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子宫内膜异位症的中药和天然药物临床试验注册情况及特征:一项综合分析

Registration and characteristics of clinical trials on traditional Chinese medicine and natural medicines for endometriosis: a comprehensive analysis.

作者信息

Zhao Yi, Wang Yike, Xue Zhu, Weng Yuanyuan, Xia Cencan, Lou Jingyang, Jiang Minmin

机构信息

Department of Drug Clinical Trials, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.

出版信息

Front Med (Lausanne). 2024 Nov 5;11:1432815. doi: 10.3389/fmed.2024.1432815. eCollection 2024.

Abstract

OBJECTIVE

To investigate the characteristics of clinical trials on traditional Chinese medicine (TCM) or natural medicines for treating endometriosis, aiming to inform future clinical practice and the development of new effective drugs.

METHOD

The global clinical trial registration platform was searched to identify clinical trials investigating the efficacy of TCM/natural medicine in treating endometriosis. Relevant trials were selected based on stringent inclusion and exclusion criteria. Data entry was performed using Microsoft Excel, while data analysis was conducted using SPSS version 23.

RESULTS

The study encompassed 57 trials, of which ClinicalTrials.gov accounted for 18, ChiCTR for 3, ICRP for 15, and ChiDTR for 21 trials. The number of registrations showed a significant positive correlation with the years. Of the 57 clinical trials, 87.7% were randomized, 63.2% were blinded, 78.9% followed a parallel intervention model, and 56.1% had a sample size below 100. Regarding trial phases, 45.6% of clinical trials did not specify a phase, while Phase 3 and Phase 4 clinical trials accounted for 17.5%. Nine clinical trials involved drugs that are already on the market, including six Chinese patent medicines: Sanjie Zhentong Capsules, Honghua Ruyi Pills, Huayu Sanjie Enema Liquid, Kuntai Capsules, Wenjing Tang, and Xuefu Zhuyu Capsules. Outside China, Iran has the highest number of registrations for natural medicine treatments for endometriosis, with curcumin being the most registered natural medicine.

CONCLUSION

The analysis reveals that clinical trials on TCM and natural remedies for endometriosis often utilize randomization; however, substantial deficiencies remain in blinding and sample size adequacy. These findings suggest that, despite growing interest in TCM and natural remedies, further methodological improvements are necessary to enhance the credibility of future studies. This research highlights the importance of rigorously designed clinical trials in verifying the safety and efficacy of these alternative therapies, which may influence future therapeutic approaches for managing endometriosis.

摘要

目的

探讨治疗子宫内膜异位症的中药或天然药物临床试验的特点,旨在为未来的临床实践和新型有效药物的研发提供参考。

方法

检索全球临床试验注册平台,以识别研究中药/天然药物治疗子宫内膜异位症疗效的临床试验。根据严格的纳入和排除标准选择相关试验。使用Microsoft Excel进行数据录入,而数据分析则使用SPSS 23版进行。

结果

该研究涵盖57项试验,其中ClinicalTrials.gov有18项,中国临床试验注册中心(ChiCTR)有3项,国际临床试验注册平台(ICRP)有15项,中国药物临床试验注册平台(ChiDTR)有21项试验。注册数量与年份呈显著正相关。在这57项临床试验中,87.7%为随机试验,63.2%为盲法试验,78.9%采用平行干预模型,56.1%的样本量低于100。关于试验阶段,45.6%的临床试验未明确阶段,而3期和4期临床试验占17.5%。9项临床试验涉及已上市药物,包括6种中成药:散结镇痛胶囊、红花如意丸、化瘀散结灌肠液、坤泰胶囊、温经汤和血府逐瘀胶囊。在中国境外,伊朗在子宫内膜异位症天然药物治疗方面的注册数量最多,姜黄素是注册最多的天然药物。

结论

分析表明,中药和天然药物治疗子宫内膜异位症的临床试验常采用随机化;然而,在盲法和样本量充足性方面仍存在重大缺陷。这些发现表明,尽管对中药和天然药物的兴趣日益增加,但仍需进一步改进方法,以提高未来研究的可信度。本研究强调了严格设计的临床试验在验证这些替代疗法的安全性和有效性方面的重要性,这可能会影响未来子宫内膜异位症的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73df/11573583/ca7977ca91d7/fmed-11-1432815-g001.jpg

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