An Overview of Systematic Reviews of Using Chinese Medicine to Treat Polycystic Ovary Syndrome

OBJECTIVE: This review sought to evaluate the strength and validity of the existing evidence for the use of Chinese medicine for the treatment of polycystic ovary syndrome (PCOS). METHODS: We retrieved systematic evaluations and meta-analyses of randomized controlled trials (RCTs) evaluating Chinese herbal interventions in polycystic ovaries, including the use of decoctions or Chinese patent medicines. The quality of these systematic evaluations was assessed using AMSTAR2 tools, and ovulation rate, pregnancy rate, effective rate, serum hormones (testosterone, luteinizing hormone, and follicle-stimulating hormone), and adverse reactions were recorded. Finally, the reliability of each result was evaluated according to the GRADE system. Data Sources. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, CQVIP, and SINOMED databases were searched up to January 1, 2021. Outcomes. A total of 18 publications were included, all of which showed that PCOS symptoms were improved with Chinese medicine compared with control groups. However, most of the evaluations did not have good research designs and had issues with the analysis of their results. The reliability of most outcome measures was rated low or very low, and it is presumed that the reliability of the results was low due to the poor quality of the RCTs. CONCLUSIONS: At present, there is insufficient evidence to suggest that improved efficacy is achieved by the combined use of Chinese and Western medicine compared with Western medicine alone in treating PCOS. Therefore, it is recommended that multicenter, large-sample RCTs adopting standard designs and rigorous methods be carried out in the future while introducing standardized assessment plans for the systematic review of clinical trials so as to improve the quality of the resulting clinical evidence.