Effects of medical abortion assisted by traditional Chinese medicine: A network meta‐analysis of randomized controlled trials

• Published in: International journal of gynecology and obstetrics Vol. 166; no. 1; pp. 152 - 162
• Main Authors: Li, Fuxing, Han, Mei, Zhang, Jiayu, Ji, Jingru, Wu, Yanfei, Wei, Junni
• Format: Journal Article
• Language: English
• Published: United States 01.07.2024
• Subjects: Abortifacient Agents - administration & dosage; Abortifacient Agents, Nonsteroidal - administration & dosage; Abortion, Induced - methods; complete abortion; Drugs, Chinese Herbal - administration & dosage; Drugs, Chinese Herbal - therapeutic use; Female; Humans; medical abortion; Medicine, Chinese Traditional - methods; Mifepristone - administration & dosage; Misoprostol - administration & dosage; network meta‐analysis; Pregnancy; Randomized Controlled Trials as Topic; traditional Chinese medicine; Uterine Hemorrhage; vaginal bleeding; traditional Chinese medicine; complete abortion; medical abortion; network meta‐analysis; vaginal bleeding
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.15272

Background To what extent traditional Chinese medicine (TCM) combined with mifepristone and misoprostol is beneficial for improving the complete abortion rate and duration of vaginal bleeding has been a subject of debate in the field of medical abortion. Objective To assess the evidence regarding the complete abortion rate and duration of vaginal bleeding of medical abortion assisted by different kinds of TCM. Search Strategy We searched electronic databases such as PubMed, Web of Science and Cochrane Library database, China National Knowledge Internet, Wan fang Database, VIP Database, and China Biology Medicine disc from 2000 to February 15, 2023. Selection Criteria The control group was medical abortion with mifepristone and misoprostol, and the experimental group was medical abortion assisted by TCM. Data Collection and Analysis Major data extraction included sample size, age, medicine used for abortion, outcome measures. RevMan 5.3 and Stata 15.1 software were used to assess the literature quality and perform network meta‐analysis, respectively. Main Results A total of 73 randomized controlled trials (RCTs) with 11 683 patients and nine kinds of TCM were included in this study. Compared with mifepristone and misoprostol, eight kinds of TCM had statistical significance in improving the complete abortion rate. The effect value of Sancao decoction was 5.86 (95% confidence interval [CI] 2.53–13.58). Seven kinds of TCM shortened the duration of vaginal bleeding. The effect value of comfrey and trichosanthin decoction was −8.75 (95% CI –10.86 to −6.64). Conclusions This network meta‐analysis showed that Lenge Zhumo decoction and Sancao decoction could have a large beneficial effect on complete abortion rate in medical abortion during early pregnancy, and comfrey and trichosanthin decoction could be the best TCM for shortening the duration of vaginal bleeding. Synopsis As a supplementary drug for medical abortion, traditional Chinese medicine can improve the rate of complete abortion and shorten the duration of vaginal bleeding.