补肾中药和克罗米芬治疗排卵障碍性不孕的Meta分析  

Meta Analysis of Kidney-tonifying Herbs and Clomiphene Citrate in the Treatment of Anovulatory Infertility

作　　者：车玲 李淑萍[2] CHE Ling;LI Shuping(Nanjing University of Chinese Medicine,Nanjing 210000,China;Changzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine)

机构地区：[1]南京中医药大学,江苏南京210000 [2]南京中医药大学附属常州市中医医院

出　　处：《西部中医药》2022年第2期61-66,共6页Western Journal of Traditional Chinese Medicine

基　　金：常州市高层次卫生人才培养工程基金项目(2016CZLJ031)。

摘　　要：目的:评价补肾中药和克罗米芬(枸橼酸氯米芬)治疗排卵障碍性不孕的临床疗效。方法:检索关于补肾中药和克罗米芬治疗排卵障碍性不孕的随机对照试验文献。由两名评价者独立对纳入的文献进行数据提取后,用RevMan 5.3软件进行Meta分析。结果:按照规定的文献检索方式,最终纳入27篇文献,研究中共纳入患者2466例,分析结果显示:补肾中药组和克罗米芬组比较,其临床优良率(OR=2.47,95%CI[1.88,3.26]),两者差异有统计学意义(P<0.00001)。同时,在改善妊娠率、黄体生成素(luteinizing hormone,LH)及雌激素(estrogen,E_(2))等方面差异均有统计学意义(P<0.05),在促排卵方面与口服克罗米芬比较差异无统计学意义(P>0.05)。绘制倒漏斗图,结果显示倒漏斗图对称性不佳,提示存在一定发表偏倚。结论:与单纯口服克罗米芬相比,补肾中药在改善优良率、排卵率、妊娠率、LH及E_(2)等方面有着一定的优势,但仍需高质量的临床随机对照研究进一步验证。Objective:To evaluate the clinical efficacy of kidney-tonifying herbs and clomiphene citrate in the treatment of anovulatory infertility.Methods:The papers of randomized controlled trials(RCTs)on kidneytonifying herbs and oral clomiphene in the treatment of anovulatory infertility were retrieved.Two reviewers independently extracted the data from the included literature and performed Meta-analysis by using RevMan 5.3 software.Results:According to the specified document retrieval method,consequently 27 papers were included,and all 2466 patients were involved in the study,the analysis results showed:when kidney-tonifying herbs groups were compared with clomiphene citrate group,the difference had statistical meaning between both groups(P<0.00001),and its clinical excellence rate was(OR=2.47,95%CI[1.88,3.26]).Meanwhile,the difference had statistical meaning in improving pregnancy rate,LH and E_(2)(P<0.05),the difference had no statistical meaning in promoting ovulation induction and oral clomiphene(P>0.05).After drawing the inverted funnel diagram,the results showed that the symmetry of the inverted funnel diagram is not good,suggesting that there is a certain publication bias.Conclusion:Compared with oral clomiphene,kidney-tonifying herbs show certain advantages in improving the excellent rate,ovulation rate,pregnancy rate,LH and E_(2),while high-quality clinical randomized controlled trial(RCTs)are needed to be further verified.

关 键 词：补肾中药 克罗米芬 排卵障碍性不孕 META分析 

分 类 号：R241.14[医药卫生—中医诊断学]