中药干预治疗反复IVF-ET失败患者子宫内膜容受性低的系统评价  

Systematic Review of Low Endometrial Receptivity in Patients with Repeated IVF-ET Failure after Traditional Chinese Medicine Intervention

作　　者：申萌萌 朱庆文 刘雁峰[3] 马小娜 徐秀丽 SHEN Mengmeng;ZHU Qingwen;LIU Yanfeng;MA Xiaona;XU Xiuli(The Third Hospital Affi liated Beijing University of Chinese Medicine,Beijing 100029,China;Chinese Medicine School,Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital Affi liated Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学中医学院,北京100029 [3]北京中医药大学东直门医院,北京100700

出　　处：《吉林中医药》2020年第5期614-619,共6页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金(81473721);2019年北京中医药大学校级课题(2019-JYB-XJSJJ-041)。

摘　　要：目的系统评价中药干预治疗反复IVF-ET失败患者子宫内膜容受性低的疗效和安全性。方法系统、全面检索数据库至2018年1月,纳入中药或中药联合西药与单纯西药或空白比较的临床随机或半随机对照试验。2名研究员独立筛查,对纳入研究进行方法学评价和资料提取,采用Revman 5.3进行Meta分析。结果纳入6篇文献,病例483例。中药干预组临床妊娠率(RR=1.84,95%CI=1.43~2.36,P<0.00001)、胚胎种植率(RR=1.86,95%CI=1.36~2.54,P<0.0001)、子宫内膜厚度(WMD=0.68,95%CI=0.06~1.30,P=0.03)均显著高于非中药干预组;子宫内膜RI(WMD=-0.19,95%CI=-0.30^-0.19,P=0.001)明显低于非中药干预组;内膜分型和PI无显著差异。纳入研究均未报告不良反应,无法进行安全性评价。结论根据当前证据,中药作为重要的辅助治疗手段能够改善反复IVF-ET失败患者再次IVF-ET的临床妊娠结局和子宫内膜容受性。由于纳入文献质量和数量限制,本评价结果需进一步在高质量证据中验证。Objective Systematic evaluation of the effectiveness and safety of traditional Chinese medicine intervention in the treatment of poor endometrial receptivity.Methods Searching for a randomized controlled trial of repeated IVF-ET failures because of endometrial receptivity with Chinese herbal medicine treatment to January 2018.Two investigators screened independently and will be included in the study literature for evaluation,using the Revman 5.3 provided by Cochrane to statistical analysis and descriptive analysis of data extracted from the literature.In the systematic evaluation of the effectiveness of traditional Chinese medicine for repeated IVF-ET failure of endometrial receptivity.6 articles were included in the study fi nally,with 483 cases.The statistical results showed that the clinical pregnancy rate of Chinese medicine intervention group(RR=1.84,95%CI=1.43-2.36,P<0.00001),embryo implantation rate(RR=1.86,95%CI=1.36-2.54,P<0.0001),endometrial thickness(WMD=0.68,95%CI=0.06-1.30, P =0.03) were higher than non-TCM intervention groups signifi cantly;endometrial RI (WMD=-0.19, 95%CI =-0.30- -0.19, P =0.001) was lower than non-TCM intervention group. There was no signifi cant diff erence in the rate ofendometrial types, endometrial PI at the day of embryo transfer. None of the included studies described adverse drugreactions. Conclusion In the systematic review, the results showed that traditional Chinese medicine as an importantadjuvant therapy can improve the clinical pregnancy outcomes and endometrial receptivity of IVF-ET patients withrepeated IVF-ET failure. However, due to the low quality of the included literature and lack of strong evidence, theresults of this study need to be further verifi ed in high-quality evidence.

关 键 词：子宫内膜容受性 反复IVF-ET失败 系统评价 META分析 

分 类 号：R271.9[医药卫生—中西医结合]