Objective Guizhi Fuling Capsule (GZFL), a classic traditional Chinese medicine prescription, is often recommended for the treatment of uterine fibroids (UFs). However, the efficacy and safety of GZFL in combination with low-dose mifepristone (MFP) remains controversial. Materials and methods We searched eight literature databases and two clinical trial registries for randomized controlled trials (RCTs) of the efficacy and safety of GZFL combined with low-dose MFP in the treatment of UFs from database inception to April 24, 2022. Data analysis was performed using the Meta package in RStudio and RevMan 5.4. GRADE pro3.6.1 software was used for the assessment of evidence quality. Results Twenty-eight RCTs were included in this study, including a total of 2813 patients. The meta-analysis showed that compared with low-dose MFP alone, GZFL combined with low-dose MFP significantly reduced follicle stimulating hormone (p < 0.001), estradiol (p < 0.001), progesterone (p < 0.001), luteinizing hormone (p < 0.001), uterine fibroids volume (p < 0.001), uterine volume (p < 0.001), menstrual flow (p < 0.001) and increased clinical efficiency rate (p < 0.001). Meanwhile, GZFL combined with low-dose MFP did not significantly increase the incidence of adverse drug reactions compared with low-dose MFP alone (p = 0.16). The quality of the evidence for the outcomes ranged from “very low” to “moderate.” Conclusion This study suggests that GZFL combined with low-dose MFP is more effective and safe in the treatment of UFs, and it is a potential treatment for UFs. However, due to the poor quality of the included RCTs formulations, we recommend a rigorous, high-quality, large-sample trial to confirm our findings.
Background: Antibiotics alter the microbial balance commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent and treat AAD by providing the gut barrier and restoring the gut microflora. This study will overview the Systematic Reviews (SRs) of probiotics in preventing and treating AAD in children. It will also assess the reporting, methodological, and evidence quality of the included SRs to provide evidence for their clinical practice.Methods: After searching PubMed, Embase, Cochrane Library, CNKI, CBM, VIP, and WanFang Data databases, and finally included SRs of probiotics in the prevention and treatment of AAD in children, which were published before 1 October 2022. The reporting, methodological, and evidence quality of the included SRs were assessed by PRISMA 2020 statement, AMSTAR 2 tool, and GRADE system.Results: A total of 20 SRs were included, and the results of PRISMA 2020 showed that 4 out of 20 SRs with relatively complete reporting, and the others within some reporting deficiencies, with scores ranging from 17 points to 26.5 points; the results of AMSTAR 2 showed that 3 SRs belonged to moderate quality level, 10 SRs belonged to low-quality level and 7 SRs being extremely low-quality level; the results of the GRADE system showed that a total of 47 outcomes were reported for the included SRs, three were high-level evidence quality, 16 were medium-level evidence quality, 24 were low-level evidence quality, and four were extremely low-level evidence quality; the results of the Meta-analysis showed that high doses (5–40 billion CFUs per day) of probiotics had a significant effect in the prevention of AAD, but it is too early to conclude the effectiveness and safety of other probiotic drugs for AAD in children, except for Lacticaseibacillus rhamnosus and Saccharomyces boulardii.Conclusion: Current evidence shows that probiotics effectively prevent and treat AAD in children, and the effect of probiotics on pediatric AAD may be a potential dose-response effect. However, the conclusion should be treated with caution due to deficiencies in the methodological, reporting, and evidence quality of the included SRs. Therefore, the methodological, reporting, and evidence quality of relevant SRs still need further improvement.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42022362328
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a common metabolic disorder. According to some epidemiological studies and different meta-analysis, it is not clear that whether the relevance of the occurrence and progression of NAFLD and coffee consumption is very close. So we conducted the present article to make it clear. METHODS The PubMed, Cochrane library and Embase were searched up to December 1, 2022. We performed the meta-analysis of not regular coffee vs. regular coffee drinking and coffee drinking vs. the progression of NAFLD, and conducted subgroup analysis of participants, kinds of coffee, methods of diagnosis to verify that relationship. The pooled odds ratio (ORs) and corresponding 95% confidence intervals (CIs) and pooled standardized mean difference (SMD) IV. Random and 95% CIs were calculated by random-effects model. RESULTS Eleven articles were included, including 7093 cases and 20625 non-cases. Whether regular coffee drinking or not was not significantly associated with NAFLD occurrence, and OR were 0.84 (95% CI: 0.43–1.62). Moreover, the pooled SMD IV. Random. from the comparison of coffee drinking vs. the progression of NAFLD was − 0.12(95%CI :-0.31-0.07), showing not statistical significance. What’s more, subgroup analysis of people being obese or not, methods of diagnosis of NAFLD, types of coffee, suggested non beneficial efficacy of coffee drinking on NAFLD. CONCLUSIONS The existing evidence showed coffee drinking did not significantly decrease the occurrence and progression of NAFLD. In addition, different kinds of coffee failed to show any beneficial efficacy on NAFLD. Thus, coffee is not recommended for people to decrease the occurrence and slow the progression of NAFLD. As we were unable to assess the components of coffee on NAFLD, the results of this meta-analysis should be interpreted with caution. Further study is needed to assess the influence of main ingredient of coffee, caffeine, on NAFLD.
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