BACKGROUND Chinese medicinal retention enemas have gradually attracted the attention of clinicians as an alternative approach for tubal obstructive infertility. The purpose of this study was to investigate the efficacy and safety of conventional surgery combined with traditional Chinese medicinal retention enemas for the treatment of tubal obstructive infertility. MATERIALS AND METHODS Eight electronic databases were searched from their inception to November 30, 2022. To assess the efficacy and safety of different treatments, following outcomes were measured: clinical pregnancy rate, clinical total effective rate, incidence of ectopic pregnancy, the improvement of Traditional Chinese Medicinal (TCM) symptoms, the improvement of the signs of obstructive tubal infertility and side effects. RESULTS A total of 23 Randomized Controlled Trials (RCTs) with 1909 patients met the inclusion criteria. The pooled results showed a higher pregnancy rate in the experimental group than in the control group (RR 1.75, 95% CI [1.58, 1.94], Z = 10.55, P<0.00001). The clinical total effective rate in the experimental group was higher than that in the control group (RR 1.28, 95% CI [1.23, 1.34], Z = 11.07, P<0.00001). The incidence of ectopic pregnancy in the experimental group was lower than that in the control group (RR 0.40, 95% CI [0.20, 0.77], Z = -2.73, P = 0.01). CONCLUSION Based on current evidence, we concluded that conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility was superior to conventional surgery alone in improving the clinical pregnancy rate, improving clinical total effective rate, improving TCM symptoms, improving the signs of obstructive tubal infertility and lowering the incidence of ectopic pregnancy. However, further clinical trials with high-quality methodologies need to be conducted.

中文翻译：

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循证补充和替代医学常规手术结合中药保留灌肠治疗输卵管梗阻性不孕症：系统评价和荟萃分析。

背景技术中药保留灌肠作为输卵管梗阻性不孕症的一种替代治疗方法，逐渐受到临床医生的重视。本研究旨在探讨常规手术联合中药保留灌肠治疗输卵管梗阻性不孕症的疗效和安全性。材料和方法 从建立到 2022 年 11 月 30 日，搜索了八个电子数据库。为了评估不同治疗的有效性和安全性，测量了以下结果：临床妊娠率、临床总有效率、异位妊娠发生率、传统治疗的改善中医症状，改善阻塞性输卵管不孕症的体征和副作用。结果 共有 23 项随机对照试验 (RCT) 涉及 1909 名患者符合纳入标准。汇总结果显示，实验组的妊娠率高于对照组（RR 1.75，95% CI [1.58，1.94]，Z = 10.55，P<0.00001）。实验组临床总有效率高于对照组（RR 1.28，95% CI [1.23，1.34]，Z = 11.07，P<0.00001）。实验组异位妊娠发生率低于对照组（RR 0.40，95% CI [0.20，0.77]，Z = -2.73，P = 0.01）。结论 基于现有证据，我们得出结论，常规手术联合中药保留灌肠治疗输卵管梗阻性不孕症在提高临床妊娠率方面优于单纯常规手术，提高临床总有效率，改善中医症状，改善梗阻性输卵管不孕症的体征，降低异位妊娠的发生率。但是，需要使用高质量的方法进行进一步的临床试验。