乳癖消联合三苯氧胺治疗乳腺增生疗效的Meta分析  

Meta-analysis of Rupixiao Combined with Tamoxifen in the Treatment of Hyperplasia of Mammary Glands

作　　者：陈蕴博[1] 马民[1] 蒋雪峰 袁艿君 鲁淳欣 郝小倩 CHEN Yunbo;MA Min;JIANG Xuefeng;YUAN Naijun;LU Chunxin;HAO Xiaoqian(Jinan University, Guangzhou 510632, Guangdong, China)

机构地区：[1]暨南大学

出　　处：《辽宁中医药大学学报》2018年第6期74-78,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81673979);广东省中医药局项目(20141070);暨南大学科研培育与创新基金项目(21615464)

摘　　要：目的：系统评价乳癖消治疗乳腺增生症的有效性,为临床提供循证参考。方法：计算机检索中国期刊全文数据库、中国学位论文全文数据库、万方数据库、中文科技期刊数据库、Cochrane图书馆、Medline和Pub Med,收集乳癖消联合三苯氧胺（试验组）对比单纯三苯氧胺（对照组）治疗乳腺增生症的随机对照试验（RCT）,提取资料并按照修改后的Jadad评分量表和Cochrane偏倚风险评估量表评价纳入研究质量,采用Rev Man 5.3统计软件进行Meta分析。结果：共纳入23项RCT,合计2926例患者。Meta分析结果显示,试验组患者临床疗效[OR=3.60,95%CI（2.86,4.53）,P〈0.00001]、孕酮P[MD=1.54,95%CI（0.71,2.37）,P=0.0003]显著高于对照组,胃肠道反应[OR=0.66,95%CI（0.47,0.92）,P=0.01]、月经异常发生情况[OR=0.27,95%CI（0.18,0.40）,P〈0.00001]、促黄体激素LH[MD=-0.98,95%CI（-1.84,-0.12）,P=0.02]、肿块大小[MD=-0.68,95%CI（-0.86,-0.49）,P〈0.00001]、疼痛分级[OR=0.10,95%CI（0.04,0.22）,P〈0.00001]显著低于对照组,差异均有统计学意义。血清雌激素E2[MD=-3.95,95%CI（-8.68,0.78）,P=0.10]比较,差异无统计学意义。结论：乳癖消联合三苯氧胺治疗乳腺增生症疗效较好,可以显著改善患者的治疗效果,调节患者内分泌系统,减轻患者的疼痛感以及控制不良反应发生率。Objective：To systematically review the efficacy and safety of Rupixiao combined with tamoxifen in the treatment of hyperplasia of mammary glands,and provide evidence-based reference for clinic. Methods：Retrieved from VIP,Wan Fang Database,CJFD,Medline,Pub Med,Elsevier,Springer,Web of Science and Ovid,randomized control trials（RCT）about Rupixiao combined with tamoxifen（test group）versus simple use of tamoxifen（control group）in the treatment of hyperplasia of mammary glands were collected. Meta-analysis was performed by using Rev Man 5.3 software provided by Cochrane after data extraction and quality evaluation modified by Jadad scale. Results：Totally 23 RCTs were enrolled,involving 2926 patients. Results of Meta-analysis showed,the total effective rate[OR=3.60,95%CI（2.86,4.53）,P〈0.00001],progesterone [MD=1.54,95%CI（0.71,2.37）,P=0.0003] in test group were significantly higher than control group,gastrointestinal reaction [OR=0.66,95%CI（0.47,0.92）,P=0.01],abnormal menstruation [OR=0.27,95%CI（0.18,0.40）,P〈0.00001],luteinizing hormone[MD=-0.98,95%CI（-1.84,-0.12）,P=0.02],pain grading [OR=0.10,95%CI（0.04,0.22）,P〈0.00001],tumor size [MD=-0.68,95%CI（-0.86,-0.49）,P〈0.00001] were significantly lower than control group,with statistical significance. There were no significant difference in serum estrogen[MD=-3.95,95% CI（-8.68,0.78）,P=0.10]. Conclusion：Rupixiao combined with tamoxifen can improve patients＇ treatment effect,regulate endocrine system,alleviate the pain of the patients and control the incidence of adverse reactions.

关 键 词：乳癖消 乳腺增生症 临床疗效 系统评价 META分析 

分 类 号：R655.8[医药卫生—外科学]