Bixie Fenqing decoction in the treatment of chronic prostatitis: A systematic review and meta-analysis

Background: Traditional Chinese medicine (TCM) posits that chronic prostatitis is associated with the accumulation of damp-heat pathogenic factors in the lower jiao. The Bixie Fenqing decoction (BFD) eliminates damp-heat pathogenic factors in the body, thereby alleviating inflammation and improving symptoms. Methods: Databases such as CNKI, WanFang, VIP, CBM, ClinicalKey, PubMed, Embase, and the Cochrane Library were searched. The search time ranged from the establishment of the database until March 30, 2024. RCTs that used BFD for chronic prostatitis were screened. The methodological quality of the studies was evaluated using the Cochrane Scoring System. Meta-analysis of outcome indicators was performed using RevMan 5.4 software, and Egger analysis of publication bias for the primary outcome indicators was conducted using Stata 16 software. Results: This analysis included 1104 patients. Meta-analysis showed that BFD significantly improved clinical efficacy in patients with chronic prostatitis, with a total effective rate (RR = 1.20, 95% CI: 1.13 to 1.26, P < .00001) and cure rate (RR = 1.52, 95% CI: 1.24 to 1.86, P < .00001). It significantly reduced the NIH-CPSI (National Institutes of Health-Chronic Prostatitis Symptom Index) scores, levels of inflammatory factors, white blood cell counts, and TCM syndrome scores in patients with chronic prostatitis. Specifically, the NIH-CPSI total scores (MD = −4.41, 95% CI: −5.27 to −3.55, P < .00001), NIH-CPSI pain scores (MD = −2.08, 95% CI: −2.93 to −1.23, P < .00001), NIH-CPSI urinary symptom scores (MD = −1.13, 95% CI: −1.69 to −0.57, P < .0001), NIH-CPSI quality of life scores (MD = −1.25, 95% CI: −1.76 to −0.75, P < .00001), levels of inflammatory factors TNF-α (MD = −11.18, 95% CI: −13.84 to −8.53, P < .00001) and IL-10 (MD = −20.60, 95% CI: −26.82 to −14.37, P < .00001) in prostatic fluid, white blood cell counts in prostatic fluid (MD = −2.91, 95% CI: −5.46 to −0.36, P = .03), and TCM syndrome scores (MD = −7.01, 95% CI: −8.13 to −5.90, P < .00001) were all significantly improved. Conclusion: BFD has a definite effect on the treatment of chronic prostatitis.