Objective To conduct Meta-analyses on published literatures about the Jianpi Bushen Decoction combined with western medicine for dysfunctional uterine bleeding (DUB), so as to evaluate its efficacy and safety compared with the western medicine treatment. Methods The following databases such as PubMed (1995 to 2011), EMCC (1995 to 2011), CBM (1995 to 2011), CNKI (1995 to 2011), Wanfang (1989 to 2011) and VIP (1989 to 2011) were searched to collect the randomized controlled trials (RCTs) on Jianpi Bushen Decoction combined with western medicine for DUB. The selection of studies, assessment of methodological quality and data extraction were performed independently by two reviewers according to the Cochrane systematic review methods, and Meta-analyses were performed by using RevMan5.0 software. Results A total of 12 RCTs involving 925 cases were included, of which 471 ones were in the experimental group while the other 454 ones were in the control group. Each study was comparable in baseline data, all with reporting of using random methods, but no mention of detailed random methods, blind methods and allocation concealment. The results of Meta-analyses indicated that compared with single therapy of western medicine, Jianpi Bushen Decoction combined with western medicine for DUB was superior in the total effective rate (OR=5.60, 95%CI 3.25 to 9.67, Plt;0.000 01), bleeding recovery rate (OR=3.79, 95%CI 2.70 to 5.32, Plt;0.000 01), and bleeding recurrence rate (OR=0.14, 95%CI 0.05 to 0.42, P=0.000 5), with significant differences. Conclusions The integrated treatment of Jianpi Bushen Decoction and western medicine has certain effects on dysfunctional uterine bleeding, and it may be a promising treatment option. Due to the poor quality and high possibility of bias of the included studies, more well-designed multi-centered RCTs should be performed.
Objective To evaluate the efficacy and safety of mifepristone for perimenopause dysfunctional uterine bleeding (PDUB). Methods Such databases as VIP, CNKI, Wanfang and CBM were retrieved for collecting randomized controlled trials (RCTs) on mifepristone for PDUB. The quality of included studies was evaluated and Meta-analysis was performed according to the Cochrane methods. Results Forty RCTs involving 3 850 PDUB patients were included. The control group was divided into two sub-groups according to the features of intervention drugs: the sub-group of diagnostic curettage plus progestational hormone, and the sub-group of diagnostic curettage plus antiestrogenic drugs. The Meta-analysis indicated that compared with the sub-group of diagnostic curettage plus progestational hormone, the diagnostic curettage plus mifepristone group was more effective to increase the total effective rate, such as improving symptoms and signs of PDUB (RR=1.11, 95%CI 1.06 to 1.16, Plt;0.000 01), and to reduce recurrence (RR=0.44, 95%CI 0.36 to 0.52, Plt;0.000 01). But no differences were found between the two groups in the change of endometrial thickness, contents of hemoglobin, and serum level of FSH, LH, E2 and P hormone. Both the intervention and control groups appeared mild adverse reactions, such as rashes, tidal fever, nausea, anorexia, vomiting and breast distending, but with no liver and kidney damages. The long-term safety failed to be evaluated due to short follow-up time. Conclusion Based on this review, diagnostic curettage plus mifepristone shows certain advantage in the treatment of PDUB including the total effective rate and reducing recurrence. But there is no difference in regulating sex hormone level, inhibiting endometrial proliferation and improving anemia compared with the group of diagnostic curettage plus progestational hormone. However, this evidence is not b enough due to the low quality of included trials, possible bias risk, and failure of evaluating its long-term safety.