Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials
BackgroundGuizhi Fuling (GZFL) pill, a traditional Chinese herbal formula including Semen Persicae, Ramulus Cinnamomi, Poria, Radix Paeoniae Alba, and Cortex Moutan, has been widely applied in the management of gynecological diseases.ObjectiveTo evaluate the add-on effect of the GZFL formula for tre...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.995106/full |
| _version_ | 1827964948507000832 |
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| author | Anna Rong Na Ta Lihua E. Wenbin Meng |
| author_facet | Anna Rong Na Ta Lihua E. Wenbin Meng |
| author_sort | Anna Rong |
| collection | DOAJ |
| description | BackgroundGuizhi Fuling (GZFL) pill, a traditional Chinese herbal formula including Semen Persicae, Ramulus Cinnamomi, Poria, Radix Paeoniae Alba, and Cortex Moutan, has been widely applied in the management of gynecological diseases.ObjectiveTo evaluate the add-on effect of the GZFL formula for treating reduced fertility potential in women with polycystic ovary syndrome (PCOS) by conducting a systematic review and meta-analysis.MethodsTwo reviewers independently searched the PubMed, Embase, Cochrane Library, Wanfang, SinoMed, and CKNI databases until 09/11/2022. Eligible studies were randomized controlled trials (RCTs) of the GZFL formula plus Western medicine versus the Western medicine for treating PCOS. The primary endpoint was the ovulation, pregnancy, and miscarriage rate. The secondary endpoints included the serum follicle-stimulating hormone (FSH), total testosterone, luteinizing hormone (LH), estradiol, and homeostasis model assessment insulin resistance (HOMA-IR).ResultsThere were 16 RCTs with 1,385 patients identified. The GZFL formula plus Western medicine significantly improved the ovulation rate (risk ratios [RR] 1.24; 95% confidence intervals [CI] 1.15–1.34) and pregnancy rate (RR 1.53; 95% CI 1.38 to 1.69) than the Western medicine alone. Adjuvant treatment with the GZFL formula also significantly decreased the serum FSH (mean difference [MD] -0.48 U/l; 95% CI -0.80 to -0.15), total testosterone (standard mean difference [SMD] -1.07; 95% CI -1.71 to -0.44), LH level (MD -2.19 U/l; 95% CI -3.04 to -1.34), and HOMA-IR (MD -0.47; 95% CI -0.60 to -0.34). However, there was no significant difference in the miscarriage rate (RR 0.89; 95% CI 0.36–2.20) and serum estradiol level (SMD 0.34; 95% CI -0.25 to 0.94) between two groups.ConclusionsThe GZFL formula as adjuvant therapy can improve the ovulation and pregnancy rates in women with PCOS. Its beneficial effects may correlate with reducing FSH, total testosterone, and LH and ameliorating insulin resistance. However, more well-designed RCTs with larger samples and multicenter trials are required to confirm the current findings due to uncertainty of the evidence.Systematic review registrationPROSPERO identifier, CRD42022354530. |
| first_indexed | 2024-04-09T17:24:42Z |
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| language | English |
| last_indexed | 2024-04-09T17:24:42Z |
| publishDate | 2023-04-01 |
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| spelling | doaj.art-34ef3b69b9e64fbca4f8461c356fcf232023-04-18T14:14:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-04-011310.3389/fendo.2022.995106995106Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trialsAnna Rong0Na Ta1Lihua E.2Wenbin Meng3Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, ChinaDepartment of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, ChinaDepartment of Stomatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, ChinaDepartment of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, ChinaBackgroundGuizhi Fuling (GZFL) pill, a traditional Chinese herbal formula including Semen Persicae, Ramulus Cinnamomi, Poria, Radix Paeoniae Alba, and Cortex Moutan, has been widely applied in the management of gynecological diseases.ObjectiveTo evaluate the add-on effect of the GZFL formula for treating reduced fertility potential in women with polycystic ovary syndrome (PCOS) by conducting a systematic review and meta-analysis.MethodsTwo reviewers independently searched the PubMed, Embase, Cochrane Library, Wanfang, SinoMed, and CKNI databases until 09/11/2022. Eligible studies were randomized controlled trials (RCTs) of the GZFL formula plus Western medicine versus the Western medicine for treating PCOS. The primary endpoint was the ovulation, pregnancy, and miscarriage rate. The secondary endpoints included the serum follicle-stimulating hormone (FSH), total testosterone, luteinizing hormone (LH), estradiol, and homeostasis model assessment insulin resistance (HOMA-IR).ResultsThere were 16 RCTs with 1,385 patients identified. The GZFL formula plus Western medicine significantly improved the ovulation rate (risk ratios [RR] 1.24; 95% confidence intervals [CI] 1.15–1.34) and pregnancy rate (RR 1.53; 95% CI 1.38 to 1.69) than the Western medicine alone. Adjuvant treatment with the GZFL formula also significantly decreased the serum FSH (mean difference [MD] -0.48 U/l; 95% CI -0.80 to -0.15), total testosterone (standard mean difference [SMD] -1.07; 95% CI -1.71 to -0.44), LH level (MD -2.19 U/l; 95% CI -3.04 to -1.34), and HOMA-IR (MD -0.47; 95% CI -0.60 to -0.34). However, there was no significant difference in the miscarriage rate (RR 0.89; 95% CI 0.36–2.20) and serum estradiol level (SMD 0.34; 95% CI -0.25 to 0.94) between two groups.ConclusionsThe GZFL formula as adjuvant therapy can improve the ovulation and pregnancy rates in women with PCOS. Its beneficial effects may correlate with reducing FSH, total testosterone, and LH and ameliorating insulin resistance. However, more well-designed RCTs with larger samples and multicenter trials are required to confirm the current findings due to uncertainty of the evidence.Systematic review registrationPROSPERO identifier, CRD42022354530.https://www.frontiersin.org/articles/10.3389/fendo.2022.995106/fullGuizhi Fuling capsule/pillinsulin resistancemeta-analysispolycystic ovary syndromepregnancysex hormone |
| spellingShingle | Anna Rong Na Ta Lihua E. Wenbin Meng Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials Frontiers in Endocrinology Guizhi Fuling capsule/pill insulin resistance meta-analysis polycystic ovary syndrome pregnancy sex hormone |
| title | Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Add-on effect of the Guizhi Fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | add on effect of the guizhi fuling formula for management of reduced fertility potential in women with polycystic ovary syndrome a systematic review and meta analysis of randomized controlled trials |
| topic | Guizhi Fuling capsule/pill insulin resistance meta-analysis polycystic ovary syndrome pregnancy sex hormone |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.995106/full |
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