Evidence-based complementary and alternative medicine conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility: A systematic review and meta-analysis

PLoS One. 2023 May 18;18(5):e0285859. doi: 10.1371/journal.pone.0285859. eCollection 2023.

Abstract

Background: Chinese medicinal retention enemas have gradually attracted the attention of clinicians as an alternative approach for tubal obstructive infertility. The purpose of this study was to investigate the efficacy and safety of conventional surgery combined with traditional Chinese medicinal retention enemas for the treatment of tubal obstructive infertility.

Materials and methods: Eight electronic databases were searched from their inception to November 30, 2022. To assess the efficacy and safety of different treatments, following outcomes were measured: clinical pregnancy rate, clinical total effective rate, incidence of ectopic pregnancy, the improvement of Traditional Chinese Medicinal (TCM) symptoms, the improvement of the signs of obstructive tubal infertility and side effects.

Results: A total of 23 Randomized Controlled Trials (RCTs) with 1909 patients met the inclusion criteria. The pooled results showed a higher pregnancy rate in the experimental group than in the control group (RR 1.75, 95% CI [1.58, 1.94], Z = 10.55, P<0.00001). The clinical total effective rate in the experimental group was higher than that in the control group (RR 1.28, 95% CI [1.23, 1.34], Z = 11.07, P<0.00001). The incidence of ectopic pregnancy in the experimental group was lower than that in the control group (RR 0.40, 95% CI [0.20, 0.77], Z = -2.73, P = 0.01).

Conclusion: Based on current evidence, we concluded that conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility was superior to conventional surgery alone in improving the clinical pregnancy rate, improving clinical total effective rate, improving TCM symptoms, improving the signs of obstructive tubal infertility and lowering the incidence of ectopic pregnancy. However, further clinical trials with high-quality methodologies need to be conducted.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Complementary Therapies*
  • Drugs, Chinese Herbal* / therapeutic use
  • Enema
  • Female
  • Humans
  • Infertility* / drug therapy
  • Medicine, Chinese Traditional
  • Pregnancy
  • Pregnancy, Ectopic* / drug therapy

Substances

  • Drugs, Chinese Herbal

Grants and funding

This research was financially supported by the Construction Program for National Famous Traditional Chinese Medicine Experts Inheritance Studio in 2022 (No.75 [2022] of Chinese Medicine People's Education Letter).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.