Comparative Efficacy of Oral Chinese Patent Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome With Sexual Dysfunction: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Oral Chinese patent medicine (OCPM) combined with western medicine (WM) are believed to be effective for the therapy of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with sexual dysfunction (SD). These western medicines mainly involve antibiotics, phosphodiesterase type-5 inhibitor (PDE-5i), α-blockers. But there is no randomized controlled trial (RCT) that directly compares the efficacy of different OCPM. Hence, we operated a network meta-analysis (NMA) to contrast the efficacy of different OCPM for CP/CPPS with SD.Methods: Relevant studies were searched in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. All of the RCTs concentrated on the use of OCPM to cure CP/CPPS with SD from the inception of the databases to November 2020. We appraised the risk of bias under the Cochrane Handbook and CONSORT statement. The data were statistically analyzed via STATA 13.0 and WinBUGS 1.4.3 instrument.Results: Altogether, 30 pieces of literature with 2,996 participants containing 11 oral Chinese patent medicine and 11 interventions were included in the NMA. In terms of The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), Qianlie Shutong Capsules (QLSTC) + WM had the most possible of being the optimal treatment. In the light of the International Index of Erectile Function (IIEF-5), Congrong Yishen Granules (CRYSG) + WM had the most possible of being the optimal treatment. Shugan Yiyang Capsules (SGYYC) + WM performed the highest likelihood efficacy under cluster rank graph combined NIH-CPSI and IIEF-5. Liuwei Dihuang Pills/Yougui capsules (LWDHP/YGC) + WM had highly possible to be the optimal treatment not only for the clinical effective rate of CP/CPPS but also for the clinical effective rate of SD. Considering four outcomes, QLSTC, CRYSG, SGYYC, LWDHP/YGC, Qianlie Beixi Capsules (QLBXC) plus WM were the best therapy approach for CP/CPPS with SD, especially LWDHP/YGC + WM and QLBXC + WM.Conclusion: Based on the NMA, QLSTC, CRYSG, SGYYC, LWDHP/YGC, QLBXC plus WM demonstrated the maximum probability of being the optimal therapies. Owing to the limitations of this research, these results should be confirmed by elaborate RCTs.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021224060].

Efficacy and safety assessment of traditional Chinese medicine for erectile dysfunction: A meta‐analysis and trial sequential analysis

“…As for the combination with pharmaceuticals for complications or comorbidities, type 2 diabetes mellitus and diabetic nephropathy, hyperuricemia, late-onset hypogonadism, hypertension, and benign prostatic hyperplasia are involved. Several lines of evidence suggest that diabetes, 7,84,85 hypogonadism, 86,87 hypertension, 88 and benign prostatic hyperplasia 89,90 are all closely associated with ED, and the corresponding treatment or combination therapy could alleviate ED. [90][91][92] As for hyperuricemia, a strong association with ED is only observed in patients with type 2 diabetes mellitus.…”

A review of current treatments for chronic prostatitis/chronic pelvic pain syndrome under the UPOINTS system

“…Zhang et al reviewed the literature on the combination of Western medicine such as alpha blockers, and PDE-5 inhibitors with CHM for sexual dysfunction in CP/ CPPS, and found significant improvement in IIEF-5 scores when CHMs were combined with Western medicine. 41…”

“…There have been several treatment results of CHM for CP/CPPS with sexual dysfunction, but most of them are reported in Chinese. Zhang et al reviewed the literature on the combination of Western medicine such as alpha blockers, and PDE‐5 inhibitors with CHM for sexual dysfunction in CP/CPPS, and found significant improvement in IIEF‐5 scores when CHMs were combined with Western medicine 41 …”

A Scoping Review of Oral Chinese Traditional Medicine for Vascular Dementia

“…Although listed in the CNEHIP, CNEML, or CP, the medicines were defined as eliciting actions with TCM syndrome differentiation, instead of targeted for specific diseases, and only Tianzhi and Fufang Congrong Yizhi were licensed treatments for VaD across the indications of 17 medicines. Despite clinical research of these medicines having been conducted for multiple diseases [9,[19][20][21][22] , the clinical evidence for their application in VaD remains limited.…”