中医药治疗复发性自然流产的Meta分析  

A meta-analysis of Chinese medicines on treatment of recurrent spontaneous abortion

作　　者：梁程程[1] 雷磊[1] 

机构地区：[1]湖南中医药大学,湖南410007

出　　处：《北京中医药大学学报》2016年第5期429-436,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.81273797;No.81473714)

摘　　要：目的运用循证医学的方法对中医药治疗复发性自然流产(RSA)的临床疗效进行系统评价。方法计算机检索国内主要数据库,并手工检索相关会议论文集及药厂资料等,按纳入与排除标准选择试验、提取资料并质量评价,采用描述性分析进行系统评价,采用Cochrane协作网提供的RevMan 5.3软件对数据进行Meta分析。结果共纳入15篇文献、1 051例,Mate分析结果显示:与对照组相比,中药治疗RSA的临床有效率[OR=3.92,95%CI(2.11,7.28)],改善症状积分[WMD=1.83,95%CI(1.77,1.89)],保胎成功率[OR=5.55,95%CI(2.29,13.41)],人绒毛膜促性腺激素(HCG)水平[WMD=10 791.66,95%CI(8 644.24,12 939.08)],抗磷脂抗体(ACA)转阴率[OR=4.13,95%CI(2.05,8.33)],抗子宫内膜抗体(Em Ab)转阴率[OR=3.13,95%CI(1.53,6.39)],抗CD3-BE[WMD=-2.48,95%CI(-4.73,-0.23)],抗CD8-BE[WMD=0.98,95%CI(0.16,1.79)],其差异均有统计学意义(P=0.00)。但在抗CD4-BE[WMD=1.04,95%CI(-0.13,2.22)],2组差异无统计学意义(P=0.08)。结论当前证据显示,中药治疗RSA具有一定的优势。但由于纳入研究存在选择性偏倚和测量偏倚的可能性,势必影响结果的论证强度,本研究尚需更多高质量的随机双盲对照试验加以验证。Objective To systematic review on Chinese medicines for recurrent spontaneous abortion（ RSA） by meta-analysis. Methods The literature was collected by computer retrieval on domestic database,manual retrieval on conference proceedings and information of pharmaceutical factories. According to the inclusive and exclusive criteria,tests were selected,data were extracted and evaluated and the systematic review was carried out by description analysis,the meta-analysis was conducted using Rev Man 5.3 software from Cochrane Collaboration. Results 15 studies with 1 051 cases were included. The following indicators in Chinese medicine group（ experiment group） were superior to those of control group（ P= 0. 00） —clinical efficiency[OR = 3. 92,95% CI（ 2. 11,7. 28） ],improvement of symptom score[WMD= 1. 83,95% CI（ 1. 77,1. 89） ],successful tocolysis rate[OR = 5. 55,95% CI（ 2. 29,13. 41） ],HCG levels[WMD = 10 791. 66,95% CI（ 8 644. 24,12 939. 08） ],negative rate of ACA[OR = 4. 13,95% CI（ 2. 05,8. 33） ],negative rate of Em Ab[OR = 3. 13,95% CI（ 1. 53,6. 39） ],CD3 antibody[WMD =-2. 48,95% CI（- 4. 73,- 0. 23） ],CD8 antibody[WMD = 0. 98,95% CI（ 0. 16,1. 79） ]. However,there was no significant difference in CD4 antibody[WMD = 1. 04,95% CI（- 0. 13,2. 22） ]（ P = 0. 08）.Conclusion Current evidence proves that Chinese medicine has advantages in treating RSA. Due to the bias from selection and detection,the argumentation intensity was loosen inevitably. So much more high quality randomized double-blind controlled trials are needed to provide more high quality evidence.

关 键 词：中医药 复发性自然流产 META分析 随机对照试验 

分 类 号：R271.421[医药卫生—中医妇科学]