Chinese herbal medicine for primary dysmenorrhoea

Chinese Medicine Program, University of Western Sydney, Center for Complementary Medicine Research, Bldg 3, Bankstown Campus, Locked Bag 1797, Penrith South DC, Sydney, New South Wales, Australia, 2750.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2008; 16(2):CD005288. DOI: 10.1002/14651858.CD005288.pub3
Source: PubMed

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

Download full-text


Available from: Caroline Smith, Aug 09, 2015
1 Follower
  • Source
    • "Oral contraceptive pills are also effective (Campbell & McGrath 1997, Proctor & Farquhar 2002). Additionally, traditional Chinese medicine (TCM) for dysmenorrhea has been broadly used in Asian cultures, and its efficacy has been established (Zhu et al. 2008). In Taiwanese culture, less emphasis was placed on oral analgesics than on the centuryold TCM treatment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigates the selection and efficacy of various strategies employed by young Taiwanese women in the self-management of dysmenorrhea. Dysmenorrhea is the common gynaecological problem in reproductive-aged women. In the past, non-specific treatments such as heat and exercise were found to be less effective. Current therapies for dysmenorrhea include prostaglandin synthetase inhibitors and herbal remedies. Descriptive survey. The researcher-designed questionnaire listed common strategies used in Taiwan to self-manage dysmenorrhea. Content validity was applied for the determination of content items in measures. The total reliability of menstrual distress questionnaire was 0·95, menstrual symptoms questionnaire was 0·92 and coping strategies questionnaire was 0·94. The participants were asked to indicate if they used any of the methods over the past 12 months and, if so, if they were effective. Chi-square test comparisons were used to analyse the data collected. Of the 616 individuals who completed the questionnaire, 570 reported experiencing dysmenorrhea at least once in the past year. Of these, 180 reported dysmenorrhea at every period and were categorised as Group I. The remaining 390 women were classified as Group II. Women in Group I used all of the listed strategies more frequently; however, they benefited less from all therapies except paracetamol. The most effective strategies in both groups were found to be paracetamol and Dang-Qui-Shao-Ya-San. Paracetamol and Dang-Qui-Shao-Ya-San are the most effective strategies in relieving dysmenorrhea in young Taiwanese women, while other less effective strategies are used more frequently. Identification of the most effective therapies for dysmenorrhea among commonly used strategies will help women choose the right therapy for them. As some young, inexperienced women might take two or more medications simultaneously because of ineffectiveness, thus increasing the risk of adverse effects, this study is of critical importance in promoting the safe use of medication for self-management of dysmenorrhea.
    Journal of Clinical Nursing 02/2011; 20(7-8):1018-25. DOI:10.1111/j.1365-2702.2010.03363.x · 1.23 Impact Factor
  • Source
    • "Tongjing powder, a Chinese medicinal formula, could improve the state of blood circulation and treat the dysmenorrhea effectively (Wu et al., 1998). A recent review found promising evidence supporting the use of CHM for primary dysmenorrhea; however, results are limited by the poor methodological quality of the included trials (Zhu et al., 2008). Although CHM and acupuncture have satisfactory curative effects in treating dysmenorrhea, especially the primary dysmenorrhea, most of the clinical researches are not large-scale, multicentre, randomized, doubleblind and placebo-controlled clinical ones, which should be addressed in the future. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Traditional Chinese Medicine (TCM) has significant advantages in treating gynaecological disorders. The paper has provided a brief introduction on the current progress of treating some gynaecological disorders including endometriosis, infertility, dysmenorrhea, abnormal uterine bleeding, premenstrual syndrome, menopausal syndrome, uterine fibroids, chronic pelvic inflammation, polycystic ovarian syndrome (PCOS), cervicitis and vaginitis with Chinese Herbal Medicine (CHM) and acupuncture. The use of TCM in the field of assisted reproductive techniques (ART) has also been included in the review. In addition, thirty-two commonly used Chinese medicinal formulas in treating gynaecological disorders have been introduced.
    African Journal of Traditional, Complementary and Alternative Medicines 01/2009; 6(4):494-517. DOI:10.4314/ajtcam.v6i4.57181 · 0.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Cochrane Collaboration, an international not-for-profit organization that prepares and maintains systematic reviews of randomized trials of health care therapies, has produced reviews summarizing much of the evidence on Traditional Chinese Medicine (TCM). Our objective was to review the evidence base according to Cochrane systematic reviews. In order to detect reviews focusing on TCM, we searched the titles and abstracts of all reviews in Issue 4, 2008 of the Cochrane Database of Systematic Reviews. For each review, we extracted data on the number of trials included and the total number of participants. We provided an indication of the strength of the review findings by assessing the reviewers' abstract conclusions statement. We supplemented our assessment of the abstract conclusions statements with a listing of the comparisons and outcomes showing statistically significant meta-analyses results. We identified 70 Cochrane systematic reviews of TCM, primarily acupuncture (n = 26) and Chinese herbal medicine (n = 42), and 1 each of moxibustion and t'ai chi. Nineteen (19) of 26 acupuncture reviews and 22/42 herbal medicine reviews concluded that there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment, while the remaining 7 acupuncture and 20 herbal medicine reviews and each of the moxibustion and t'ai chi reviews indicated a suggestion of benefit, which was qualified by a caveat about the poor quality and quantity of studies. Most reviews included many distinct interventions, controls, outcomes, and populations, and a large number of different comparisons were made, each with a distinct forest plot. Most Cochrane systematic reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine's benefits to certain patient populations, underscoring the importance and appropriateness of further research. These preliminary findings should be considered tentative and need to be confirmed with rigorous randomized controlled trials.
    Journal of alternative and complementary medicine (New York, N.Y.) 09/2009; 15(9):1001-14. DOI:10.1089/acm.2008.0414 · 1.52 Impact Factor
Show more