원발성 월경통에서 경구 투여 탕제 한약의 프로스타글란딘 조절 효과 : 체계적 문헌 고찰 및 메타분석
Effects of Oral Decoction Herbal Medicine on Prostaglandin Regulation in Primary Dysmenorrhea : Systematic Review and Meta-Analysis
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Objectives: This study aimed to systematically evaluate and meta-analyze the effects of orally administered decoction-type herbal medicine (HM) on prostaglandin (PG) regulation and clinical outcomes in primary dysmenorrhea (PD). Methods: Literature search was conducted in 8 databases up to July 2024. Randomized controlled trials (RCTs) comparing HM with non-steroidal anti-inflammatory drugs (NSAIDs) or oral contraceptive pills (OCPs) and reporting PG outcomes, were included. Results: 19 RCTs involving 1,689 participants met the inclusion criteria. HM significantly reduced PGF2α (SMD=-0.72, 95% CI : -1.15 to -0.30) and increased PGE2 (SMD=0.99, 95% CI : 0.62 to 1.36) compared to NSAIDs/OCPs. Clinical outcomes also favored HM, with improvements in total effective rate, visual analogue scale, and traditional symptom scores. Combined therapy of HM with NSAIDs/OCPs showed superior effects over NSAIDs/OCPs alone. The incidence of adverse events and recurrence rate were significantly lower in the HM group. Conclusions: HM appears to be an effective and safe treatment for PD, especially for patients intolerant of NSAIDs/OCPs or seeking alternatives. Nevertheless, further high-quality, multicenter RCTs are required to confirm these findings and clarify the underlying mechanisms.
Abstract
Objectives: This study aimed to systematically evaluate and meta-analyze the effects of orally administered decoction-type herbal medicine (HM) on prostaglandin (PG) regulation and clinical outcomes in primary dysmenorrhea (PD). Methods: Literature search was conducted in 8 databases up to July 2024. Randomized controlled trials (RCTs) comparing HM with non-steroidal anti-inflammatory drugs (NSAIDs) or oral contraceptive pills (OCPs) and reporting PG outcomes, were included. Results: 19 RCTs involving 1,689 participants met the inclusion criteria. HM significantly reduced PGF2α (SMD=-0.72, 95% CI : -1.15 to -0.30) and increased PGE2 (SMD=0.99, 95% CI : 0.62 to 1.36) compared to NSAIDs/OCPs. Clinical outcomes also favored HM, with improvements in total effective rate, visual analogue scale, and traditional symptom scores. Combined therapy of HM with NSAIDs/OCPs showed superior effects over NSAIDs/OCPs alone. The incidence of adverse events and recurrence rate were significantly lower in the HM group. Conclusions: HM appears to be an effective and safe treatment for PD, especially for patients intolerant of NSAIDs/OCPs or seeking alternatives. Nevertheless, further high-quality, multicenter RCTs are required to confirm these findings and clarify the underlying mechanisms.