二甲双胍对氯米芬抵抗的多囊卵巢综合征患者促排卵治疗有效性的系统性评价  

The effectiveness of metformin on ovulation induction in clomiphene citrate–resistant women with polycystic ovary syndrome:a systematic review and metaanalysis

作　　者：肖劲松[1] 常双[2] 陈双陨[3] 张春莲[3] 

机构地区：[1]湖北省十堰市湖北医药学院附属太和医院生殖中心,442000 [2]湖北省十堰市湖北医药学院附属太和医院肿瘤科,442000 [3]湖北省十堰市湖北医药学院附属太和医院妇产科,442000

出　　处：《中国优生与遗传杂志》2012年第3期110-114,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的系统性评价二甲双胍对氯米芬抵抗的多囊卵巢综合症(PCOS)患者促排卵治疗有效性。方法计算机检索CBMDISC(中国生物医学文献数据库1979～2011)、万方(1994～2011)、CNKI(中国学术期刊网专题全文数据库1994～2011)、维普(中国生物医学期刊数据库1989～2011);PUBMED(1997～2011)、ProQust Medical Libraray(PML)(1997-2011)、《外文生物医学期刊文献数据库》(FMJS)(2000-2011),读秀学术搜索(www.duxiu.com),并手检相关杂志9种。纳入二甲双胍与氯米芬用于多囊卵巢综合症促排卵治疗的随机对照试验,质量评价后进行Meta分析。结果共纳入5篇RCT,合计172例。Meta分析结果显示,与安慰剂组比较,二甲双胍组排卵率高于安慰剂组[OR 3.74(0.49～14.88)],两组差异无统计学意义;有主导卵泡的患者数和妊娠率二甲双胍组高于安慰剂组[Peto OR 9.51(5.12～17.66)]和[Peto OR 6.27(2.15～18.30)],两组差异有统计学意义。结论对于氯米芬抵抗的PCOS患者,二甲双胍有促进卵泡发育,促进排卵、提高妊娠率的积极作用,使用二甲双胍进行预治疗是必要的和有效的。上述结论仍需设计严谨,多中心,大样本的随机对照试验的证实和更新。Objective： To evaluate of the effectiveness of metformin on ovulation induction in clomiphene citrate–resistant women with polycystic ovary syndrome（PCOS）.Methods： CBMdisc（1979-2011）,Wanfang（1994-2011）,CNKI（1994-2011）,VIP（1989-2011）,PUBMED（1997-2011）,PML（1997-2011）、FMJS（2000-2011）,duxiu scholar seacher（www.duxiu.com） and 9 related journals were searched for randomized controlled trails（RCTs） on the comparison between metformin and clomiphene citrate used for PCOS patients.The quality of included trials was critically appraised.RevMan4.2.7 software was used for statistical analysis.Results： Five pubished studies with 172 participants were included.The results of Meta-analyses showed that,compared with placebo group,ovulation rate in metformin group was higher with no significant difference;patients with leading follicles and pregnancy rate were higher with a significant difference [Peto OR 9.51（5.12~17.66）]and [Peto OR 6.27（2.15~18.30）].Conclusions：As to clomiphene citrate–resistant women with polycystic ovary syndrome,metformin can play an active role in promoting follicular growth,increasing ovulation and improving pregnancy rate.Moreover,it is essential and effective to use metformin for pre-treatment in ovulation induction.The above conclusions still need to confirme and update by means of well-structured,multi-center,large sample randomized controlled trials.

关 键 词：二甲双胍 氯米芬抵抗 多囊卵巢综合征 促排卵 Meta分析 系统性评价 

分 类 号：R711.75[医药卫生—妇产科学]