Efficacy of Chinese herbal medicines combined with high-intensity focused ultrasound for patients with uterine fibroids: A meta-analysis with core herbs exploration

Huang YT, Wang MC, Liao JA, Chen WC, Chou YT, Cheng WJ · Phytomedicine · 2025 July

DOI 10.1016/j.phymed.2025.156811

Objective

To investigate the effectiveness of Chinese herbal medicines (CHMs) combined with high-intensity focused ultrasound (HIFU) for uterine fibroids (UFs) through a meta-analysis on randomised controlled trials (RCTs) and to identify core herbal patterns that may enhance HIFU outcomes.

Conclusions

The study found that combining CHMs with HIFU resulted in more significant reductions in UF volumes and higher clinical effectiveness rates compared to HIFU therapy alone. Core pattern analysis identified key herbs that may enhance the efficacy of HIFU treatment for UFs.

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Insights

Combining Chinese herbal medicines with high-intensity focused ultrasound improves the clinical effectiveness in treating uterine fibroids.

Researchers conducted a meta-analysis of 19 randomized controlled trials, in English and Chinese databases until May 2024, to assess the combined effects of high-intensity focused ultrasound (HIFU) and Chinese herbal medicines (CHMs) on uterine fibroids. The quality of these studies was evaluated using the Cochrane Risk of Bias 2 tool, and the results were analyzed using RevMan 5.4 software. The primary outcomes considered were changes in fibroid volume and clinical effectiveness, while secondary outcomes included changes in uterus volume, Traditional Chinese Medicine syndrome scores, recurrence rates, and adverse reactions. The study found that the combination of CHMs and HIFU had a greater impact on reducing uterine fibroid volumes and had a higher clinical efficacy rate than HIFU therapy alone. A total of 26 single herbs and 93 commonly used herbal combinations were identified. The most frequently used herbs were: Curcumae Rhizoma, Sparganii Rhizoma, Astragalus membranaceus, Poria cocos, Paeonia suffruticosa, and Trionyx sinensis. Furthermore, the study proposed a dual-phase mechanism through which core CHMs might enhance the effectiveness of HIFU. This mechanic involves promoting apoptosis during thermal ablation and modulating fibrotic and proliferation signaling pathways in the post-ablation phase.