Article type
Year
Abstract
Background: the existing evidence of antibiotics and α-blockers for treating chronic prostatitis are limited. Though the majority of doctors in China may use herbal patent in treatment of this disease, approximately half of them have never studied traditional Chinese medicine theory.
Objectives: this guideline aims to guide Western physicians to use Chinese patent medicine (CPM) rationally in treating chronic prostatitis, to improve clinical efficacy and reduce the potential safety hazards caused by unreasonable use of CPM.
Methods: the panel composed clinical problems according to PICO (patient, intervention, comparison, outcome) standards and formed a summary table of research questions after expert consultation. The sources of evidence related to the effectiveness and safety of CPM in treating chronic prostatitis (regarding pain, lower urinary tract symptoms and quality of life) included the relevant guidelines, consensus, systematic reviews, published/unpublished randomized controlled trials (RCT) and other observational studies, alone or in combination. We developed the inclusion criteria and search strategy according to the research questions. We assessed methodological quality of the included systematic reviews by AMSTAR, and the included RCTs according to Cochrane's 'Risk of bias' tool. Data synthesis was applied when high-quality systematic reviews and meta-analysis were absent. We used Review Manager software (version 5.3) for pooling data. We used GRADE to evaluate the strength of the evidence, and formed recommendations using expert consensus, with three rounds of survey and two meetings, based on the current available evidence.
Results: the evidence was mainly generated from the included 129 RCTs and two systematic reviews. Considering the level of the evidence (according to GRADE assessment) and the experts' consensus, this guideline gave Qian Lie Xin Capsule and Long Qing Tablet strong recommendation for pain relief and for alleviating lower urinary tract symptoms, gave Prostant and Ning Bi Tai Capsule weak recommendation for pain relief and alleviating lower urinary tract symptoms, and gave Fu Fang Xuan Ju Capsule and Shuang Shi Tong Lin Capsule weak recommendations for other accompanying symptoms (burning sensation of urethra or erectile dysfunction). However, we realized that in the absence of high-quality evidence, the formulation of this guideline relied more on expert consensus. Since there are some differences between clinical experience and indications of CPM instructions, it may have an impact on the users of guidelines.
Conclusions: due to the limited and low-level clinical evidence, this guideline only recommended six out of 74 CPM, which have been assessed in clinical studies. We will update the literature search every six months to supplement the potential new high-quality evidence of corresponding CPM, and update the guidelines in a timely fashion.
Objectives: this guideline aims to guide Western physicians to use Chinese patent medicine (CPM) rationally in treating chronic prostatitis, to improve clinical efficacy and reduce the potential safety hazards caused by unreasonable use of CPM.
Methods: the panel composed clinical problems according to PICO (patient, intervention, comparison, outcome) standards and formed a summary table of research questions after expert consultation. The sources of evidence related to the effectiveness and safety of CPM in treating chronic prostatitis (regarding pain, lower urinary tract symptoms and quality of life) included the relevant guidelines, consensus, systematic reviews, published/unpublished randomized controlled trials (RCT) and other observational studies, alone or in combination. We developed the inclusion criteria and search strategy according to the research questions. We assessed methodological quality of the included systematic reviews by AMSTAR, and the included RCTs according to Cochrane's 'Risk of bias' tool. Data synthesis was applied when high-quality systematic reviews and meta-analysis were absent. We used Review Manager software (version 5.3) for pooling data. We used GRADE to evaluate the strength of the evidence, and formed recommendations using expert consensus, with three rounds of survey and two meetings, based on the current available evidence.
Results: the evidence was mainly generated from the included 129 RCTs and two systematic reviews. Considering the level of the evidence (according to GRADE assessment) and the experts' consensus, this guideline gave Qian Lie Xin Capsule and Long Qing Tablet strong recommendation for pain relief and for alleviating lower urinary tract symptoms, gave Prostant and Ning Bi Tai Capsule weak recommendation for pain relief and alleviating lower urinary tract symptoms, and gave Fu Fang Xuan Ju Capsule and Shuang Shi Tong Lin Capsule weak recommendations for other accompanying symptoms (burning sensation of urethra or erectile dysfunction). However, we realized that in the absence of high-quality evidence, the formulation of this guideline relied more on expert consensus. Since there are some differences between clinical experience and indications of CPM instructions, it may have an impact on the users of guidelines.
Conclusions: due to the limited and low-level clinical evidence, this guideline only recommended six out of 74 CPM, which have been assessed in clinical studies. We will update the literature search every six months to supplement the potential new high-quality evidence of corresponding CPM, and update the guidelines in a timely fashion.