Browse > Article
http://dx.doi.org/10.15204/jkobgy.2019.32.3.227

Application of Traditional East Asian Herbal Medicine for Atrophic Vaginitis: A Systematic Review of Randomized Controlled Trials  

Park, Eo-Jin (Dept. of Korean Medicine Obstetrics and Gynecology, Chung Yeon Korean Medicine Hospital)
Jo, Hee-Geun (Chung Yeon Central Institute)
Publication Information
The Journal of Korean Obstetrics and Gynecology / v.32, no.3, 2019 , pp. 227-244 More about this Journal
Abstract
Objectives: To evaluate the effectiveness and safety of application of Traditional East Asian Herbal Medicine (TEAM) in the treatment of Atrophic Vaginitis (AV). Methods: Randomized Controlled Trials (RCTs) were obtained from PubMed, Cochrane Library, Embase, CNKI, RISS, NDSL, and KISS. The risk of bias was assessed by using Cochrane's risk of bias tool, and RevMan 5.3 software was used. Results: 26 RCTs with 3,162 patients were identified and reviewed. Among them, 21 RCTs observe the effect of integrated traditional Chinese and Western medicine. 23 RCTs reported treatment groups was statistically effective than control groups in the study. Also, the recurrence rate was estimated in 10 RCTs and was lower than control groups. 12 studies observed adverse events (AEs) and severe AEs were not reported. Conclusions: This review suggested that TEAM was safe and effective in the treatment of AV. TEAM may also decrease the recurrence rate. However, this could not be proven conclusively. To ensure evidence-based clinical practice, well-designed trials with larger sample sizes are needed.
Keywords
Atrophic Vaginitis; Traditional East Asian Herbal Medicine (TEAM); Korean Herbal Medicine; Randomized Controlled Trial (RCT);
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Mills BB. Vaginitis: Beyond the Basics. Obstet Gynecol Clin North Am. 2017;44(2):159-77.   DOI
2 Paladine HL, Desai UA. Vaginitis: Diagnosis and Treatment. Am Fam Physician. 2018;97(5):321-9.
3 Nappi RE, Kokot-Kierepa M. Women's voices in the menopause: results from an international survey on vaginal atrophy. Maturitas. 2010;67(3):233-8.   DOI
4 Crandall C, et al. Association of breast cancer and its therapy with menopause-related symptoms. Menopause. 2004;11(5):519-30.   DOI
5 Bachmann G, et al. Efficacy and safety of low-dose regimens of conjugated estrogens cream administered vaginally. Menopause. 2009;16(4):719-27.   DOI
6 Wang Y, et al. Clinical efficacy of Xianlinggubao Capsule combined with Baofukang suppository in preventing and treating atrophic vaginitis. CJITWM. 2010;30(07):766-8.
7 Hou Y. Clinical Observation on Treatment of Atrophic Vaginitis with Combination of Traditional Chinese Medicine and Western Medicine. Chin J Misdiagn. 2010;10(07):1588.
8 Bachmann G. Urogenital ageing: an old problem newly recognized. Maturitas. 1995;22 Suppl:S1-5.   DOI
9 McEndree B. Clinical application of the vaginal maturation index. Nurse Pract. 1999;24(9):48, 51-2, 55-6.   DOI
10 Greendale GA, et al. Development and validation of a physical examination scale to assess vaginal atrophy and inflammation. Climacteric. 1999;2(3):197-204.   DOI
11 Kim SH, Yook TH, Kim JU. Rehanniae Radix, an Effective Treatment for Patients with Various Inflammatory and Metabolic Diseases: Results from a Review of Korean Publications. J Pharmacopuncture. 2017;20(2):81-8.   DOI
12 Rios JL. Chemical constituents and pharmacological properties of Poria cocos. Planta Med. 2011;77(7):681-91.   DOI
13 Li X, Ma L, Zhang L. Molecular basis for Poria cocos mushroom polysaccharide used as an antitumor drug in China. Prog Mol Biol Transl Sci. 2019;163:263-96.   DOI
14 Kamazeri TSAT, et al. Antimicrobial activity and essential oils of Curcuma aeruginosa, Curcuma mangga, and Zingiber cassumunar from Malaysia. Asian Pac J Trop Med. 2012;5(3):202-9.   DOI
15 Almeida JRGS, et al. Borneol, a bicyclic monoterpene alcohol, reduces nociceptive behavior and inflammatory response in mice. Scientific World J. 2013;2013(18):1-5.
16 Lee TH, et al. New Coumarins and Anti-Inflammatory Constituents from the Fruits of Cnidium monnieri. Int J Mol Sci. 2014 Jun;15(6):9566-78.   DOI
17 Vesco KK, et al. Clinician knowledge, attitudes, and barriers to management of vulvovaginal atrophy: variations in primary care and gynecology. Menopause. 2019;26(3):265-72.   DOI
18 Slamenova D, et al. Investigation of anti-oxidative, cytotoxic, DNA-damaging and DNA-protective effects of plant volatiles eugenol and borneol in human-derived HepG2, Caco-2 and VH10 cell lines. Mutat Res. 2009;677(1-2):46-52.   DOI
19 Li T, et al. Baofukang suppository promotes the repair of vaginal epithelial cells in response to Candida albicans. AMB Express. 2016;6(1):1-8.   DOI
20 Baek SE, et al. Systematic Review of Fumigation Therapy for Atrophic Vaginitis. J Korean Obstet Gynecol. 2016;29(1):92-101.   DOI
21 Dien PH, et al. Main constituents from the seeds of Vietnamese Cnidium monnieri and cytotoxic activity. Nat Prod Res. 2012;26(22):2107-11.
22 Rahmani Y, et al. Effect of Herbal Medicine on Vaginal Epithelial Cells: A Systematic Review and Meta-analysis. J Menopausal Med. 2018;24(1):11-6.   DOI
23 Crandall C. Vaginal estrogen preparations: a review of safety and efficacy for vaginal atrophy. J Womens Health (Larchmt). 2002;11(10):857-77.   DOI
24 Doyle H. Effective topical treatments for atrophic vaginitis. JAAPA. 2006;19(10):33-8.   DOI
25 Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016;(8):CD001500.
26 Ghazanfarpour M, Sadeghi R, Roudsari RL. The application of soy isoflavones for subjective symptoms and objective signs of vaginal atrophy in menopause: A systematic review of randomized controlled trials. J Obstet Gynecol. 2016;36(2):160-71.   DOI
27 Zhou J, Qu F. Treating gynecological disorders with traditional Chinese medicine: a review. Afr J Tradit Complement Altern Med. 2009;6(4):494-517.
28 Kim SY, et al. NECA's guidance for under taking systematic reviews and meta-analyses for intervention. 1st edition. Seoul:National Evidence-based Healthcare Collaborating Agency. 2011:65-85.
29 Wang Y. Clinical Observation on Modified Bushen Zhidai Decoction in Treating Postmenopausal Atrophic Vaginitis. CJGMCM. 2019;34(4):562-4.
30 Chen R, et al. Randomized, Double-Blind, Placebo-Controlled Study of Modified Erzhi Granules in the Treatment of Menopause-Related Vulvovaginal Atrophy. eCAM. 2018;2018(7):1-15.
31 Kim JH, et al. Inhibitory effects of an aqueous extract from Cortex Phellodendri on the growth and replication of broad-spectrum of viruses in vitro and in vivo. BMC Complement Altern Med. 2016;16(1):1-13.
32 Shi Z, et al. Antitumor effects of concanavalin A and Sophora flavescens lectin in vitro and in vivo. Acta Pharmacol Sin. 2014;35(2):248-56.   DOI
33 He X, et al. Sophora flavescens Ait.: Traditional usage, phytochemistry and pharmacology of an important traditional Chinese medicine. J Ethnopharmacol. 2015;172:10-29.   DOI
34 Oh YS, Kwon YS, Jung BD. Anti-inflammatory Effects of the Natural Compounds Cortex Phellodendri and Humulus japonicus on Pelvic Inflammatory Disease in Mice. Int J Med Sci. 2017;14(8):729-34.   DOI
35 Shapiro M. What should guide our patient management of vulvovaginal atrophy?. Climacteric. 2019 Feb;22(1):38-43.   DOI
36 Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;2018(10):387-95.   DOI
37 Crandall CJ, et al. Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study. Menopause. 2018;25(1):11-20.   DOI
38 Lyytinen H, Pukkala E, Ylikorkala O. Breast cancer risk in postmenopausal women using estrogen-only therapy. Obstet Gynecol. 2006;108(6):1354-60.   DOI
39 The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013;20(9):888-902.   DOI
40 Wang L, Zhang X, Zhang J. A Clinical Study of 30 Cases of Atrophic Vaginitis Treated with “Zi Yin He Ji” and Herbal Fumigation. Jiangsu Journal of TCM. 2018;50(11):44-6.
41 Zhang J, Wei H, Zhang H. Clinical research on nifuratel nystatin suppository combined with Baofukang suppository for atrophic vaginitis before colposcopy. Practical Pharmacy and Clinical Remedies. 2017;20(06):676-8.
42 Su L. Clinical Study on the Combination of Traditional Chinese and Western Medicine in the Treatment of Yin Deficiency and Dampness-heat Atrophic Vaginitis. CJGMCM. 2018;33(16):2418-20.
43 Wang Z, Zheng Y, Chen J. The efficacy of kuntai capsule combined with tinidazole suppositories local treatment on atrophic vaginitis. Journal of Practical Gynecologic Endocrinology. 2018;5(23):37-9.
44 Wei J, et al. Therapeutic effect of Jiawei Bushen Zhidai Decoction on postmenopausal atrophic vaginitis. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2018;24(5):99-100, 107.
45 Shi J, Liang X, Chen X. Observation of curative effect of Kuntai capsules combined with compound Shajizi suppository on the treatment of atrophic vaginitis. Hebei J TCM. 2016;38(05):662-5.
46 Sun H. Effect of Baofukang suppository combined with diethylstilbestrol on atrophic vaginitis in postmenopausal women. Mod Diagn Treat. 2016;27(10):1823-4.
47 Zhang N, Lu L. Effect of Baofukang suppository combined with diethylstilbestrol on atrophic vaginitis in postmenopausal women. Chin J Mod Drug Appl. 2016;10(06):192-3.
48 Wu Y, Ye L, Qian H. Combination of "Kushen Ningjiao"and Estriol Ointment for the treatment of atrophic vaginitis. SH J TCM. 2014;48(12):61-2.
49 Zhao Y. Therapeutic effect of Baofukang suppository combined with estrogen on senile vaginitis. Journal of Practical Gynecologic Endocrinology. 2015;2(04):105-6.
50 Li J. Treatment of atrophic vaginitis with Baofukang suppository combined with low-dose estrogen ointment. China's Naturopathy. 2015;23(01):59.
51 Zhang L. Clinical Observation on Treatment of Atrophic Vaginitis with Baofukangshuan and Bujiale. Strait Pharmaceutical Journal. 2012;24(7):125-7.   DOI
52 Chen L. Clinical Efficacy of Premarin Ointment Combined with Compound Shajiziyou Suppository in Treating Atrophic Vaginitis in 32 Cases. China Pharmaceuticals. 2014;23(11):91-2.
53 Ren L. Clinical Observation on Treatment of 52 Cases of Atrophic Vaginitis with Yiyin Decoction and Yinyin Oil. Chinese Journal of Ethnomedicine and Ethnopharmacy. 2014;23(05):60-1.
54 Hong B. Clinical study on the treatment of atrophic vaginitis in postmenopausal women in rural areas. China Parc Med. 2013;8(21):199-200.
55 Yu S. Clinical experience of nylestriol combined with Baofukang suppository in the treatment of atrophic vaginitis. Nei Mongol Journal of TCM. 2012;31(24):98-9.
56 Jiang H. Clinical Observation on 120 Cases of Atrophic Vaginitis Treated by Baofukang Suppository Combined with Estrogen. Chinese Community Doctors. 2012;14(23):180-1.
57 Li Z, Wang Y. Clinical Study on Sanqiang Soup Combined with Hormone in Treating Atrophic Vaginitis with Yin Deficiency and Dampness-heat Syndrome. Chinese Journal of Information on TCM. 2012;19(4):9-11.
58 Pi G. Therapeutic effect of integrated traditional Chinese and Western medicine on atrophic vaginitis. Chinese Community Doctors. 2011;13(27):195.
59 Lin W, Wang Y. Clinical efficacy of metronidazole combined with Xianling Guyu in the treatment of postmenopausal atrophic vaginitis. Prog Obstet Gynecol. 2011;20(7):589-90.
60 Li L. Treatment of Atrophic Vaginitis with Combination of Traditional Chinese Medicine and Western Medicine. Proceeding of Clinical Medicine. 2014;23(09):677, 705.
61 Zhang Y, Yuan D. Comparison of three treatment methods for atrophic vaginitis in postmenopausal women in rural areas. Chinese Journal of Gerontology. 2010;30(24):3779.