补肾化痰中药与炔雌醇环丙孕酮片治疗多囊卵巢综合征疗效的Meta分析  

Bushen Huatan Chinese Medicine Versus Ethinylestradiol and Cyproterone Acetate Tablets in Treatment of Polycystic Ovary Syndrome:A Meta-analysis

作　　者：胡华卿 姚婷 林涛 HU Huaqing;YAO Ting;LIN Tao(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Traditional Chinese Medicine,Shenzhen Luohu District Maternity&Child Healthcare Hospital,Shenzhen 518019,China;Department of Obstetrics and Gynecology,Tianjin Hospital of Integrated Chinese and Western Medicine Nankai Hospital,Tianjin 300100,China)

机构地区：[1]广州中医药大学,广州510405 [2]深圳市罗湖区妇幼保健院中医科,广东深圳518019 [3]天津市中西医结合医院·南开医院妇产科,天津300100

出　　处：《医学综述》2021年第24期4975-4982,共8页Medical Recapitulate

摘　　要：目的系统评价补肾化痰中药与炔雌醇环丙孕酮片(达英-35)治疗多囊卵巢综合征(PCOS)的有效性和安全性。方法计算机检索万方、知网、维普、PubMed、The Cochrane Library数据库中关于补肾化痰中药与达英-35治疗PCOS的随机对照试验(RCT)研究,检索时限为建库至2020年12月31日。根据纳入和排除标准由两名研究人员独立进行文献筛选、资料提取、质量评价,采用RevMan 5.4软件进行Meta分析。结果最终纳入10项RCT研究,共719例患者,其中完成研究711例,观察组354例、对照组357例。Meta分析结果显示:观察组在提高有效率、降低睾酮和黄体生成素/卵泡刺激素方面均优于对照组(RR=1.29,95%CI 1.19~1.40,P<0.00001;SMD=-0.55,95%CI-0.91~-0.19,P=0.003;MD=-0.19,95%CI-0.33~-0.06,P=0.006);观察组与对照组在降低黄体生成素方面比较差异无统计学意义(SMD=-0.49,95%CI-1.02~0.03,P=0.06),通过亚组分析、敏感性分析找出并剔除可能的异质性来源文献后统计结果改变(SMD=-0.69,95%CI-1.04~-0.34,P=0.0001)。结论与达英-35治疗相比,补肾化痰中药或中西药联合治疗PCOS的临床效果显著,可以有效降低雄激素、黄体生成素/卵泡刺激素水平。Objective To systematically evaluate the effectiveness and safety of Bushen Huatan(tonifying kidney and resolving phlegm)Chinese medicine versus ethinylestradiol and cyproterone acetate tablets(Diane-35)in the treatment of polycystic ovary syndrome(PCOS).Methods Researches about randomized controlled trial(RCT)study on the treatment of Bushen Huatan Chinese medicine versus Diane-35 in the treatment of PCOS was conducted based on the articles from databases of Wanfang Data,CNKI,VIP,PubMed and The Cochrane Library with the retrieval time limit from the establishment of the database to Dec.31st,2020.By adopting the inclusion and exclusion criteria,two researchers had undertaken article screening,data extraction and quality assessment independently,and Meta-analysis was done through the RevMan 5.4 software.Results Altogether 10 RCT studies were included,with a total of 719 patients,including 711 who completed the study,354 patients in the observation group and 357 in the control group.Meta-analysis showed that the observation group was superior to the control group in improving response rate and reducing testosterone and luteinizing hormone/follicle-stimulating hormone(RR=1.29,95%CI 1.19-1.40,P<0.00001;SMD=-0.55,95%CI-0.91--0.19,P=0.003;MD=-0.19,95%CI-0.33--0.06,P=0.006);while there was no statistically significant difference in reducing luteinizing hormone(SMD=-0.49,95%CI-1.02-0.03,P=0.06).However the statistical results significantly changed(SMD=-0.69,95%CI-1.04--0.34,P=0.0001),after exclusion of possible heterogeneous sources of articles via the subgroup analysis and sensitivity analysis.Conclusion Compared with Diane-35,Bushen Huatan Chinese medicine or a combination of the herbal medicine and Diane-35 has a significant clinical effect in the treatment of PCOS,which can effectively reduce androgen and luteinizing hormone/follicle-stimulating hormone.

关 键 词：多囊卵巢综合征 补肾化痰 炔雌醇环丙孕酮片 META分析 

分 类 号：R271.1[医药卫生—中医妇科学]