Review Article

Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review

Table 1

The RCTs of effective CHM formula for PID with oral administration.

Study IDDesignSample sizeInterventionsOutcomesCompositionLimitations

[21]RCT144Treatment arm:
Dachaihu Decoction + cefoxitin + doxycycline hyclate
Control arm:
cefoxitin + doxycycline hyclate
Treatment arm:
TFR, 97.22% (70 of 72)
Control arm:
TFR, 84.72% (61 of 72)
Dachaihu Decoction:
White peony root (Bai shao), Corydalis tuber (Yan hu suo), Herba Patriniae (Bai jiang cao), Bupleurum (Chai hu), Coix seed (Yi yi ren), rhubarb root and rhizome (Da huang), dandelion (Pu gong ying), dried ginger rhizome (Gan jiang), fruit of citron or trifoliate orange (Zhi shi), Pinellia ternata (Ban xia), Trogopterus dung (Wu ling zhi), Radix scutellariae (Huang qin), Jujube (Da zao) , Delavay honeysuckle (Jin yin hua), Monkshood (Fu zi)
Not mentioned blindness and drop-out rate

[22]RCT360Treatment arm:
Gongying Tuling Decoction 
+ moxifloxacin
Control arm:
moxifloxacin
Treatment arm:
TFR, 91.67% (165 of 180)
Control arm:
TFR, 84.44% (152 of 180)
Gongying Tuling Decoction:
dandelion (Pu gong ying), bearded scutellaria (Ban zhi lian), Coix seed (Yi yi ren), glabrous greenbrier rhizome (Tu fu ling), white Atractylodes rhizome (Bai zhu), Pinellia rhizome (Ban xia), Amur cork-tree bark (Huang bai), Corydalis tuber (Yan hu suo), Atractylodes rhizome (Cang zhu)
Not mentioned blindness and drop-out rate

[23]RCT78Treatment arm: Hongteng Baijiang Decoction + levofloxacin + metronidazole
Control arm:
levofloxacin 
+ metronidazole
Treatment arm:
TFR, 94.87% (37 of 39)
Control arm:
TFR, 79.49% (31 of 39)
Hongteng Baijiang Decoction:
Herba Patriniae (Bai jiang cao), weeping forsythia capsule (Lian qiao), Delavay honeysuckle (Jin yin hua), Sargentodoxa cuneata (Hong teng), dandelion (Pu gong ying), Tokyo violet (Zi hua di ding), Poria (Fu ling), wild chrysanthemum flower (Ye ju hua), Salvia (Dan shen), combined spicebush root (Wu yao)
Modifications:
Inflammation: safflower (Hong hua), Chinese wax gourd seed (Dong gua ren), Chinese honeylocust spine (Zao jiao ci)
Chest oppression: Bupleurum (Chai hu), long stamen onion bulb (Xie bai), snake gourd fruit (Gua lou)
Severe phlegm-heat: Moutan (Dan pi), weeping forsythia capsule
(Lian qiao)
Not mentioned blindness and drop-out rate

[24]RCT96Treatment arm:
Yiqi Huayu Penyan Decoction 
+ levofloxacin 
+ Guizhi Fuling capsules
Control arm:
levofloxacin 
+ Guizhi Fuling capsules
Treatment arm:
TFR, 95.83% (46 of 48)
Control arm:
TFR, 83.33% (40 of 48)
Yiqi Huayu Penyan Decoction:
Radix codonopsis (Dang shen), Astragalus (Huang qi), Angelica sinensis (Dang gui), Salvia (Dan shen), Ligusticum wallichii (Chuan xiong), Cyperus (Xiang fu), Liquidambar formosana Hance (Lu lu tong), white peony root (Bai shao), leech (Shuizhi), licorice (Gancao)
Modifications:
Abnormal vaginal discharge: add heartleaf houttuynia (Yu xing cao), bearded scutellaria (Ban zhi lian), Amur cork-tree bark (Huang bai)
Pruritus vulvae: add Coix seed (Yi yi ren), Hypoglaucous Collett Yam Rhizome (Bi xie)
Diarrhea: add Psoralea (Bu gu zhi), common yam rhizome (Shan yao)
Not mentioned blindness and drop-out rate

[25]RCT108Treatment arm: Dahuangmudan Decoction + cefoxitin + doxycycline
Control arm: cefoxitin + doxycycline
Treatment arm:
TFR, 94.55% (52 of 55)
Control arm:
TFR, 79.25% (42 of 53)
Dahuangmudan Decoction:
rhubarb root and rhizome (Da huang), Moutan (Mu dan pi), Semen Persicae (Tao ren), Chinese wax gourd seed (Dong gua zi), sodium sulfate (Mang xiao), Herba Patriniae (Bai jiang cao), Delavay honeysuckle (Jin yin hua), red peony (Chi shao), Coix seed (Yi yi ren), licorice (Gan cao)
Not mentioned blindness and drop-out rate

[26]RCT100Treatment arm:
self-made Qingre Huayu Decoction + levofloxacin
Control arm: levofloxacin
Treatment arm:
TFR, 94% (47 of 50)
Control arm:
TFR, 80% (40 of 50)
Self-made Qingre Huayu Decoction:
licorice (Gan cao), Amur cork-tree bark (Huang bai), Semen Persicae (Tao ren), Chinese wax gourd seed (Dong gua zi), Herba Leonuri (Yi mu cao), Corydalis tuber (Yan hu suo), Indian bread (Fu ling), Danshen root (Dan shen), red peony root (Chi shao), Sargentodoxa cuneata (Hong teng), Patrinia (Bai jiang cao), Tokyo violet (Zi hua di ding), dandelion (Pu gong ying), Delavay honeysuckle (Jin ying hua)
Not mentioned blindness and drop-out rate

[27]RCT118Treatment arm:
Fuyanshu capsule + levofloxacin hydrochloride + metronidazole
Control arm:
Fuyanshu capsule simulator + levofloxacin hydrochloride + metronidazole
Treatment arm:
RR, 18.64% (11 of 59)
Control arm: RR, 86.44% (51 of 59)
Fuyanshu capsule:
honeysuckle stem (Ren dong teng), Sargent gloryvine stem (Da xue teng), licorice (Gan cao), woad root (Da qing ye), dandelion (Pu gong ying), red peony root (Chi shao), rhubarb root and rhizome (Da huang), Danshen root (Dan shen), giant knotweed rhizome (Hu zhang), Toosendan fruit (Chuan lian zi), Corydalis tuber (Yan hu suo)
Not mentioned blindness and drop-out rate

[28]RCT110Treatment arm:
Danbai granules + azithromycin
Control arm:
azithromycin
Treatment arm:
TFR, 98.2% (54 of 55)
Control arm:
TFR, 90.9% (50 of 55)
Danbai granules:
white peony root (Bai shao), Moutan (Mu dan pi), Tokyo violet (Zi hua di ding), common burr reed tuber (San leng), Ailanthus bark or root bark (Chuan pi), Patrinia root (Mu tou hui), Patrinia (Bai jiang cao), Sparganium (San leng), Curcumae rhizome (E zhu), Nightshade (Bai ying), Sichuan lovage root (Chuan xun), Sargent gloryvine stem (Da xue teng), glabrous greenbrier rhizome (Tu fu ling), Chinese Angelica (Dang gui), Oldenlandia (Bai hua she she cao)
Not mentioned blindness and drop-out rate

[29]RCT96Treatment arm:
Fuyanning Decoction + levofloxacin
Control arm:
levofloxacin
Treatment arm:
TFR, 97.92% (47 of 48)
Control arm:
TFR, 87.50% (42 of 48)
Fuyanning Decoction:
Danshen root (Dan shen), Astragalus root (Huang qi), Myrrh (Mo yao), Sargentodoxa cuneata (Hong teng), Dodder seed (Tu si zi), Morinda root (Ba ji tian), heartleaf houttuynia (Yu xing cao), flying squirrel faeces (Wu ling zhi), Herba Patriniae (Bai jiang cao), white Atractylodes rhizome (Bai zhu), degelatinated deer antler powder (Lu jiao shaung), Coix seed (Yi yi ren), Indian bread (Fu ling), Lychee seed (Li zhi he), Cassia twig (Gui zhi), Licorice (Gan cao)
Not mentioned blindness and drop-out rate

[30]RCT120Treatment arm:
Guizhi Fuling pills + ornidazole
Control arm:
ornidazole
Treatment arm:
TFR, 91.67% (55 of 60)
Control arm:
TFR, 78.33% (47 of 60)
Guizhi Fuling pills:
Cassia twig (Gui zhi), Indian bread (Fu ling), Moutan (Mu dan pi), red peony root (Chi shao), Semen Persicae (Tao ren)
Not mentioned blindness and drop-out rate

[31]RCT155Treatment arm:
the first 14 days: placebo (levofloxacin + metronidazole) + Jinying capsules; remaining 14 days: Jinying capsules
Control arm:
the first 14 days: Jinying capsules placebo + levofloxacin + metronidazole; remaining 14 days: Jinying capsule placebo
Treatment arm:
TFR, 76.32% (60 of 78)
Control arm:
TFR, 59.46%(46 of 77)
Jinying capsules:
Delavay honeysuckle (Jin yin hua), Amur cork-tree bark (Huang Bai), Tokyo violet (Zi hua di ding), wild chrysanthemum flower (Ye ju hua), dandelion (Pu gong ying), Atractylodes rhizome (Cang zhu), Chinese honeylocust spine (Zao jiao ci), Salvia (Dan shen), red peony (Chi shao), Corydalis tuber (Yan hu suo)
Not mentioned blindness and drop-out rate

[32]RCT38Treatment arm: Penning granule
Control arm:
levofloxacin + metronidazole
Treatment arm:
TFR, 91.3% (21 of 23)
Control arm:
TFR, 60% (9 of 15)
Penning granule:
Sargent gloryvine stem (Da xue teng), Patrinia (Bai jiang cao), Oldenlandia (Bai hua she she cao), red peony (Chi shao), Angelica sinensis (Dang gui), Frankincense (Ru Xiang), Myrrh (Mo yao), common burr reed tuber (San leng), Curcumae rhizome (E zhu), Chinese honeylocust spine (Zao jiao ci), Salvia (Dan shen), Bupleurum (Chai hu), Manchurian wild ginger (Xi xin), Astragalus (Huang qi), Pangolin scales (Chuan shan jia)
Not mentioned blindness, drop-out rate, and small sample size

[33]RCT90Tongluo Qingre Decoction arm
GeXia Zhuyu decoction arm
Tongluo Qingre Decoction arm:
TFR, 91.11% (41 of 45)
GeXia Zhuyu Decoction arm:
TFR, 82.22% (37 of 45)
Tongluo Qingre Decoction:
giant knotweed rhizome (Hu zhang), glabrous greenbrier rhizome (Tu fu ling), Amur cork-tree bark (Huang bai), ground beetle (Tu bie chong), Red peony (Chi shao), Moutan (Mu dan pi), Semen Persicae (Tao ren), Sichuan lovage root (Chuan xiong), Toosendan fruit (Chuan lian zi), leech (Shui zhi), Chinese Angelica (Dang gui), safflower (Hong hua), turmeric root tuber (Yu jin)
GeXia Zhuyu Decoction:
flying squirrel faeces (Wu ling zhi), Chinese Angelica (Dang gui), Sichuan lovage root (Chuan xiong), Semen Persicae (Tao ren), Moutan (Mu dan pi), red peony (Chi shao), combined spicebush root (Wu yao), Corydalis tuber (Yan hu suo), licorice (Gan cao), Cyperus (San leng cao), nutgrass galingale rhizome (Xiang fu), safflower (Hong hua), bitter orange (Zhi qiao)
Not mentioned blindness and drop-out rate

[34]RCT180Treatment arm: pelvic inflammatory decoction
Decoction arm: physical therapy
Physiotherapy arm: inflammatory decoction + physical therapy
Treatment arm:
TFR, 96.3% (59 of 60)
decoction arm:
TFR, 86.7% (52 of 60)
Physiotherapy arm: TFR, 76.7% (46 of 60)
Pelvic inflammatory decoction:
Atractylodes rhizome (Cang zhu), Astragalus (Huang qi), licorice (Gan cao), Radix codonopsis (Dang shen), Liquidambar formosana Hance (Lu lu tong), weeping forsythia capsule (Lian qiao), Platycodon root (Jie geng), combined spicebush root (Wu yao), common self-heal fruit-spike (Xia ku cao), Delavay honeysuckle (Jin yin hua)
Not mentioned blindness and drop-out rate

[35]RCT80Treatment arm:
Shaofu Zhuyu Decoction + tinidazole + levofloxacin
Control arm:
tinidazole + levofloxacin
Treatment arm:
TFR, 95% (38 of 40)
Control arm:
TFR, 80%(32 of 40)
Shaofu Zhuyu Decoction:
Fennel (Xiao hui xiang), dried ginger rhizome (Gan jiang), Corydalis tuber (Yuan hu), Trogopterus dung (Wu ling zhi), Ligusticum wallichii (Chuan xiong), Cattail Pollen (Pu huang), Angelica sinensis (Dang gui), red peony (Chi shao), cinnamon bark (Rou gui)
Modifications:
Pain: Toosendan fruit (Chuan lian zi)
Chest oppression: Cyperus (Xiang fu), turmeric root tuber (Yu jin)
Waist pain: Eucommia (Du zhong), Psoralea (Bu gu zhi)
Lack of strength: Radix codonopsis (Dang shen), Astragalus (Huang qi)
Not mentioned blindness, drop-out rate, and small sample size

Note. RCT: randomized clinical trial; TFR: total effective rate; RR: recurrence rate. versus treatment arm.