二仙汤加减治疗卵巢功能早衰疗效的系统评价  

Systematical Review of Modified Erxian Decoction in the Treatment of Premature Ovarian Failure

作　　者：朱梦蝶 崔彬 林文君 窦丹 王清[2] ZHU Mengdie;CUI Bin;LIN Wenjun;DOU Dan;WANG Qing(College of China-Japan Friendship Hospital,Beijing University of Chinese Medicine,Beijing 100029,China;Dept.of Gynecology of Traditional Chinese Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学中日友好临床医学院,北京100029 [2]中日友好医院中医妇科,北京100029

出　　处：《中国医院用药评价与分析》2022年第2期224-231,236,共9页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价二仙汤加减治疗卵巢功能早衰的临床疗效,以期为临床用药提供循证参考。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase和the Cochrane Library,收集二仙汤加减治疗卵巢功能早衰的随机对照研究(包括二仙汤加减联合西药与西药比较、二仙汤加减与西药比较),检索时限为各数据库建库至2021年4月,根据相关标准筛选文献、评价质量和提取数据,使用RevMan 5.3软件进行Meta分析。结果:二仙汤加减联合西药治疗卵巢功能早衰最终纳入8篇文献,二仙汤加减治疗卵巢功能早衰最终纳入9篇文献,共1281例患者。Meta分析结果显示,与单纯西药治疗比较,二仙汤加减治疗卵巢功能早衰可明显提高总有效率(二仙汤加减联合西药:OR=3.18,95%CI=2.08~4.86,P<0.00001;二仙汤加减:OR=3.55,95%CI=2.03~6.22,P<0.00001),明显提高E;水平(二仙汤加减联合西药:MD=7.55,95%CI=6.77~8.33,P<0.00001;二仙汤加减:MD=9.38,95%CI=5.14~13.63,P<0.0001)、CD4^(+)水平(二仙汤加减联合西药:MD=7.05,95%CI=5.60~8.49,P<0.0001;二仙汤加减:MD=4.72,95%CI=3.21~6.24,P<0.00001)和CD4^(+)/CD8^(+)水平(二仙汤加减联合西药:MD=0.49,95%CI=0.45~0.52,P<0.00001;二仙汤加减:MD=0.52,95%CI=0.41~0.62,P<0.00001),明显降低FSH水平(二仙汤加减联合西药:MD=-10.85,95%CI=-15.59~-6.11,P<0.00001;二仙汤加减:MD=-4.49,95%CI=-5.68~-3.31,P<0.00001)、LH水平(二仙汤加减联合西药:MD=-6.60,95%CI=-7.12~-6.09,P<0.00001;二仙汤加减:MD=-5.95,95%CI=-7.23~-4.67,P<0.00001)和不良反应发生率(OR=0.29,95%CI=0.11~0.76,P=0.01),上述差异均有统计学意义。在降低CD8^(+)水平方面,二仙汤加减联合西药治疗明显优于单纯西药治疗,差异有统计学意义(MD=-4.70,95%CI=-5.38~-4.01,P<0.00001)。结论:二仙汤加减或二仙汤加减联合西药治疗卵巢功能早衰的疗效优于单纯西药治疗,但仍需更多大样本、多中心、高质量和科学规范的�OBJECTIVE:To systematically evaluate the clinical efficacy of modified Erxian decoction in the treatment of premature ovarian failure,so as to provide evidence-based reference for clinical drug use.METHODS:CNKI,Wanfang Data,VIP database,CBM,PubMed,Embase and the Cochrane Library were retrieved to collect the randomized controlled trial of modified Erxian decoction in the treatment of premature ovarian failure(comparison of modified Erxian decoction combined with western medicine and western medicine,comparison of modified Erxian decoction and western medicine).The retrieval time was from the establishment of the database to Apr.2021.Literature was screened,quality was evaluated and data was extracted according to relevant criteria.Meta-analysis was performed by using RevMan 5.3 software.RESULTS:Eight literature were enrolled in the treatment of premature ovarian failure by modified Erxian decoction combined with western medicine,and 9 literature were enrolled in the treatment of premature ovarian failure by modified Erxian decoction,with a total of 1281 patients.The results of Meta-analysis showed that compared with the simple western medicine treatment,the modified Erxian decoction in the treatment of premature ovarian failure can significantly improve the total effective rate(modified Erxian decoction combined with western medicine:OR=3.18,95%CI=2.08-4.86,P<0.00001;modified Erxian decoction:OR=3.55,95%CI=2.03-6.22,P<0.00001),significantly increase the E;level(modified Erxian decoction combined with western medicine:MD=7.55,95%CI=6.77-8.33,P<0.00001;modified Erxian decoction:MD=9.38,95%CI=5.14-13.63,P<0.0001),CD4^(+)level(modified Erxian Decoction combined with western medicine:MD=7.05,95%CI=5.60-8.49,P<0.0001;modified Erxian decoction:MD=4.72,95%CI=3.21-6.24,P<0.00001)and CD4^(+)/CD8^(+)level(modified Erxian decoction combined with western medicine:MD=0.49,95%CI=0.45-0.52,P<0.00001;modified Erxian decoction:MD=0.52,95%CI=0.41-0.62,P<0.00001),significantly decrease the FSH level(modified Erxian decoction combine

关 键 词：二仙汤加减 西药 卵巢功能早衰 META分析 

分 类 号：R932[医药卫生—生药学]