针药结合治疗少弱精症有效性的Meta分析  

Clinical effect of acupuncture combined with traditional Chinese medicine in treatment of oligozoospermia/asthenozoospermia: a meta-analysis

作　　者：杨滨 孟庆宇[1] 陈昊[1] 高友玲 沈洁[1] 穆艳云[1] 夏有兵[1,3] YANG Bin;MENG Qing-yu;CHEN Hao;GAO You-ling;SHEN Jie;MU Yan-yun;XIA You-bing(Second School of Clinical Medicine,Nanjing University of Chinese Medicine,Nanjing 210000,China;Department of Acupuncture and Moxibustion,Yangzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Yangzhou 225000,Jiangsu Province;The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province)

机构地区：[1]南京中医药大学第二临床医学院,南京210000 [2]南京中医药大学附属扬州市中医院针灸科,江苏扬州225000 [3]徐州医科大学附属医院,江苏徐州221000

出　　处：《针刺研究》2020年第3期243-250,共8页Acupuncture Research

基　　金：国家自然科学基金项目(No.81873371);江苏省中医药局科技项目(No.YB2015005、YB2017005)。

摘　　要：目的:系统评估针药联合治疗少弱精症的有效性。方法:计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普中文科技期刊全文数据库、PubMed、Embase、The Cochrane Library中针灸联合中药治疗男性少弱精症的临床随机对照试验文献,检索时间从建库至2019年2月15日。由两名研究者独立进行纳入研究的质量评价和资料提取,采用RevMan5.3软件对纳入的文献进行Meta分析。结果:共纳入13篇文献(12项研究),1 183例患者。Meta分析显示,针药联合治疗少弱精症妊娠率高于单纯中药治疗[RR=1.46,95%CI(1.13,1.90),P=0.004]。针药联合治疗少弱精症有效率高于单纯中药治疗[RR=1.17,95%CI(1.10,1.24),P<0.000 01]。针药联合治疗少弱精症患者精子活率改善情况优于单纯中药治疗[MD=8.28,95%CI(6.48,10.08),P<0.000 01]。针药联合治疗少弱精症患者精子活力改善情况优于单纯中药治疗[MD=17.01,95%CI(11.06,22.96),P<0.000 01]。针药联合治疗少弱精症患者精液浓度改善情况优于单纯中药治疗[MD=8.71,95%CI(5.92,11.50),P<0.000 01]。针药联合治疗少弱精症患者a级精子数目改善情况优于单纯中药治疗[MD=6.39,95%CI(5.27,7.50),P<0.000 01]。结论:针药联合治疗少弱精症对比单纯中药治疗具有更好的临床疗效。但由于纳入研究方法学质量较低,针灸联合中药治疗少弱精症的疗效证据较低,在临床使用时还应具体结合临床实际加以应用。Objective To evaluate the clinical effect of acupuncture combined with Chinese medicine in the treatment of oligozoospermia/asthenozoospermia. Methods Randomized controlled trials(RCTs) of acupuncture combined with traditional Chinese medicine(TCM) in the treatment of oligozoospermia/asthenozoospermia published up to February 15, 2019 were searched from databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Embase, and The Cochrane Library. Two reviewers independently performed quality assessment and data extraction of the studies, and RevMan5.3 was used to perform the meta-analysis. Results A total of 13 articles with 12 RCTs were included, with a total of 1 183 patients. The meta-analysis showed that acupuncture combined with TCM achieved a significantly higher pregnancy rate than TCM alone in the treatment of oligozoospermia/asthenozoospermia(risk ratio [RR] =1.46, 95% confidence interval [CI]: 1.13-1.90,P=0.004). The patients treated with acupuncture combined with TCM had a significantly higher effective rate than those treated with TCM alone(RR=1.17, 95% CI:1.10-1.24, P<0.000 01). Compared with TCM alone, acupuncture combined with TCM achieved significantly better improvements in sperm survival rate(mean difference [MD]=8.28, 95% CI: 6.48-10.08, P<0.000 01), sperm motility(MD=17.01, 95%CI:11.06-22.96, P<0.000 01), sperm concentration(MD=8.71, 95%CI:5.92-11.50, P<0.000 01), and number of grade A sperms(MD=6.39, 95%CI:5.27-7.50, P<0.000 01). Conclusion Acupuncture combined with TCM has a better clinical effect than TCM alone in the treatment of oligozoospermia/asthenozoospermia. Due to the low methodological quality of the studies included in this analysis, acupuncture combined with TCM in the treatment of oligozoospermia/asthenozoospermia should be used based on patients’ conditions in clinical practice.

关 键 词：针药联合 少精症 弱精症 META分析 

分 类 号：R245-0[医药卫生—针灸推拿学]