Meta-Analysis of Bushen Huoxue Method in the Treatment of Recurrent Spontaneous Abortion Due to Prethrombotic State

Abstract

Objective: To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion (RSA) due to prethrombotic state (PTS). Methods: Databases such as CNKI, WanFang, VIP, CBM, PubMed, Embase, and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021; meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation. Results: Seven trials were included, with 496 patients; the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate [RR = 1.22, 95% CI (1.10, 1.35), Z = 3.80 (P = 0.0001)], embryo survival rate at pregnancy of 12 weeks [RR = 1.25, 95% CI (1.10, 1.41), Z = 3.53 (P = 0.0004)], D-dimer levels [SMD = -1.59, 95% CI (-2.20, -0.97), Z = 5.07 (P < 0.00001)], and fibrinogen levels [MD = -1.00, 95% CI (-1.29, -0.70), Z = 6.61 (P < 0.00001)], but the statistical heterogeneity was significant; in terms of incidence of adverse reactions, there was no statistical difference between Bushen Huoxue prescription and western medicine. Conclusion: Compared with western medicine alone, Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency, embryonic survival rate at 12 weeks of pregnancy, and reducing D-dimer values as well as fibrinogen levels, without any significant difference in the incidence of adverse effects; however, the number of included studies is small and there are drawbacks, such as small sample size and low quality; therefore, high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.