中西医结合治疗妊娠合并缺铁性贫血的Meta分析  

Meta-Analysis of Integrated Chinese and Western Medicine in Treatment of Pregnancy with Iron Deficiency Anemia

作　　者：齐利丽 何苗 朱丽红[1,2] 袁宁霞[2] 杨小颀[2] 张小菜 裴巧丽[2] QI Lili;HE Miao;ZHU Lihong;YUAN Ningxia;YANG Xiaoqi;ZHANG Xiaocai;PEI Qiaoli(Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,China;The Second Affiliated Hospital,Shaanxi University of Traditional Chinese Medicine,Xianyang,712000,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学第二附属医院,陕西咸阳712000

出　　处：《山东中医杂志》2020年第7期669-677,683,共10页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81774133);陕西中医药大学“生殖与代谢营养”创新团队(编号:2019-QN08);陕西中医药大学第二附属医院“代谢营养、阴道微生态与妊娠结局”研究创新团队(编号:2020XKTD-A05)。

摘　　要：目的:系统评价中西医结合治疗妊娠合并缺铁性贫血的临床疗效。方法:计算机检索2000年1月至2019年3月发表在CNKI、万方、维普、Pubmed、Medicine数据库中的中西医结合治疗妊娠合并缺铁性贫血临床研究的随机对照试验,并追索纳入文献的参考文献,由两位评价者独立进行文献筛查和资料提取,最后采用Rev Man 5.3软件对符合条件的文献进行Meta分析。结果:入选文献15篇,总样本量1764例。Meta分析结果显示:15篇中发现中西医结合治疗能显著提高妊娠合并缺铁性贫血治疗的总有效率OR=4.92,95%CI[3.54,6.84],P<0.000 01];治疗后红细胞计数WMD=1.59,95%CI [1.06,2.11],P <0.000 01,血红蛋白值SMD=1.46,95%CI[1.12,1.79],P<0.000 01,血清铁值SMD=2.29,95%CI[1.43,3.16],P<0.000 01,血清铁蛋白值SMD=1.57,95%CI[0.50,2.65],P=0.004,表明治疗组在改善妊娠合并缺铁性贫血指标方面优于对照组;同时也能降低不良反应OR=0.26,95%CI[0.10,0.66],P=0.005,并减少不良妊娠结局的发生OR=0.46,95%CI[0.46,0.76],P=0.003,治疗组与对照组对比均有统计学意义。结论:中西医结合治疗妊娠合并缺铁性贫血在提高总有效率、改善患者妊娠期合并缺铁性贫血的指标以及减少不良反应、不良妊娠结局方面优于单纯西医治疗。Objective:To systematically evaluate the clinical efficacy of integrated Chinese and western medicine in the treatment of pregnancy with iron deficiency anemia.Methods:Randomized controlled trials(RCTs)of pregnancy with iron deficiency anemia treated with combining traditional Chinese and western medicine from January 2000 to March 2019 were searched in CNKI,Wanfang Data,VIP,Pubmed and medicine.Two evaluators independently screened the literature and performed data extraction.Rev Man 5.3 was applied for meta-analysis.Results:Fifteen researches were included,with 1764 cases totally.Meta-analysis results showed the integrated Chinese and western medicine treatment could significantly increase the total effective rate in pregnancy with iron deficiency anemia[OR=4.92,95%CI(3.54,6.84),P<0.00001],red blood cell count,[WMD=1.59,95%CI(1.06,2.11),P<0.00001],hemoglobin concentration[SMD=1.46,95%CI(1.12,1.79),P<0.00001,serum iron concentration[SMD=2.29,95%CI(1.43,3.16),P<0.00001],and serum ferritin concentration[SMD=1.57,95%CI(0.50,2.65),P=0.004].Besides,this treatment could reduce the adverse reaction[OR=0.26,95%CI(0.10,0.66),P<0.005],and adverse pregnancy outcomes[OR=0.46,95%CI(0.46,0.76),P=0.003].There was statistical difference between the experimental group and control group.Conclusions:The integrated Chinese and western medicine is better than the western medicine alone for pregnancy with iron deficiency anemia,for it could improve the total effective rate and the indicators of pregnancy with iron deficiency anemia,and reduce adverse reactions and adverse pregnancy outcomes.

关 键 词：妊娠合并缺铁性贫血 中西医结合 META分析 系统评价 补气生血 

分 类 号：R271[医药卫生—中医妇科学]