中医药治疗多囊卵巢综合征并胰岛素抵抗的特征评价及疗效分析  

Characteristic Evaluation and Curative Effect Analysis of Traditional Chinese Medicine in the Treatment of Polycystic Ovary Syndrome Complicated with Insulin Resistance

作　　者：陈佩佩 毛萍 蔡三金[1] 付先芸[1] 王薇[2] CHEN Peipei;MAO Ping;CAI Sanjin;FU Xianyun;WANG Wei(China Three Gorges University,Hubei Yichang 443002,China;Clinical Hospital of Traditional Chinese Medicine of China Three Gorges University,Hubei Yichang 443002,China)

机构地区：[1]三峡大学,湖北宜昌443002 [2]三峡大学中医临床医院,湖北宜昌443000

出　　处：《中医药临床杂志》2022年第6期1086-1092,共7页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81973897);中国妇幼保健协会华润三九专项研究基金项目(ZXY2020B13)。

摘　　要：目的:运用数据挖掘及网状Meta分析的方法探索中医药治疗多囊卵巢综合征并胰岛素抵抗(PCOS-IR)的处方特征并评价疗效。方法:计算机全面检索自建库至2020年11月的CNKI、WanFang、VIP、PubMed、Web of Science等数据库,按照纳入标准筛选采用中药协定方治疗PCOS-IR的临床随机对照实验,评估偏倚风险,提取广泛使用的协定处方作为临床验方。运用Microsoft Excel对验方的药物种类进行频数统计、采用SPSS Modeler 18.0软件Apriori 模版分析关联规则,获取其组方特征。采用网状Meta分析方法比较临床验方、二甲双胍、以及两者联用对改善IR、降低BMI、提高妊娠率及调控LH/FSH水平的差异。结果:最终纳入18项符合标准的研究,18个临床验方中共含62味中药,其中使用频率较高的依次为苍(白)术、茯苓、菟丝子等。规则分析共得到药对关联规则9条,3味中药药组关联规则3条,苍(白)术分别与黄芪、丹参及川芎、黄连形成了最高频的药物组合。网状Meta 分析结果显示,在降低BMI、调控LH/FSH、提高妊娠率及药物安全性方面,中药有较大优势。中药联合二甲双胍的治疗疗效优于单一治疗方案。结论:本研究挖掘了以苍(白)术、茯苓、菟丝子为主方、配伍黄芪、丹参、川芎、黄连的药物组合。中药治疗在改善PCOS-IR患者BMI水平、调控LH/FSH,提高妊娠率及减少药物副作用方面具有显著优势,可与二甲双胍联合使用提高临床疗效。Objective:To explore the prescription characteristics of traditional Chinese medicine in the treatment of polycystic ovary syndrome with insulin resistance (PCOS-IR) and evaluate the curative effect by means of data mining and network meta-analysis.Methods:CNKI,WanFang,VIP,PubMed,Web of Science and other databases were comprehensively searched by computer from the establishment of the database to November 2020.According to the inclusion criteria,clinical randomized controlled trials using traditional Chinese medicine in the treatment of PCOS-IR were screened,and the risk of bias was assessed.Extract widely used protocol prescriptions as clinical prescriptions.Microsoft Excel was used to conduct frequency statistics on the drug types of the prescription,and SPSS Modeler 18.0 software Apriori template was used to analyze the association rules to obtain the characteristics of the prescriptions.A network meta-analysis was used to compare the differences of clinical prescriptions,metformin,and their combination in improving IR,reducing BMI,improving pregnancy rate and regulating LH/FSH levels.Results:18 studies that met the criteria were finally included,and 18 clinical prescriptions contained a total of 62 traditional Chinese medicines.A total of 9 association rules for drug pairs and 3 association rules for 3 traditional Chinese medicine groups were obtained through rule analysis.Cang (Bai) Zhu formed the highest frequency drug combination with Astragalus,Salvia miltiorrhiza,Chuanxiong and Rhizoma Coptidis respectively.The results of network meta-analysis showed that traditional Chinese medicine has great advantages in reducing BMI,regulating LH/FSH,improving pregnancy rate and drug safety.The therapeutic effect of traditional Chinese medicine combined with metformin is better than that of single treatment.Conclusion:This study excavated the drug combination with Cang (Bai) Zhu,Poria,and Dodder as the main prescription,in combination with Astragalus,Salvia,Chuanxiong and Coptis chinensis.Traditional Chinese medicine

关 键 词：多囊卵巢综合征 胰岛素抵抗 数据挖掘 网状Meta分析 

分 类 号：R271.9[医药卫生—中西医结合]