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Ubat herba Cina untuk sakit haid primer

Abstract

Background

Conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Chinese herbal medicine may be a suitable alternative.

Objectives

To determine the efficacy and safety of Chinese herbal medicine for primary dysmenorrhoea when compared with placebo, no treatment, and other treatment.

Search methods

The Cochrane Menstrual Disorders and Subfertility Group Trials Register (to 2006), MEDLINE (1950 to January 2007), EMBASE (1980 to January 2007), CINAHL (1982 to January 2007), AMED (1985 to January 2007), CENTRAL (The Cochrane Library issue 4, 2006), China National Knowledge Infrastructure (CNKI, 1990 to January 2007), Traditional Chinese Medicine Database System (TCMDS, 1990 to December 2006), and the Chinese BioMedicine Database (CBM, 1990 to December 2006) were searched. Citation lists of included trials were also reviewed.

Selection criteria

Any randomised controlled trials involving Chinese herbal medicine versus placebo, no treatment, conventional therapy, heat compression, another type of Chinese herbal medicine, acupuncture or massage. Exclusion criteria were identifiable pelvic pathology and dysmenorrhoea resulting from the use of an intra‐uterine contraceptive device.

Data collection and analysis

Quality assessment, data extraction and data translation were performed independently by two review authors. Attempts were made to contact study authors for additional information and data. Data were combined for meta‐analysis using either Peto odds ratios or relative risk (RR) for dichotomous data or weighted mean difference for continuous data. A fixed‐effect statistical model was used, where suitable. If data were not suitable for meta‐analysis, any available data from the trial were extracted and presented as descriptive data.

Main results

Thirty‐nine randomised controlled trials involving a total of 3475 women were included in the review. A number of the trials were of small sample size and poor methodological quality. Results for Chinese herbal medicine compared to placebo were unclear as data could not be combined (3 RCTs). Chinese herbal medicine resulted in significant improvements in pain relief (14 RCTs; RR 1.99, 95% CI 1.52 to 2.60), overall symptoms (6 RCTs; RR 2.17, 95% CI 1.73 to 2.73) and use of additional medication (2 RCTs; RR 1.58, 95% CI 1.30 to 1.93) when compared to use of pharmaceutical drugs. Self‐designed Chinese herbal formulae resulted in significant improvements in pain relief (18 RCTs; RR 2.06, 95% CI 1.80 to 2.36), overall symptoms (14 RCTs; RR 1.99, 95% CI 1.65 to 2.40) and use of additional medication (5 RCTs; RR 1.58, 95% CI 1.34 to 1.87) after up to three months of follow‐up when compared to commonly used Chinese herbal health products. Chinese herbal medicine also resulted in better pain relief than acupuncture (2 RCTs; RR 1.75, 95% CI 1.09 to 2.82) and heat compression (1 RCT; RR 2.08, 95% CI 2.06 to 499.18).

Authors' conclusions

The review found promising evidence supporting the use of Chinese herbal medicine for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials.

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Plain language summary

Ubat herba Cina mungkin membantu dalam mengurangkan sakit haid

Sakit haid merupakan suatu aduan yang amat biasa, ia merujuk kepada kesakitan akibat kekejangan abdomen yang berlaku semasa haid. Sakit haid primer merujuk kepada kesakitan yang tiada puncanya (iaitu, tiada masalah perubatan yang dapat dikenal pasti). Walaupun ubat anti‐radang bukan jenis steroid atau ubat kontraseptif didapati kerkesan, namun, lebih banyak wanita masih sedang mencari rawatan yang tidak memerlukan ubat‐ubatan. Ubat herba Cina telah digunakan selama berabad‐abad di negara China dan ia sedang digunakan di hospital awam di China untuk merawat sakit haid primer. Ulasan kajian telah menunjukkan bukti awal tentang kegunaan ubat herba Cina dalam mengurangkan sakit haid bagi merawat sakit haid primer, berbanding dengan ubat‐ubatan lazim seperti ubat anti‐radang bukan jenis steroid dan ubat kontraseptif oral, akupuntur dan mampatan haba. Tiada kesan negatif yang ketara dapat dikenal pasti melalui ulasan kajian ini. Walau bagaimanapun, penjumpaan ini harus ditafsirkan dengan berhati‐hati kerana kajian‐kajian yang dirangkumi mempunyai kualiti metodologi yang rendah secara amnya.