Cochrane Library, Scopus, Web of Sceince, CNKI, VIP, and Wanfang. Finally, all randomized controlled studies comparing Salvia miltiorrhiza-containing CHM paired with GnRH-a to GnRH-a alone for postoperative endometriosis management were included. Results: A total of 10 trials involving 836 patients were reported and analyzed. Compared with the control group, the Salvia miltiorrhiza-containing CHM combined with GnRH-a group showed significant superiority in decreasing endometriosis recurrence (risk ratio [RR] = 0.26; 95% confidence intervals [CI]: 0.16–0.41) and increasing the pregnancy rate ([RR] = 1.96; 95% CI: 1.58–2.44). Similarly, the effect of the Salvia miltiorrhiza-containing CHM combined with GnRH-a on CA-125 serum levels was positive (standardized mean difference [SMD] = -0.79; 95% CI: −1.11 to −0.47). Furthermore, this group showed a significant reduction in adverse effects. Conclusion: The results indicate that Salvia miltiorrhiza-containing CHM may be a viable choice for postoperative endometriosis therapy, with the potential to enhance pregnancy while decreasing recurrence and adverse effects.
Highlights
Endometriosis is a gynecological disease characterized by the presence of endometrial epithelium and stroma outside the uterine cavity, which causes chronic pelvic pain, dysmenorrhea, deep dyspareunia, dysuria and infertility (Patzkowsky, 2021)
Medical subheadings (MeSH) words combined with free words were used for retrieval in the English library, and the search terms AND (Chinese Traditional Medicine OR Chinese herbal medicine) AND (GnRH agonist OR Gonadotropin-releasing hormone agonist OR gonadotropin-releasing hormone agonist (GnRH-a)) were used as keywords
All studies were unclear on the blinding of outcome assessment, patients with endometriosis have objective evaluation indexes for recurrence, pregnancy and serum Cancer antigen 125 (CA-125) level, and it was difficult to affect the outcomes evaluation
Summary
Endometriosis is a gynecological disease characterized by the presence of endometrial epithelium and stroma outside the uterine cavity, which causes chronic pelvic pain, dysmenorrhea, deep dyspareunia, dysuria and infertility (Patzkowsky, 2021). GnRH-a is frequently used after surgery to eliminate microscopic lesions and prevent recurrence of endometriosis. It inhibits follicle development and ovulation by lowering FSH and LH secretion, which decreases the synthesis of estradiol and progesterone to suppress the progression of the lesion and treat endometriosis-related pain (Della Corte et al, 2020). Endometriosis is an estrogen-dependent gynecological inflammatory condition that may lead to infertility and recurrent pelvic pain. The purpose of this research was to determine the efficacy and safety of Salvia miltiorrhiza-containing Chinese herbal medicine (CHM) combined with gonadotropin-releasing hormone agonist (GnRH-a) for postoperative endometriosis management
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