生精类中成药治疗男性少、弱精子症的Network Meta分析和系统评价  

Efficacy of the Chinese patent medicine for treatment of oligospermia and asthenospermia:a systematic review and Network Meta-analysis

作　　者：安琪[1,2] 邹练[1] 

机构地区：[1]中国人民解放军第二炮兵总医院泌尿外科,北京100088 [2]苏州大学中国人民解放军第二炮兵总医院研究生培养基地,北京100088

出　　处：《生殖与避孕》2016年第1期42-48,74,共8页Reproduction and Contraception

摘　　要：目的:利用Network Meta分析观察生精类中成药治疗男性少、弱精子症的疗效。方法:检索Cochrane图书馆、Pubmed数据库、中国生物医学文献数据库、CNKI数据库、VIP数据库、万方数据库等,纳入生精类中成药治疗少、弱精子症的随机对照试验(RCT)研究,并进行方法学质量评价。采用ADDIS软件v1.16.5进行统计学分析,对纳入的RCT的研究结果进行合并,并进行偏倚评估和稳定性分析。结果:共纳入20篇RCT文献,累计病例2 947例,包括8种干预措施(生精胶囊、麒麟丸、养精胶囊、黄精赞育胶囊、复方玄驹胶囊、生精片、四子种王胶囊和五子衍宗丸)。Network Meta分析显示8种生精类中成药在两两比较改善和提高精子参数总有效率、a级精子率、a+b级精子率和精子浓度方面,除四子种王胶囊对五子衍宗丸在a级精子和精子浓度之间有统计学差异之外,其余各药之间对比差异则无统计学意义(P>0.05)。结论:基于贝叶斯理论的Network Meta分析对8种干预措施进行疗效排序显示,虽然8种生精类中成药在治疗男性少、弱精子症方面对改善和提高精子参数各自具有独特的优势,但需要在辨病、辨证的基础上灵活组合搭配使用,并通过大数据、高质量、多中心的随机对照双盲临床试验进一步加以验证。Objective： To explore the efficacy of the Chinese patent medicine on oligospermia and asthenospermia through Network Meta-analysis. Methods： The studies involving randomized controlled trials （RCT） were collected from the database, such as the Cochrane Library, Pubmed, CBM Disc, CNKI, VIP and Wanfang from the founded year to November 2014. After the necessary methodological quality evaluation of the selected studies and assessment of publication bias analysis, the statics analysis was conducted by the softnvare ADDIS v 1.16.5. Results： Twenty eligible reports were identified in this study, including 2 947 cases. The Network Meta-analysis showed that there were significant differences in improving the grade a sperm rate and the sperm concentration between SiZiZhongWang capsule and WuZiZong pill. There was no significant difference for other 6 kinds of intervention methods to improve the total effective rate, the grade a sperm rate, the grade a＋b sperm rate and the sperm concentration in the treatment of male infertility. Conclusion： Network Meta-analysis based on Bayesian theory could rank 8 kinds of intervention methods and showed that the 8 kinds of the Chinese patent medicine have their unique advantages in treatment of male infertility. Although the Chinese patent medicine did show a definitely effect on the treatment of male infertility, we still need flexibly combine and collocate them on the basis of differentiation of disease and syndrome, and urge more further large-scale, high quality, multi-centre, randomized, double-blind, parallel-controlled trials to prove it.

关 键 词：男性不育症 少 弱精子症 循证医学 NETWORK META分析 

分 类 号：R277.5[医药卫生—中医学]