Background Hyperprolactinaemia is a common adverse effect of antipsychotics(APs). The results of PeonyGlycyrrhiza decoction(PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent.Ai...Background Hyperprolactinaemia is a common adverse effect of antipsychotics(APs). The results of PeonyGlycyrrhiza decoction(PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent.Aim This meta-analysis of randomised controlled trials(RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia.Methods English(PubMed, Embase, Cochrane Library,PsycINFO) and Chinese(Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PIC0 S一/^rticipants: adult patients with schizophrenia; Aitervention: PGD plus APs; Cbmparison: APs plus placebo or AP monotherapy;(Xjtcomes: efficacy and safety; Study design: RCTs. The weighted mean difference(WMD) and risk ratio(RR) along with their 95% CIs were calculated using Review Manager(RevMan) V.5.3 software.Results Five RCTs(n=450) were included and analysed.Two RCTs(n=140) were double-blind and four RCTs(n=409) reported ‘random' assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group(n=380, WMD:-32.69 ng/mL(95% Cl-41.66 to 23.72),/X0.00001, ^=97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale(n=403,WMD:-0.62(95% Cl-2.38 to 1.15), p=0.49, ^=0%). There were similar rates of all-cause discontinuation(n=330, RR0.93(95% Ci 0.63 to 1.37),/t=0.71, ^=0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low'(14.3%),‘low'(42.8%),‘moderate'(14.3%),to ‘high,(28.6%>.Conclusions Current evidence supports the adjunctive use of PGD to suppress elevated prolactin and improve prolactininduced symptoms without significant adverse events in adult patients with AP-induced hyperprolactinaemia. Highquality RCTs with longer duration are needed to confirm these findings.Trial registration number 42016037017.展开更多
Objective:To systematically and objectively evaluate clinical efficacy of retention enema with integrated traditional Chinese and western medicine on radiation proctitis(RP).Methods:CNKI,WANFANG,VIP,CMB and foreign la...Objective:To systematically and objectively evaluate clinical efficacy of retention enema with integrated traditional Chinese and western medicine on radiation proctitis(RP).Methods:CNKI,WANFANG,VIP,CMB and foreign language databases like Embase,Central and Medline were searched.Search dates were from establishment of the databases until May 2020.Randomized controlled trials(RCTs)of retention enema with integrated traditional Chinese and western medicine for RP were retrieved.Two system reviewers selected literature materials,extracted literature data,and evaluated the quality of the literatures.RevMan 5.3 software was used for data analysis.Results:A total of 12 studies were included,including 941 patients.Meta-analysis results showed:Clinical efficacy in the retention enema group with integrated traditional Chinese and western medicine was better than that in the simple western medicine enema or blank enema group(OR=5.96,95%CI[5.50,14.29],P<0.00001).Improvement of abdominal pain in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.57,95%CI[-0.72,-0.42],P<0.00001).Treatment for hematochezia in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.55,95%CI[-0.69,-0.42],P<0.00001).Improvement of diarrhea in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.69,95%CI[-0.91,-0.48],P<0.00001).KPS scores in the retention enema group with integrated traditional Chinese and western medicine were better than those in the control group(MD=11.91,95%CI[3.81,20.01],P<0.00001).Conclusion:Clinical efficacy of retention enema with integrated traditional Chinese and western medicine on RP is better than simple western medicine enema or blank enema.Due to the low quality of the included clinical literatures,it is necessary to carry out more deliberate,detailed,high-quality,randomized,double-blind,and multi-center RCTs in order to give more powerful demonstration on its clinical efficacy on RP.展开更多
基金supported by the University of Macao(SRG2014-00019-FHSMYRG2015-00230 FHS+4 种基金MYRG2016-00005-FHS)the Affiliated Brain Hospital of Guangzhou Medical University(2016YFC0906302816713342014Y2-001052015BAI13B02)
文摘Background Hyperprolactinaemia is a common adverse effect of antipsychotics(APs). The results of PeonyGlycyrrhiza decoction(PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent.Aim This meta-analysis of randomised controlled trials(RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia.Methods English(PubMed, Embase, Cochrane Library,PsycINFO) and Chinese(Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PIC0 S一/^rticipants: adult patients with schizophrenia; Aitervention: PGD plus APs; Cbmparison: APs plus placebo or AP monotherapy;(Xjtcomes: efficacy and safety; Study design: RCTs. The weighted mean difference(WMD) and risk ratio(RR) along with their 95% CIs were calculated using Review Manager(RevMan) V.5.3 software.Results Five RCTs(n=450) were included and analysed.Two RCTs(n=140) were double-blind and four RCTs(n=409) reported ‘random' assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group(n=380, WMD:-32.69 ng/mL(95% Cl-41.66 to 23.72),/X0.00001, ^=97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale(n=403,WMD:-0.62(95% Cl-2.38 to 1.15), p=0.49, ^=0%). There were similar rates of all-cause discontinuation(n=330, RR0.93(95% Ci 0.63 to 1.37),/t=0.71, ^=0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low'(14.3%),‘low'(42.8%),‘moderate'(14.3%),to ‘high,(28.6%>.Conclusions Current evidence supports the adjunctive use of PGD to suppress elevated prolactin and improve prolactininduced symptoms without significant adverse events in adult patients with AP-induced hyperprolactinaemia. Highquality RCTs with longer duration are needed to confirm these findings.Trial registration number 42016037017.
基金Scientific Research Projects of Shanxi Provincial Administration of Traditional Chinese Medicine(2019ZYY2006)Construction Projects of the Third National TCM Master Inheritance Studio and National Famous TCM Doctor Inheritance Studio(General Office and Department of Personnel and Education of National Administration of Traditional Chinese Medicine[2018]No.119)。
文摘Objective:To systematically and objectively evaluate clinical efficacy of retention enema with integrated traditional Chinese and western medicine on radiation proctitis(RP).Methods:CNKI,WANFANG,VIP,CMB and foreign language databases like Embase,Central and Medline were searched.Search dates were from establishment of the databases until May 2020.Randomized controlled trials(RCTs)of retention enema with integrated traditional Chinese and western medicine for RP were retrieved.Two system reviewers selected literature materials,extracted literature data,and evaluated the quality of the literatures.RevMan 5.3 software was used for data analysis.Results:A total of 12 studies were included,including 941 patients.Meta-analysis results showed:Clinical efficacy in the retention enema group with integrated traditional Chinese and western medicine was better than that in the simple western medicine enema or blank enema group(OR=5.96,95%CI[5.50,14.29],P<0.00001).Improvement of abdominal pain in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.57,95%CI[-0.72,-0.42],P<0.00001).Treatment for hematochezia in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.55,95%CI[-0.69,-0.42],P<0.00001).Improvement of diarrhea in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.69,95%CI[-0.91,-0.48],P<0.00001).KPS scores in the retention enema group with integrated traditional Chinese and western medicine were better than those in the control group(MD=11.91,95%CI[3.81,20.01],P<0.00001).Conclusion:Clinical efficacy of retention enema with integrated traditional Chinese and western medicine on RP is better than simple western medicine enema or blank enema.Due to the low quality of the included clinical literatures,it is necessary to carry out more deliberate,detailed,high-quality,randomized,double-blind,and multi-center RCTs in order to give more powerful demonstration on its clinical efficacy on RP.
