- 期刊Journal of ethnopharmacology（J Ethnopharmacol）
- 发表时间2026-09-02
- 作者Liu Z, Liu Y, Li S, Zhang X, Qiang R, Jin F, Guo L, Hou T, Fang J, Zhu Y, Liang J, Li J
- 卷期页码121203
- 文献类型Review
- DOI10.1016/j.jep.2026.121203
- PMID42962945
摘要机译
【ETHNOPHARMACOLOGICAL相关性】由于手术只能切除肉眼可见的较大尺寸的病变，因此子宫肌瘤术后复发率高。
近年来，众多学者发现中药治疗在降低术后肌瘤复发率、提高临床治疗率、调节血清激素水平、降低血浆黏度、促进术后子宫容积恢复等方面均有疗效。
采用桂枝涪苓丸、消证汤、香冷丸、正甲汤、消瘤汤、桂枝鸡柳丸、活血化瘀方、活血消证汤、疏肝散结汤、贡六消胶囊、红金消结浓缩丸、加味桂枝涪苓汤等中药专利制剂，对子宫肌瘤术后复发的防治进行了多项随机对照试验。
然而，还没有研究系统地评估中草药（CHM）在降低子宫肌瘤术后复发率方面的作用。[研究目的]本研究旨在对CHM预防子宫肌瘤术后复发的随机对照试验进行荟萃分析，评估其有效性和安全性。
[材料和方法]综合检索PubMed、Cochrane、Embase、Web of Science、中国知网（CNKI）、VIP信息数据库（VIP）、万方数据库和中国生物医学数据库（CBM），以确定截至2025年3月进行的随机对照临床研究，这些研究检查了CHM治疗术后子宫肌瘤患者的疗效。
两个研究所被独立地未充分选择，并使用Cochrane风险偏差2.0工具提取数据并评估质量。使用Review Manager软件5.4进行Meta分析，并生成林地。使用GRADEpro3.2.2评估证据质量。这项研究在PROSPERO注册（CRD420251000288）。
[结果]本研究纳入16个试验，主要分析治疗后的术后复发率，CHM治疗降低子宫肌瘤患者术后复发率较空白组（6个试验，n=588；OR（优势比）=0.22；95%CI（95%置信区间）=0.14-0.34；I2=0%，p<0.00001），常规西药（CWM）（1个试验，n=80；OR=0.30；
95%CI=0.09-0.93， p=0.04），并将CHM与CWM联合应用（9项试验，n=959；OR=0.29；95%CI=0.19-0.46；I2=0%，p<0.00001）。此外，CHM在提高临床效率、恢复血清性激素水平、降低血浆粘度、减少子宫容积等方面也有效，CHM通常被认为是安全的，不良反应发生率较低。
[结论]CHM能有效避免子宫肌瘤术后复发，在整体有效性、恢复女性激素水平、改善血液流变学指标、促进子宫恢复和安全方面表现出色。然而，这些发现是初步的，仍需更高质量的研究来验证。
展开英文摘要原文
【ETHNOPHARMACOLOGICAL RELEVANCE】Since surgery can only remove lesions of a larger size visible to the naked eye, the recurrence rate of uterine fibroids after surgery is high. In recent years, numerous scholars have found that traditional Chinese medicine (TCM) treatment is effective in reducing the recurrence rate of postoperative fibroids, as well as improving the clinical treatment rate, regulating serum hormone levels, reducing plasma viscosity, and promoting the restoration of uterine volume following surgery. Several randomized controlled trials have been undertaken on the prevention and treatment of postoperative recurrence of uterine fibroids using patented Chinese medicines and self-proposed formulations, such as Guizhi Fuling Pill, Xiaozheng decoction, Xiangleng pill, Zhengjia decoction, Xiaoliu decoction, Guizhi Jiliu pill, Huoxue Huayu formula, Huoxue Xiaozheng decoction, Shugan Sanjie decoction, Gongliuxiao capsule, Hongjin Xiaojie concentrated pill, and Jiawei Guizhi Fuling decoction. However, no study has systematically evaluated Chinese herbal medicine (CHM) in reducing the recurrence rate of uterine fibroids after surgery.
【AIM OF THE STUDY】This study aimed to conduct a meta-analysis of randomized controlled trials of CHM for the prevention of postoperative recurrence of uterine fibroids, evaluating its efficacy and safety.
【MATERIALS AND METHODS】A comprehensive search was conducted on PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP Information Database (VIP), WanFang Database, and China Biomedical Database (CBM) to identify randomized controlled clinical studies conducted up to March 2025 that examined the efficacy of CHM in treating patients with postoperative uterine fibroids. Two institutes were independently under-selected, and data were extracted and quality assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analyses were performed using Review Manager software 5.4, and forest plots were generated. The quality of evidence was assessed using GRADEpro 3.2.2. This study was registered in PROSPERO (CRD420251000288).
【RESULTS】16 trials were included in this study, and the postoperative recurrence rate after treatment was mainly analyzed. CHM treatment reduces postoperative recurrence rates in patients with uterine fibroids compared to the blank (6 trials, n = 588; OR (odds ratio) = 0.22; 95% CI (95% confidence intervals) = 0.14-0.34; I2 = 0%, p < 0.00001), conventional western medicine (CWM) (1 trial, n = 80; OR = 0.30; 95% CI = 0.09-0.93, p = 0.04), and combined CHM with CWM (9 trials, n = 959; OR = 0.29; 95% CI = 0.19-0.46; I2 = 0%, p < 0.00001). In addition, CHM is also effective in improving clinical efficiency, restoring serum sex hormone levels, lowering plasma viscosity, and reducing uterine volume. CHM is generally considered safe, with a low incidence of adverse reactions.
【CONCLUSION】CHM is effective in avoiding recurrence of uterine fibroids after surgery, excelling in terms of overall effectiveness, restoring female hormone levels, improving hemorheological indices, and promoting uterine recovery and safety. However, these findings are preliminary and still need to be validated by higher-quality studies.
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