Examining the effect of Kuntai capsule combined with HRT in the treatment of premature ovarian insufficiency: A systematic review and meta‑analysis

Lin,Fengning; Lian,Junyu; Wu,Lijing

doi:10.3892/etm.2025.12866

Examining the effect of Kuntai capsule combined with HRT in the treatment of premature ovarian insufficiency: A systematic review and meta‑analysis

Authors:
- Fengning Lin
- Junyu Lian
- Lijing Wu
View Affiliations

Affiliations: Department of Obstetrics and Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
Published online on: April 9, 2025 https://doi.org/10.3892/etm.2025.12866
Article Number: 116
Copyright: © Lin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

While Chinese herbal medicines have been used to treat premature ovarian insufficiency (POI), their efficacy is currently unclear. The present study aimed to review and evaluate the efficacy of the Kuntai capsule combined with hormone replacement therapy (HRT) in treating POI. The China National Knowledge Infrastructure, WanFang, Chinese Biomedical Literature, PubMed, Embase and Cochrane Library databases were searched from the inception of the database to 25th October 2020, for studies comparing the therapeutic effect of Kuntai capsule combined with HRT vs. HRT alone in women with POI. The Cochrane Risk of Bias assessment tool was used to assess the quality of the studies, and the results were reported as weighted mean differences (MD) with 95% confidence intervals (CI). The present study included 10 trials involving 742 women with POI. When compared with HRT alone, HRT combined with Kuntai capsule significantly increased the number of antral follicles (AFC) (MD=0.88; 95% CI, 0.48‑1.29; P<0.00001), anti‑Müllerian hormone (AMH) levels (MD=0.24, 95% CI, 0.13 to 0.35, P<0.00001) and significantly improved peri‑menopausal symptoms [MD=‑2.26; 95% CI, ‑3.77‑(‑0.75); P=0.003]. The combined treatment regimen significantly decreased the levels of follicle‑stimulating hormone [MD=‑5.60; 95% CI, ‑7.98‑(‑3.22); P<0.00001] and luteinizing hormone [MD=‑2.42; 95% CI, ‑3.40‑(‑1.44), P<0.00001] and significantly increased the level of estradiol (MD=13.94; 95% CI, 4.16‑23.71; P<0.00001). Therefore, the Kuntai capsule combined with HRT could potentially be used as a supplementary therapy to alleviate menstrual disorders and peri‑menopausal symptoms and improve serum sex hormone levels in women with POI. The observed increase in the number of AFC in patients with POI treated with the combined therapy was indicative of improved ovarian reserve function. Therefore, combining the Kuntai capsule and HRT had am improved curative effect for POI treatment compared with HRT alone. However, as the present study was limited by the quality of the included reports, additional high‑quality studies with extensive sample sizes are required to verify the findings.

View Figures

View References

1	Maclaran K and Panay N: Current concepts in premature ovarian insufficiency. Womens Health (Lond). 11:169–182. 2015.PubMed/NCBI View Article : Google Scholar
2	European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI. Webber L, Davies M, Anderson R, Bartlett J, Braat D, Cartwright B, Cifkova R, de Muinck Keizer-Schrama S, Hogervorst E, et al: ESHRE guideline: Management of women with premature ovarian insufficiency. Hum Reprod. 31:926–937. 2016.PubMed/NCBI View Article : Google Scholar
3	Sadrzadeh S, Painter RC, van Kasteren YM, Braat DDM and Lambalk CB: Premature ovarian insufficiency and perinatal parameters: A retrospective case-control study. Maturitas. 96:72–76. 2017.PubMed/NCBI View Article : Google Scholar
4	Podfigurna-Stopa A, Czyzyk A, Grymowicz M, Smolarczyk R, Katulski K, Czajkowski K and Meczekalski B: Premature ovarian insufficiency: The context of long-term effects. J Endocrinol Invest. 39:983–990. 2016.PubMed/NCBI View Article : Google Scholar
5	Sullivan SD, Sarrel PM and Nelson LM: Hormone replacement therapy in young women with primary ovarian insufficiency and early menopause. Fertil Steril. 106:1588–1599. 2016.PubMed/NCBI View Article : Google Scholar
6	Chi J and Zhang Y: Observations on the efficacy of auricular pressure therapy combined with kuntai capsule in the treatment of uterine fibroids combined with perimenopausal syndrome. Hainan Med J. 27:3032–3034. 2016.
7	Xu J and Sun J: Experimental study on the effect of prevention and treatment of Kuntai capsule on osteoporosis in ovariectomized rats-CNKI. Mode J Inte Trad Chin West Med. 24:2873–2875. 2015.
8	Zhu J and Wang X: Meta-analysis of efficacy and safety of Kuntai capsule combined with hormone therapy in treatment of climacteric syndrome. Chin Arch Trad Chin. 58–65. 2021.
9	Zhang B, Zhang L, Yang Y, Sun X, Yang L, Wang L and Zhang X: Efficacy of Kuntai capsule for treating ovarian reserve dysfunction: A meta-analysis. Chin J Reprod Contracep. 40:750–755. 2020.
10	Xu L: Clinical effect analysis of dehydroepiandrosterone combined with Kuntai capsule in the treatment of infertility due to hypo-ovarian reserve. Mater Child Heal Care Chin. 35:3851–3854. 2020.
11	Cao H, Li H, Lin G, Li X, Liu S, Li P, Cong C and Xu L: The clinical value of acupuncture for women with premature ovarian insufficiency: A systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). 15(1361573)2024.PubMed/NCBI View Article : Google Scholar
12	Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, et al: The cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ. 343(d5928)2011.PubMed/NCBI View Article : Google Scholar
13	Moher D, Liberati A, Tetzlaff J and Altman DG: PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 6(e1000097)2009.PubMed/NCBI View Article : Google Scholar
14	Luan S, Cui Q, Zhang Y and Ma H: Clinical efficacy of Kuntai capsule in the treatment of premature ovarian failure. Chin Tradit Pat Med. 39:1318–1320. 2017.
15	Li W, An L, Zhang G, et al: The combined application of estradiol valerate-cproterone acetate and Kuntai capsule in poor ovarian responders of in vitro fertilization. J Pract Obstet Gynecol. 30:681–685. 2014.
16	Jia X: Clinical effect of Kuntai capsule combined with estradiol tablet/estradiol didroxyprogesterone tablet in the treatment of infertility with low ovarian reserve function. Pract Clin Med. 20:42–43. 2019.
17	Wu S: Study on the value of Kuntai and HRT treating premature ovarian failure. Pract Gynecol Endocr. 6:114–119. 2019.
18	Yuan H and Hu Y: Effect of Kuntai capsule combined with hormone replacement therapy on premature ovarian failure. Hubei J TCM. 41:16–18. 2019.
19	Yuan H and Hu Y: Clinical observation of climen combined with kuntai capsule in treatment of diminished ovarian reserve. Hubei J TCM. 40:7–9. 2018.
20	Hong: Clinical study on treatment of premature ovarian insufficiency with integrated Chinese and western medicine (unpublished thesis). Hubei University of Traditional Chinese Medicine, 2018.
21	Hu Y: The application of kuntai combined with femoston in patients with premature ovarian insufficiency complicated with infertility. Chin Med Mod Distance Edu China. 16:107–109. 2018.
22	Xiao PM, Xu YY and Shi YH: Clinical efficacy of Climen combined with Kuntai capsule for premature ovarian failure. Chin J Gener Pract. 13:774–775, 787. 2015.
23	Yao Y, Xia M, Wang C and Wan D: Clinical observation of Kuntai capsule combined with climen in treatment of diminished ovarian reserve. In: Proceedings of the 13th National Conference on traditional Chinese Medicine and Gynecology, Guiyang, pp611-612, 2013.
24	Torrealday S, Kodaman P and Pal L: Premature ovarian insufficiency-an update on recent advances in understanding and management. F1000Res. 6(2069)2017.PubMed/NCBI View Article : Google Scholar
25	Zhang J, Fang L, Shi L, Lai Z, Lu Z, Xiong J, Wu M, Luo A and Wang S: Protective effects and mechanisms investigation of Kuntai capsule on the ovarian function of a novel model with accelerated aging ovaries. J Ethnopharmacol. 195:173–181. 2017.PubMed/NCBI View Article : Google Scholar
26	Zhang H, Qin F, Liu A, Sun Q, Wang Q, Li Q, Lu S, Zhang D and Lu Z: Kuntai capsule attenuates premature ovarian failure through the PI3K/AKT/mTOR pathway. J Ethnopharmacol. 239(111885)2019.PubMed/NCBI View Article : Google Scholar
27	Zhou X, Wang L, Pan W and Li J: Clinical Observation on the treatment of premature ovarian failure with Kuntai capsule combined with hormone. J New Chin Med. 49:79–81. 2017.
28	Liu W, Nguyen TN, Tran Thi TV and Zhou S: Corrigendum to ‘Kuntai capsule plus hormone therapy vs hormone therapy alone in patients with premature ovarian failure: A systematic review and meta-analysis’. Evid Based Complement Alternat Med. 2021(5737914)2021.PubMed/NCBI View Article : Google Scholar
29	Chen JM, Gao HY, Ding Y, Yuan X, Wang Q, Li Q and Jiang GH: Efficacy and safety investigation of Kuntai capsule for the add-back therapy of gonadotropin releasing hormone agonist administration to endometriosis patients: A randomized, double-blind, blank- and tibolone-controlled study. Chin Med J (Engl). 128:427–432. 2015.PubMed/NCBI View Article : Google Scholar
30	Ma Q, Tan Y and Mo G: Effectiveness of cotreatment with Kuntai capsule and climen for premature ovarian failure: A meta-analysis. Evid Based Complement Alternat Med. 2020(4367359)2020.PubMed/NCBI View Article : Google Scholar
31	Zhang X, Zhang L, Xiong L, Liu X, Zhang J, Yu F, Li Y, Chang W and Chen W: Kuntai capsule for the treatment of diminished ovarian reserve: A systematic review and meta-analysis of randomized controlled trials. J Ethnopharmacol. 329(118167)2024.PubMed/NCBI View Article : Google Scholar
32	Lian F and Jiang XY: Effect of kuntai capsule on the number of retrieved oocytes, high-quality oocytes and embryos in in vitro fertilization of poor ovarian response patients. Zhongguo Zhong Xi Yi Jie He Za Zhi. 34:917–921. 2014.PubMed/NCBI(In Chinese).
33	Liu W, Nguyen TN, Tran Thi TV and Zhou S: Kuntai capsule plus hormone therapy vs hormone therapy alone in patients with premature ovarian failure: A systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019(2085804)2019.PubMed/NCBI View Article : Google Scholar
34	Lin W, Zeng XP, Deng J, Liu Y, Cai RH, Chen HY and Shi DH: Kuntai capsules in treatment of premature ovarian failure: A systematic review and meta-analysis. J Herb Med. 31(100524)2022.