单独针灸疗法治疗卵巢早衰的系统评价与Meta分析  

Systematic Evaluation and Meta-analysis of Acupuncture-Moxibustion Alone in Treating Premature Ovarian Failure

作　　者：张金焕 刘永锋[2] 黄杏贤[2] 于海波[2] ZHANG Jin-Huan;LIU Yong-Feng;HUANG Xing-Xian;YU Hai-Bo(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Dept.of Acupuncture-Moxibustion,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院针灸科,广东深圳518033

出　　处：《广州中医药大学学报》2020年第6期1189-1197,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：“三名工程”中国中医科学院刘保延首席研究员中国针灸临床评价方法创新项目(编号:SZSM201612001)。

摘　　要：【目的】系统评价单独针灸疗法治疗卵巢早衰的临床疗效。【方法】计算机检索中国知网期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学数据库(CBM)及PubMed、Cochrane Library、Embase数据库,筛选针灸治疗卵巢早衰的随机对照试验(RCTs)文献。采用Cochrane偏倚风险评估工具对纳入研究进行质量评价,采用RevMan 5.3统计软件进行Meta分析。【结果】共纳入16篇符合标准的文献,涉及1102例患者。Meta分析结果显示,针灸治疗卵巢早衰的有效率显著高于西药组[OR=4.70,95%CI(3.34,6.61),P<0.00001],并且针灸治疗在降低促卵泡生成素(FSH)[MD=-3.30,95%CI(-5.88,-0.72),P=0.01]、降低促黄体生成素(LH)[MD=-5.81,95%CI(-7.42,-4.20),P<0.00001]及升高雌二醇(E2)方面[MD=24.15,95%CI(12.82,35.48),P<0.0001]均优于西药对照组。【结论】单独针灸治疗卵巢早衰在提高有效率及改善激素水平方面疗效显著,不良反应少,但鉴于纳入的研究样本量少,研究质量不高,有待更多高质量、大样本的随机对照试验进一步验证。Objective To systematically evaluate the clinical efficacy of acupuncture-moxibustion alone for the treatment of premature ovarian failure. Methods The literature about randomized control trials(RCTs) of acupuncture-moxibustion treatment for premature ovarian failure were searched out from CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library,and Embase databases. The included RCTs were given quality evaluation by Cochrane bias risk assessment tool. Meta-analysis was carried out by RevMan 5.3 software. Results A total of 16 literature according with standard were included, involving 1 102 cases of patients. The Mata-analysis results showed that the overall response rate of acupuncture-moxibustion treatment for premature ovarian failure was superior to that of the western medicine group [OR = 4.70,95% CI(3.34,6.61),P < 0.000 01]. Compared with the western medicine group,the acupuncture-moxibustion alone decreased follicle stimulating hormone(FSH)level [MD =-3.3,95% CI(-5.88,-0.72),P = 0.01],decreased luteinizing hormone(LH)level [MD =-5.81,95% CI(-7.42,-4.20),P < 0.000 01],and elevated estradiol(E2)level [MD = 24.15,95% CI(12.82,35.48),P < 0.000 1],showing that the effect was superior to that of the western medicine group. Conclusion Acupuncture-moxibustion alone treatment for premature ovarian failure is significantly effective for enhancing the response rate and improving hormone level,and has less adverse reactions. But due to the less sample size and lower quality of the included RCTs,the above results need to be verified by more large-scale and high-quality RCTs.

关 键 词：针灸 卵巢早衰 META分析 

分 类 号：R246.9[医药卫生—针灸推拿学]