背景:尖锐湿疣(CA)是一种常见的性传播疾病。先前使用随机对照试验(RCTs)的研究表明,Paiteling(PTL),中成药配方,能有效缓解CA症状。然而,证据需要更具凝聚力,并且需要对现有随机对照试验进行明确总结,以评估PTL的总体疗效和安全性.
目的:本研究旨在对随机对照试验进行全面综述和荟萃分析,检查PTL和物理治疗在CA中的疗效。
方法:在多个数据库中进行了文献检索,包括PubMed,MEDLINE,科克伦图书馆,等。到2022年12月1日使用Revman5.4和Stata15.0进行数据统计和敏感性分析。
结果:31项试验共2868例患者纳入本综述。结果表明,PTL加物理治疗比单独使用物理治疗有效。(RR=1.60,95%CI[1.38,1.86];P<0.00001)。亚组分析显示,物理治疗的类型,性别,疣的位置可能是异质性的主要来源。此外,PTL可降低复发率(RR=0.27,95%CI[0.19,0.39];P<0.00001),提高HPV转阴率(RR=1.15,95%CI[1.02,1.30];P=0.02),提高免疫功能。没有观察到严重的不良反应或身体损伤,让计划怀孕的女性成为更好的选择。
结论:与物理疗法相比,PTL能有效消除CA症状,降低复发率,保证安全性。然而,由于异质性和方法论上的缺陷,仍然需要大样本量和高质量严格的RTC来加强这一临床证据.
BACKGROUND: Condyloma acuminatum (CA) is a common sexually transmitted disease. Previous studies using randomized controlled trials (RCTs) have revealed that Paiteling (PTL), a Chinese patent medicine formula, can effectively relieve CA symptoms. However, the evidence needs to be more cohesive and there is a need for a clear summary of the existing RCTs to assess the overall efficacy and safety profile of PTL.
OBJECTIVE: This study aimed to conduct a comprehensive
review and meta-analysis of RCTs, to examine the efficacy of PTL and physical therapies in CA.
METHODS: A literature search was conducted in multiple databases, including PubMed, MEDLINE, Cochrane Library, etc. up to December 1, 2022. Revman 5.4 and Stata 15.0 was used for data statistics and sensitivity analyses.
RESULTS: 31 trials with a total of 2868 patients were included in this
review. The results showed that PTL plus physical therapies were significantly more effective than physical therapies used alone (RR = 1.60, 95% CI [1.38, 1.86]; P < 0.00001). Subgroup analysis showed that the type of physical therapies, gender, and wart location might be the primary sources of heterogeneity. Additionally, PTL can reduce recurrence rates (RR = 0.27, 95% CI [0.19, 0.39]; P < 0.00001), improve the negative conversion rate of HPV (RR = 1.15, 95% CI [1.02, 1.30]; P = 0.02), and improve immune function. No severe adverse reactions or physical injuries were observed, making it a better choice for women planning to become pregnant.
CONCLUSIONS: Compared with physical therapies, PTL can effectively eliminate CA symptoms and reduce the recurrence rates with safety ensured. However, due to the heterogeneity and methodological shortcomings, large sample sizes and high-quality rigorous RTCs are still needed to strengthen this clinical evidence.