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: 6.03). 02/2008; 16(2):CD005288. DOI: 10.1002/14651858.CD005288.pub3
Source: PubMed


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.

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    • "However, these medications have not been effective in 20% to 25% of women. Some adverse events such as digestive disorders were reported [5]. "
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    ABSTRACT: Objective . This study was a multicenter, randomized, double-blind, and controlled trial with two parallel arms: the GJBNH group and the placebo group. This trial recruited 100 women aging 18 to 35 years with primary dysmenorrhea caused by blood stagnation. The investigational drugs, GJBNH or placebo, were administered for two menstrual periods (8 weeks) to the participants three times per day. The participants were followed up for two menstrual cycles after the administration. Results . The results were analyzed by the intention-to-treat (ITT) dataset and the per-protocol (PP) dataset. In the ITT dataset, the change of the average menstrual pain VAS score in the GJBNH group was statistically significantly lower than that in the control group. Significant difference was not observed in the SF-MPQ score change between the GJBNH group and the placebo group. No significant difference was observed in the PP analyses. In the follow-up phase, the VAS scores of the average menstrual pain and the maximum menstrual pain continually decreased in the placebo group, but they increased in the GJBNH group. Conclusion . GJBNH treatment for eight weeks improved the pain of the dysmenorrhea caused by blood stagnation, but it should be successively administered for more than two menstrual cycles. Trial Registration . This trial is registered with Current Controlled Trials no. ISRCTN30426947 .
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    • "We cannot be certain whether the product used for the treatment of hypercholesterolaemia [13] was essentially similar. In some studies, herbalism is practiced in a dynamic fashion—that is, up to 23 different herbal medicines have been administered concomitantly (see Table 1) and the formulae changed in the course of the study [11]. The results achieved with original and changed formulations cannot be considered together because they provide different active principles. "
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    • "Si-Wu-Tang is typically used for its action as a blood-tonifying (buxie) decoction [9] and is believed to stimulate the production of blood, promote blood circulation, regulate menstruation, and relieve menstrual pain [10]. A recent Cochrane review found promising evidence for the use of various Chinese herbal medicines in reducing menstrual pain in the treatment of primary dysmenorrhoea [11]. The majority of the 39 included trials used a complicated formula with more than 5 or 6 herbs. "
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    ABSTRACT: . The aim of the study was to explore the association between women's use of herbal dietary supplement Si-Wu-Tang during the postpartum period and their health-related quality of life. . This is a population-based correlational study. We used multistage, stratified, systematic sampling to recruit 24,200 pairs of postpartum women and newborns from the Taiwan National Birth Registry in 2005. A structured questionnaire was successfully administered to 87.8% of the sampled population. Trained interviewers performed home interviews 6 months after the women's deliveries between June 2005 and July 2006. The Medical Outcomes Study 36-item Short-Form (SF-36) was used to measure the quality of life of the women along with the frequency of Si-Wu-Tang use. . Si-Wu-Tang use after delivery improved women's score for bodily pain and also improved their score for mental health when used more than 10 times. In addition, there were increases in general health and vitality scores in the group who continuously used Si-Wu-Tang more than 10 times after using Sheng-Hua-Tang. . Use of Si-Wu-Tang after delivery may be associated with women's health-related quality of life especially for those who previously used Sheng-Hua-Tang. These results are exploratory and need to be replicated.
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