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. 2009 Apr 15:(2):CD005292.
doi: 10.1002/14651858.CD005292.pub2.

Herbal preparations for uterine fibroids

Jian Ping Liu  1 , Hong Yang, Yun Xia, Francesco Cardini
Affiliations

Herbal preparations for uterine fibroids

Jian Ping Liu et al. Cochrane Database Syst Rev. .

Update in

  • Herbal preparations for uterine fibroids.
    Liu JP, Yang H, Xia Y, Cardini F. Liu JP, et al. Cochrane Database Syst Rev. 2013 Apr 30;2013(4):CD005292. doi: 10.1002/14651858.CD005292.pub3. Cochrane Database Syst Rev. 2013. PMID: 23633329 Free PMC article.

Abstract

Background: Uterine fibroids are the most common non-malignant growths in women of childbearing age. They are associated with heavy menstrual bleeding and subfertility. Herbal preparations are commonly used as alternatives to surgical procedures.

Objectives: To assess the benefits and risks of herbal preparations for uterine fibroids.

Search strategy: Authors searched following electronic databases: the Trials Registers of the Cochrane Menstrual Disorders and Subfertility Group and the Cochrane Complementary Medicine Field, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, the Chinese Biomedical Database, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), AMED, and LILACS. The searches ended on 31st December 2008.

Selection criteria: Randomised controlled trials comparing herbal preparations with no intervention, placebo, medical treatment or surgical procedures in women with uterine fibroids. We also included trials of herbal preparations with or without conventional therapy.

Data collection and analysis: Two review authors collected data independently. We assessed trial risk of bias according to our methodological criteria . We presented dichotomous data as risk ratios (RR) and continuous outcomes as mean difference (MD), both with 95% confidence intervals (CI).

Main results: We included two randomised trials (involved 150 women) with clear description of randomisation methods. The methodological risk of bias of the trials varied. There were variations in the tested herbal preparations, and the treatment duration was six months. The outcomes available were not the primary outcomes selected for this review, such as symptom relief or the need for surgical treatment; trials mainly reported outcomes in terms of shrinkage of the fibroids.Compared with mifepristone, Huoxue Sanjie decoction showed no significant difference in the disappearance of uterine fibroids, number of patients with shrinking of uterine fibroids or average volume of uterine fibroids, but less effective than mifepristone on reducing average size of uterus (mean difference 23.23 cm(3),95% confidence interval 17.85 to 28.61). There was no significant difference between Nona Roguy herbal product and GnRH agonist in average volume of uterine fibroids or size of uterus. No serious adverse effects from herbal preparations was reported.

Authors' conclusions: Current evidence does not support or refute the use of herbal preparations for treatment of uterine fibroids due to insufficient studies of large sample and high quality. Further high quality trials evaluating clinically relevant outcomes are warranted.

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Figures

Figure 1
Figure 1
Methodological quality graph: review authors’ judgements about each methodological quality item presented as percentages across all included studies.
Figure 2
Figure 2
Methodological quality summary: review authors’ judgements about each methodological quality item for each included study.
Analysis 1.1
Analysis 1.1
Comparison 1 Herbal preparations versus medical treatment, Outcome 1 Disappearance of uterine fibroids.
Analysis 1.2
Analysis 1.2
Comparison 1 Herbal preparations versus medical treatment, Outcome 2 Number of patients with shrinkage of uterine fibroids.
Analysis 1.3
Analysis 1.3
Comparison 1 Herbal preparations versus medical treatment, Outcome 3 Average volume of uterine fibroids (cm3).
Analysis 1.4
Analysis 1.4
Comparison 1 Herbal preparations versus medical treatment, Outcome 4 Average size of uterus (cm3).
See this image and copyright information in PMC

References

References to studies included in this review

    1. Hazlina NNH, Pazudin MI, Nor Aliza AG, Mohsin Sahil SJ. Clinical study to compare the efficacy and adverse effects of Nona Roguy herbal formulation and gonadotrophin releasing hormone agonist (GnRH) in the treatment of uterine fibroids. International Medical Journal. 2005;12(4):295–302.
    1. Lu JX. Comparison of Huoxue Sanjie Decoction with mifepristone in the treatment of uterine fibroids. Shandong Journal of Medicine and Pharmacology. 2007;47(19):109–110.

References to studies excluded from this review

    1. Akase T, Onodera S, Jobo T, Matsushita R, Kaneko M, Tashiro S-I. A comparative study of the usefulness of Toki-shakuyaku-san and an oral iron preparation in the treatment of hypochromic anaemia in cases of uterine myoma. Yakugaku Zasshi. 2003;123(9):817–824. - PubMed
    1. An ZR. 43 cases of uterine fibroids treated by Gong Liu Tang. Modern Traditional Chinese Medicine. 2005;25(6):30.
    1. Chen QM, Li FS, Wang JP. Observation of therapeutic effects of Rupi Anxiao capsules plus small dosage of methyltestosterone in treatment of hysteromyoma. Maternal and Child Health Care of China. 2007;22(11):1459–1461.
    1. Cuan CL, Shang HQ, Fu YP. 30 cases of uterine fibroids treated by Ding Jing Tang. Shaanxi Journal of Traditional Chinese Medicine. 2002;23(11):975–976.
    1. Du WH. Retentive enema and oral taking of Guizhi Fuling Wan for treatment of 40 cases of uterine fibroids. Shandong Journal of Traditional Chinese Medicine. 1993;12(2):28–29.

Additional references

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    1. Egger M, Juni P, Bartlett C, Holenstein F, Sterne J. How important are comprehensive literature searches and the assessment of trial quality in systematic reviews? Empirical study. Health Technology Assessment. 2003;7(1):1–76. - PubMed
    1. Falcone T, Bedaiwy MA. Minimally invasive management of uterine fibroids. Current Opinion of Obstetrics and Gynecology. 2002;14:401–407. - PubMed
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