59 papers are included in total, 28 of which are randomized controlled trials, 5 are half randomized controlled trials, 8 are controlled trials, and 18 cases series observations. All the documents were published between 1992-2013.

Quality grade evaluation of evidence is shown in Table 4. It shows that there are 14 pieces of high (H) quality evidence, 17 of medium (M) quality, 12 of low (L) quality, 16 of very low (VL) quality. Evidence quality level degrading factors mainly are the research limitations ①, addition or subtraction of prescriptions ②, low accuracy ③ and indirect evidence ④. Evidence quality level upgrading factors mainly are using the original prescription of Shanghan Zabing Lun ⑤, or only using traditional Chinese medicinal intervention ⑥.

6 papers are included in total, 2 of which are randomized controlled trials, 1 is controlled trials, and 3 cases series observations. All the documents were published between 1998-2001. Quality grade evaluation of evidence is shown in Table 5. It shows that

there are 1 piece of high (H) quality evidence, 3 of medium (M) quality, 2 of low (L) quality, 16 of very low (VL) quality. Evidence quality level degrading factors mainly are the research limitations ① and low accuracy ③. Evidence quality level upgrading factors mainly are using the original prescription of Shanghan Zabing Lun ⑤, or only using traditional Chinese medicinal intervention ⑥.

4 papers are included in total, 2 of which are randomized controlled trials and 2 cases series observations. All the documents were published between 2003-2012. Quality

grade evaluation of evidence is shown in Table 6. It shows that there are 3 of low (L) quality, 1 of very low (VL) quality. Evidence quality level degrading factors mainly are the research limitations ① and addition or subtraction of prescriptions ②. Evidence quality level upgrading factors mainly is using traditional Chinese medicinal intervention ⑥.

3 papers are included in total, 2 of which are randomized controlled trials and 1 is controlled trials. All the documents were published between 1998-2012. Quality grade evaluation of evidence is shown in Table 7. It shows that there are 1 piece of high (H) quality evidence, 2 of medium (M) quality. Evidence quality level degrading factors mainly is the research limitations ①. Evidence quality level upgrading factors mainly are using the original prescription of Shanghan Zabing Lun ⑤, or only using traditional Chinese medicinal intervention ⑥.

3 papers are included in total, 1 of which is randomized controlled trial, 1 is controlled trial, and 1 cases series observation. All the document were published between 2001- 2012. Quality grade evaluation of evidence is shown in Table 8. It shows that there are 1 piece of medium (M) quality evidence, 2 of very low (VL) quality. Evidence quality level degrading factors mainly are the research limitations ①, addition or subtraction of prescriptions ② and does-effect relationship ⑦. Evidence quality level upgrading factors mainly is only using traditional Chinese medicinal intervention ⑥.

Another eight prescriptions, all have only 1 evidence support, respectively, Sini Powder, Sini Decoction, Danggui Sini plus Wuzhuyu Shengjiang Decoction, Shenqi Wan,

Huangqi Guizhi Wuwu Tang, Taohe Chenqi Decoction, Danggui Shaoyao Powder, Biejiajian Wan. Quality grade evaluation of evidence is shown in Table 9. It shows that there are 1 piece of high (H) quality evidence, 1 of low (L) quality, 6 of very low (VL) quality. Evidence quality level degrading factors mainly are the research limitations ①, addition or subtraction of prescriptions ②, low accuracy ③. Evidence level upgrading factors mainly are using the original prescription of Shanghan Zabing Lun ⑤, or only using traditional Chinese medicinal intervention ⑥.

Guizhi Fuling Wan capsule combined with Mifepristone contrasting mere Mifepristone in the treatment of endometriosis has advantages in clinical total effective rate (high quality evidence).

Pan Xiurong’s [6] implementation of a clinical randomized controlled trial, with the sample size of 85 cases: Experimental group 44 cases, control group 41 cases. Control group patients start taking mifepristone (Beijing zizhu pharmaceutical co., LTD., production) on the first day of menstruation, 12.5 mg each time, 1 time/d, lasting for six months. Patients in the experimental group, besides the treatment as control group provides, take Guizhi Fuling Wan capsule (Jiangsu kang pharmaceutical co., LTD.) every time 3 grains (0.93 g), 3 times/d, lasting for six months. Comparing the two groups, the clinical total effective relative risk (RR) of 1.23, 95% CI (1.02, 1.02), P = 0.03, with statistical significance. The curative effect standards: Recovery: Symptoms disappear, pelvic mass or some local symptoms basically disappear. Effective: Symptoms, pelvic mass is not increasing or slightly shrinks. Invalid: Main symptoms are not improving or even getting worse, local lesion is exacerbating. Recurrence: After surgery and drug treatment, or after lesions and symptoms shrinking or disappearing, clinical symptoms restore again to the level before treatment or aggravate.

Dahuang Zhechong Wan combined with Gestrinone contrasting mere Gestrinone in the treatment of endometriosis has advantages in clinical total effective rate (high quality evidence).

Li Mingzhou et al.’s [62] implementation of a clinical randomized controlled trial, with a sample size of 120 cases, experimental group of 60 and control group of 60: Patients take Dahuang Zhechong Wan (Z4202077, produced by Wuhan Zhonglian Pharmaceutical Company), 3 g, 2 times/d after meals, stop taking in menstruation, Gestrinone 25 mg once daily, after meals. The control group merely takes Gestrinone 25 mg once daily, after meals. Comparing the two groups, the clinical total effective relative risk (RR) of 1.11, 95% CI (1.01, 1.01), P = 0.03, with statistical significance. The curative effect standards: Recovery: Symptoms disappear, local signs disappeared basically. Prominently effective: Symptoms disappeared basically, mass shrinks more than 1/2 of its size. Effective: Symptoms or physical signs stay in previous condition after treatment (not turning better or worse).

WenJing Decoction contrasting Medroxyprogesterone Acetate in the treatment of endometriosis has advantages in clinical total effective rate (high quality evidence).

Zhang Yongluo et al.’s [72] implementation of a controlled clinical trial, with a sample size of 95 cases, experimental group of 45 and control group of 40: Experimental patients take WenJing Decoction. Composition: Wuzhuyu (Fructus Evodiae) 6 g, Danggui (Radix Angelicae Sinensis) 20 g, Chishao (Radix Paeoniae Rubra) 15 g, Dangshen (Radix Codonopsis) 12 g, Guizhi (Ramulus Cinnamomi) 10 g, Ejiao (Colla Corii Asini) 10 g, Danpi (Cortex Moutan) 10 g, Shengjiang (Rhizoma Zingiberis Recens) 6 g, Gancao (Radix Glycyrrhizae) 6 g, Qingbanxia (Rhizoma Pinelliae) 6 g, Maidong (Radix Ophiopogonis) 6 g, be decocted in water, once/d. 3 months for 1 course of treatment. Patients in control group take Medroxyprogesterone Acetate, from the menstrual cycle day 6th-day 25th, 4 mg each time, 1 time/d, keeping three cycles. Comparing the two groups, the clinical total effective relative risk (RR) of 1.35, 95% CI (1.03, 1.03), P = 0.03, with statistical significance. Curative effect standards: Recovery: Symptoms (blood stasis) disappear, pelvic mass or local signs disappear basically, infertility is pregnant in a year. Prominently effective: Symptoms (blood stasis) largely disappear, pelvic mass shrinks (ultrasound contrast in menstrual cycle period before and after the treatment), local signs still exist, but the infertility becomes pregnant within 3 years. Effective: Effectively relieve symptoms, pelvic mass remain unchanged (ultrasound contrast in menstrual cycle period before and after the treatment), conditions do not worsen after 3 months’ drug withdrawal. Invalid: Main symptoms do not change or deteriorate, pelvic mass remain unchanged after treatment.

Danggui Sini plus Wuzhuyu Shengjiang Decoction contrasting Duyiwei Capsule in the treatment of endometriosis has advantages in relieving dysmenorrhea (high quality evidence).

Zhu Mei’s [78] implementation of a clinical randomized controlled trial, with a sample size of 62, experimental group of 32 and control group of 30: Experimental group patients take Danggui Sini plus Wuzhuyu Shengjiang Decoction: Danggui (Radix Angelicae Sinensis) 15 g, Shaoyao (Radix Paeoniae Alba) 15 g, Zhigancao (Radix Glycyrrhizae) 10 g, Tongcao (Tetrapanax Papyriferus) 10 g, Guizhi (Ramulus Cinnamomi) 10 g, Xixin (Herba Asari) 6 g, Shengjiang (Rhizoma Zingiberis Recens) 10 g, Wuzhuyu (Fructus Evodiae) 6 g, Dazao (Fructus Jujubae) 5, Yellow rice wine 20 ml, decocte 1000 ml water for 300 - 400 ml, take the decoction warmly by 2 times in the morning and evening. Control group: take Duyiwei capsule (Gansu Duyiwei Biological Pharmaceutical co., LTD., 210970053, each grain of 0.3 g), 3 capsules per time and 3 times/d. Two groups of comparisons, dysmenorrhea efficacy relative risk (RR) of 1.28, 95% CI (1.01, 1.01), P = 0.04, with statistical significance. Curative effect standards: Index: (points before treatment subtracts points after treatment)/points after treatment mutiplies by 100%. Recovery: Dysmenorrhea symptoms disappear after treatment, integral value decreases 95% or more. Prominently effective: 95% > integral value > 70%. Effective: 70% > integral value > 30%. Invalid: integral decreases < 30% after treatment.

Guizhi Fuling Wan composed by Guizhi (Ramulus Cinnamomi), Fuling (Poria), Danpi (Cortex Moutan), Taoren (Semen Persicae), Baishao (Radix Paeoniae Alba), is from Jinkui Yaolue (Synopsis of Golden Chamber), in woman pregnant disease chapter, treating woman with mass or stasis in the abdomen. Symptoms are abnormal menstruation, amenorrhea and postmenopausal bleeding etc. Endometriosis is a relatively high frequency disease in Guizhi Fuling Wan treating spectrum. There are 14 pieces of high quality evidence and 17 of medium in Guizhi Fuling Wan related papers. 41 controlled clinical trials have shown that combination therapy of Guizhi Fuling Wan and western medicine in the treatment of endometriosis curative effect is superior to the simple application of mifepristone, medroxyprogesterone acetate, levonorgestrel etc. 18 cases of series observations show that Guizhi Fuling Wan and its variations is effective for treating endometriosis. Outcomes are observed mainly on clinical symptoms, B ultrasonic examination, serum CA125 improvement. It can show blood stasis tends to be the pathogenesis of endometriosis in clinical phenomena, which has high degree of aggregation.

Dahuang Zhechong Wan composed by Dahuang (Radix et Rhizoma Rhei), Huangqin (Radix Scutellariae), Gancao (Radix Glycyrrhizae), Taoren (Semen Persicae), Xingren (Semen Armeniacae Amarae), Shaoyao (Radix Paeoniae Alba), GanDihuang (Radix Rehmanniae), Ganqi (Resina Toxicodendri), Mangchong (Gadfly), Shuizhi (Hirudo), Qicao (Larva Holotrichiae) and Zhechong (Woodlouse), is from Jinkui Yaolue (Synopsis of Golden Chamber), in Blood Bi and consumptive disease chapter. Endometriosis is a relatively high frequency disease in Dahuang Zhechong Wan treating spectrum. There are 1 piece of high quality evidence, 3 of medium quality and 2 of low quality reports in Dahuang Zhechong Wan related papers. Three controlled clinical trials have shown that Dahuang Zhechong Wan combined with western medicine treating endometriosis is superior to the simple application of gestrinone or danazol etc. Three cases series observations show that Dahuang Zhechong Wan and its variations is effective for treating endometriosis. Outcomes are observed mainly on the improvement in clinical symptoms. It indicates that fatigue illness with blood stasis is the common pathogenesis of endometriosis, although limited evidence and low quality reports, it still can be reference to use coming to the certain disease syndrome.

WenJing Decoction composed by Wuzhuyu (Fructus Evodiae), Danggui (Radix Angelicae Sinensis), Xiongqiong (Rhizoma Chuanxiong), Shaoyao (Radix Paeoniae Alba), Renshen (Ginseng), Guizhi (Ramulus Cinnamomi), Ejiao (Colla Corii Asini), MudanPi (Cortex Moutan), Shengjiang (Rhizoma Zingiberis Recens), Gancao (Radix Glycyrrhizae), Banxia (Rhizoma Pinelliae) and Maidong (Radix Ophiopogonis), is from Jinkui Yaolue (Synopsis of Golden Chamber), in women miscellaneous diseases chapter. Endometriosis is a relatively low frequency disease in Wenjing Decoction treating spectrum. There are 1 piece of high quality evidence, 2 of medium quality reports in Wenjing Decoction related papers. Three controlled clinical trials have shown that combination therapy of WenJing Decoction and western medicine treating endometriosis is superior to the simple application of gestrinone, medroxyprogesterone acetate, mifepristone and etc. Outcomes are observed mainly on the improvement in clinical symptoms, the improvement of the ultrasound examination. Although the blood stasis is a common pathogenesis of the disease, coldness in body is also a main pathogenesis. Although the evidence is limited, this card type is used for reference. It still can be reference to use coming to the certain disease syndrome.

There is less documentary evidence or low quality or less frequency for other prescriptions, such as Danggui SiNi plus Wuzhuyu Shengjiang Decoction, Shenqi Wan, Huangqi Guizhi Wuwu Decoction, Taohe Chengqi Decoction, Danggui Shaoyao Powder, Biejiajian Wan and etc. The pathogenesises the above prescriptions’ syndromes stand for lack of enough evidence to support, but still have curative effect on the disease clinically, they can be used to refer to. More strong evidence from more researchers in the future is expected to improve the curative effect of the disease.