中药补肾疏肝法治疗绝经综合征的meta分析  

Meta-analysis of treating menopausal syndrome with the method of tonifying the kidney and soothing the liver with traditional Chinese medicine

作　　者：徐赫 陈莹[2] 千运龙 XU He;CHEN Ying;QIAN Yunlong(Graduate School,Liaoning University of Traditional Chinese Medicine,Liaoning,Shenyang 110847,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学研究生学院,辽宁沈阳110847 [2]辽宁中医药大学附属医院妇产科,辽宁沈阳110032

出　　处：《中国医药科学》2021年第23期53-56,81,共5页China Medicine And Pharmacy

摘　　要：目的系统评价中药补肾疏肝法治疗绝经综合征的症状及激素指标改善的有效性。方法检索CNKI、万方、CBM、维普、The Cochrane Library、Embase、PubMed、Web of Science等数据库公开发表的文献,纳入随机对照(RCT)研究。通过Cochrane手册5.1.0推荐的RCT偏倚风险评估,对纳入的结局指标使用RevMan 5.3软件进行统计学分析。结果共纳入19个研究,共1677例患者,均为中文发表。meta分析结果显示使用中药补肾疏肝法较其他疗法的临床有效率更高[RR=4.37,95%CI(3.20,5.97),Z=9.28,P<0.00001],临床症状Kupperman评分降低效果更好[MD=-5.52,95%CI(-7.39,-3.65),P<0.00001]。试验组较常规西药组降低血清促卵泡激素(FSH)效果更佳[SMD=-1.49,95%CI(-2.42,-0.56),Z=3.13,P=0.002<0.05]。结论以补肾疏肝法治疗绝经综合征对比西药及中成药更有优势,从临床总有效率、症状改善、血清激素值方面可以得知,期待开展样本充足、方法学完善、多中心的研究,为补肾疏肝法治疗女性绝经综合征提供更新、质量更高的循证医学证据。Objective To systematically evaluate the effectiveness of the method of tonifying the kidney and soothing the liver with Chinese materia medica in treating symptoms of menopausal syndrome and ameliorating hormone indices.Methods The relevant published literature was searched through the databases such as CNKI,Wanfang,CBM,VIP,The Cochrane Library,Embase,PubMed,Web of Science,etc.and was included in the randomized controlled trial(RCT)study.The included outcome indices were statistically analyzed by RevMan 5.3 software according to the RCT bias risk assessment recommended by Cochrane Handbook 5.1.0.Results A total of 19 studies with 1,677 patients were included,all of which were published in Chinese.Meta-analysis results showed that compared with other therapies,the method of tonifying kidney and soothing liver with Chinese materia medica has higher clinical effective rate(RR=4.37,95%CI[3.20,5.97],Z=9.28,P<0.00001),and the decreasing of Kupperman score of clinical symptoms is significant(MD=-5.52,95%CI[-7.39,-3.65],P<0.00001).As far as the reduction of serum follicular-stimulating hormone(FSH)was concerned,the effect in the experimental group was better than that in the conventional Western medicine group(SMD=-1.49,95%CI[-2.42,-0.56],Z=3.13,P=0.002<0.05).Conclusion The method of tonifying the kidney and soothing the liver has more advantages than Western medicine and Chinese patent medicine in treating menopausal syndrome.Judged by clinical total effective rate,symptom relief and serum hormone value,multi-center studies with sufficient samples and perfect methodology are expected,so as to provide newer evidence-based medicine evidence with higher quality for treating female menopausal syndrome with the method of tonifying the kidney and soothing the liver.

关 键 词：绝经 补肾疏肝法 随机对照试验 META分析 系统评价 有效性 

分 类 号：R271.1[医药卫生—中医妇科学]