补肾活血中药治疗卵巢储备功能低下的系统评价  

Systematic review on Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve

作　　者：张会仙 马堃[1] 佟雅婧 

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《中国中药杂志》2017年第23期4464-4473,共10页China Journal of Chinese Materia Medica

基　　金：2017年度中国民族医药学会科研项目(2017KYXM-Z155-15)

摘　　要：系统评价补肾活血中药治疗卵巢储备功能低下(DOR)的有效性及安全性。计算机检索CNKI,Wan Fang,VIP,CBM,Pub Med,EMbase,Cochrane Library数据库,收集补肾活血中药治疗DOR的随机/半随机对照试验,检索时限均为建库—2017年6月。根据纳入标准和排除标准筛选文献、提取资料,采用"偏倚风险评估工具"进行质量评价,运用Rev Man 5.3软件对结局指标进行Meta分析。由于纳入研究的观察组补肾活血中药不完全一致以及对照组西药类型不同,进行亚组分析或敏感性分析后均采用随机效应模型合并效应量。最终纳入11个研究,共计733例患者。Meta分析结果显示:补肾活血中药与西药相比,在降低FSH、升高AMH、增加AFC和提高中医证候疗效等方面有明显优势;在升高E2方面无明显优势;在降低FSH/LH比值和提高总有效率方面与不同西药类型相比,分析结果不一致,尚不能确定其优势。纳入研究中均未报告补肾活血中药相关不良反应。补肾活血中药治疗DOR具有一定的临床疗效,且安全性较高,但由于文献研究质量偏低,上述结论尚需规范性的多中心、大样本高质量研究加以验证。To systematically evaluate the efficacy and safety of Bushen Huoxue ricipe in treating patients suffering from diminisbed ovarian reserve. Databases such as CNKI, WanFang, VIP, CBM, PubMed, EMbase and Cochrane Library were searched on random- ized controlled trial/quasi-randomized controlled trial about Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve form the inception of the study until June 2017. The studies were screened according to inclusion and exclusion criteria. Risk of bias evaluation tools were adopted to conduct quality evaluation. Meta-analysis on outcome indicator was performed by RevMan Version 5.3 Software. Due to the different Bushen Huoxue recipe （observation group） and the different Western medicine（ control group） of all included studies, the effect size was combined by the random effect model after the subgroup analysis or sensitivity analysis was per- formed. Eventually 11 trials were included, including 733 cases of patients. Results of Meta-analysis indicated that, Bushen Huoxue recipe had advantages over Western medicine on lowering FSH, increasing AMH and AFC, enhancing the Chinese medicine symptom curative effect; Bushen Huoxue recipe had no advantages over Western medicine on increasing t~ ; the advantages of Bushen Huoxue recipe were not clear on reducing FSH/LH and increasing total effective rate because of the different outcomes to compared with the dif- ferent Western medicine; no serious adverse reaction appering from Bushen Huoxue recipe was reported in the including researches. Bushen Huoxue recipe has the clinical curative effect and high safety suffering from diminished ovarian reserve. However, limited by the poor quantity of studies, these conclusions remain to be examined by more center, more sample and high-quality studies.

关 键 词：卵巢储备功能低下 补肾活血中药 随机/半随机对照试验 系统评价 META分析 

分 类 号：R271.9[医药卫生—中西医结合]