中药治疗子宫内膜发育不良疗效的系统评价  

Efficacy of Chinese Medicine for Endometrial Hypoplasia:A Systematic Review

作　　者：孙旸[1,2] 陈亚琼[1] 侯海燕[1] 兰晓霞[2] 梁婧[3] 

机构地区：[1]中国人民武装警察部队后勤学院附属医院妇产科,天津300162 [2]中国人民武装警察部队流行病与统计学教研室,天津300309 [3]天津中医药大学,天津300193

出　　处：《中国循证医学杂志》2015年第2期215-222,共8页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价中药治疗子宫内膜发育不良的有效性。方法计算机检索Pub Med、EMbase、MEDLINE(Ovid)、The Cochrane Library(2014年第8期)、CBM、CNKI、VIP和Wan Fang Data数据库,查找有关中药治疗子宫内膜发育不良的随机对照试验(RCT)或半随机对照试验(quasi-RCT),检索时均限为建库至2014年8月。由2位研究者按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用Rev Man5.3软件进行Meta分析。结果共纳入5个RCT和6个quasi-RCT,包括914例患者。Meta分析结果显示:与对照组相比,中药治疗子宫内膜发育不良的患者在子宫内膜厚度[MD=0.86,95%CI(0.35,1.37),P=0.000 01]、临床妊娠率[RR=2.62,95%CI(2.02,3.38),P<0.000 01]、子宫内膜形态[RR=1.23,95%CI(1.06,1.42),P=0.005]、子宫动脉血流搏动指数(PI)[MD=–0.54,95%CI(–0.80,–0.28),P<0.000 1]、子宫动脉血流阻力指数(RI)[MD=–0.12,95%CI(–0.17,–0.08),P<0.000 1]和血清雌二醇水平[MD=96.03,95%CI(44.32,144.74),P=0.003]方面具有一定的优势,其差异均有统计学意义;但在血孕酮水平方面,两组差异无统计学意义[MD=2.00,95%CI(–0.64,4.65),P=0.14]。结论当前证据显示,中药治疗子宫内膜发育不良具有一定的优势。受纳入研究数量和质量限制,上述结论尚需开展更多高质量的研究予以验证。Objective To systematically review the efficacy of Chinese medicine for endometrial hypoplasia. Methods Databases such as PubMed, EMbase, MEDLINE （Ovid）, The Cochrane Library （Issue 8, 2014）, CNKI, VIP and WanFang Data were searched for randomized controlled trials （RCTs） and quasi-RCTs concerning the efficacy of Chinese medicine for endometrial hypoplasia up to August 2014. According to the inclusion and exclusion criteria, two reviewers screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results A total of 5 RCTs and 6 quasi-RCTs involving 914 patients were included. The results of meta-analysis showed that Chinese medicine group was superior to control group in endometrial thickness （MD=0.86, 95%CI 0.35 to 1.37, P=0.000 01）, clinical pregnancy rates （RR=2.62, 95%CI 2.02 to 3.38, P〈0.000 01）, endometrial morphous （RR=1.23, 95%CI 1.06 to 1.42, P=0.005）, PI of uterine artery blood flow （MD= -0.54, 95%CI -0.80 to -0.28, P〈0.000 1）, RI of uterine artery blood flow （MD= -0.12, 95%CI -0.17 to -0.08, P〈0.000 1）, and estradiol level （MD=96.03, 95%CI 44.32 to 144.74, P=0.003）; However, the two groups were alike in progesterone level without significant difference （MD=2.00, 95%CI -0.64 to 4.65, P=0.14）. Conclusion Current evidence indicated that, Chinese medicine is beneficial for endometrial hypoplasia. Due to limited quantity and quality of the included studies, the above conclusion still needs to be verified by conducting more high quality studies.

关 键 词：子宫内膜发育不良 中药 系统评价 META分析 随机对照试验 

分 类 号：R271.9[医药卫生—中西医结合]