Abstract
Purpose The aim of the research was to evaluate the efficacy and safety associated with Fuke Qianjin tablet combined with conventional therapy in the treatment of pelvic inflammatory diseases and associated complications (endometritis) using a meta-analysis approach. Patients and Methods. We searched 8 electronic databases up to December 31, 2019, including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, WanFang, VIP, and SinoMed. Eligible studies were clinical trials of Fuke Qianjin tablet combined with conventional therapy used in the treatment of acute pelvic inflammatory disease, chronic pelvic inflammatory disease, and endometritis. The meta-analysis was performed using STATA15 software. Results A total of 125 RCTs (n = 14,494) were shortlisted for the meta-analysis, which included 23 trials for acute pelvic inflammatory disease, 69 trials for chronic pelvic inflammatory disease, and 33 trials for endometritis. The overall analysis illustrated Fuke Qianjin tablet combined with conventional therapy was significantly more efficacious than conventional therapy alone across all types of antibiotics treatment for acute pelvic inflammatory disease (OR = 5.57, 95% CI 4.09–7.58, Z = 10.90, p=0.001), chronic pelvic inflammatory disease (OR = 4.70, 95% CI 4.07–5.42, Z = 21.21, p=0.001) and endometritis (OR = 5.09, 95% CI 4.03–6.43; Z = 13.63, p=0.001) in both primary endpoints and secondary endpoints. There is also a trend that Fuke Qianjin tablet combined with conventional therapy has lower adverse reaction rates than conventional therapy alone. Conclusion Fuke Qianjin tablet combined with conventional therapy showed better clinical efficacy in the treatment of acute pelvic inflammatory disease, chronic pelvic inflammatory disease, and endometritis. There were no obvious drug-related adverse reactions. Fuke Qianjin tablet presented advantages in shortening the remission time of clinical symptoms, reducing the concentration of serum inflammatory factors, improving endometrial thickness, menstruation, and reducing relapse rate.
Highlights
Pelvic inflammatory disease (PID), one of the most common infections in women of reproductive age, could lead to endometritis, oophoritis, salpingitis, tuboovarian abscess, peritonitis, and other complications [1,2,3,4]
Many researchers have performed evaluation of the clinical application of Fuke Qianjin tablets [17], but further evaluation is deemed necessary. erefore, this study aims to comprehensively evaluate the efficacy and safety of Fuke Qianjin tablets and provide a basis for its application as a treatment for pelvic inflammatory disease
Eligible studies should have met the following criteria: (1) randomized controlled trials (RCTs) of Fuke Qianjin tablets published in China or internationally; (2) patients diagnosed with acute pelvic inflammatory disease, chronic pelvic inflammatory disease, or endometritis; (3) the intervention measures of the experimental group are Fuke Qianjin tablets alone or combined with conventional treatment; and (4) the study reported one or more of the following outcome indicators: the main outcome indicators such as total effective rate and incidence of adverse reactions, and secondary outcome indicators such as clinical symptom relief time, endometrial thickness, serum inflammatory factor concentration, menstrual recovery, and relapse rate
Summary
Pelvic inflammatory disease (PID), one of the most common infections in women of reproductive age, could lead to endometritis, oophoritis, salpingitis, tuboovarian abscess, peritonitis, and other complications [1,2,3,4]. Studies have shown that about 25% of PID patients will have long-term sequelae, including annexitis, irregular menstruation, infertility, ectopic pregnancy, or chronic pelvic pain [5]. Compared with those without PID, patients with PID had a 1.864 times higher risk of developing preterm labor and a 2.121 times higher risk of developing ectopic pregnancy [6]. Studies have shown that effective treatment of endometritis can improve patient reproductive health [9]. A research reported on PID health economics showed that young women are willing to spend 1-2 years of life to prevent PID and its related sequelae [10]. In the United States, the medical cost in treating a PID case is about US$3,200 [11], and the annual PID-related
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