Method of invigorating spleen and replenishing kidney and resolving phlegm for obesity-type polycystic ovary syndrome: a network meta-analysis and summary of herbal prescription regularity.

Abstract

<h4>Objective</h4>This study aimed to evaluate the therapeutic efficacy of Invigorating Spleen and Replenishing Kidney and Resolving Phlegm Prescription (ISRKRPP) in treating obesity-type polycystic ovary syndrome (PCOS) and to analyze the prescription regularity through data mining technology.<h4>Methods</h4>Databases were retrieved up to September 30, 2024. RCTs on obesity-type PCOS treated with ISRKRPP and Western medicine (WM) were included. The Risk of Bias 2 tool was used for quality assessment. Network meta-analysis was performed using Stata 14.0. After standardizing herb names, a corresponding herbal database was built in Excel. Based on Excel and R language, the core drugs and prescription rules used in the treatment of obese PCOS were analyzed and visualized.<h4>Results</h4>A total of 14 articles, involving 1,163 patients and 7 prescriptions, were included. Network meta-analysis indicated the following: Qihuang Zengmin Decoction + WM may be optimal for overall efficacy (Confidence in Network Meta-Analysis [CINeMA]: moderate confidence); Cangfu Daotan Decoction + WM showed superiority in reducing BMI (CINeMA: moderate confidence); Method of Regulating and Supplementing Spleen and Kidney + WM most effectively improved HOMA-IR (CINeMA: moderate confidence); Cangfu Daotan Decoction + WM best regulated LH (CINeMA: moderate confidence); Heshi Powder + WM medicine most effectively reduced testosterone (CINeMA: moderate confidence). Herbal Regularity analysis revealed core herbs for the treatment included Rhizoma atractylodis, Poria cocos, Angelica sinensis, <i>Pinellia ternata</i>, and Epimedium. The herbal cluster, including Epimedium, Poria cocos, Angelica sinensis, Citrus, Spina gleditsiae, Salviae miltiorrhizae, Rhizoma atractylodis, <i>Pinellia ternata</i>, and Rhizoma cyperi may be the core prescription for the treatment of obesity-type PCOS.<h4>Conclusion</h4>Based on the results of the present studies, ISRKRPP combined with WM can improve the effect of obesity-type PCOS. Due to the limitations of the present studies, more clinical studies are needed for further validation.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024594257.