中成药联合米非司酮治疗子宫肌瘤的网状Meta分析  

Network Meta-analysis of Chinese patent medicine combined with mifepristone in treatment of uterine fibroid

作　　者：王晨[1] 汪娟 杨凤娜 魏志玲 王芳[3] WANG Chen;WANG Juan;YANG Feng-na;WEI Zhi-ling;WANG Fang(Gansu University of Chinese Medicine,Lanzhou 730000,China;Lanzhou University,Lanzhou 730000,China;Department of Reproductive Medicine,Lanzhou University Second Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]兰州大学,甘肃兰州730000 [3]兰州大学第二医院生殖医学科,甘肃兰州730000

出　　处：《中草药》2022年第21期6820-6831,共12页Chinese Traditional and Herbal Drugs

基　　金：兰州大学中国反复妊娠丢失临床诊断标准的建立多中心研究项目(071100132):兰州大学第二医院项目中国反复妊娠丢失的真实世界研究(YJS-BD-19)。

摘　　要：目的运用网状Meta分析评价不同中成药联合米非司酮治疗子宫肌瘤的有效性和安全性。方法计算机检索Scopus、PubMed、Embase、Cochrane Library、Web of Science、万方(Wanfang)、维普(VIP)、中国生物医学文献数据库(CBM)和中国知网(CNKI)数据库中成药联合米非司酮治疗子宫肌瘤的所有随机对照试验,检索期限为各数据库建库至2022年3月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用ADDIS 1.16.8软件进行网状Meta分析及排序图的绘制,运用Stata14.0软件绘制漏斗图。结果最终纳入43篇文献,共计4354例。涉及宫瘤宁胶囊、宫瘤消胶囊、宫瘤清胶囊、桂枝茯苓丸(胶囊)、血府逐瘀胶囊(口服液)、丹鳖胶囊和小金丸(胶囊)7种中成药。网状Meta分析结果显示,在临床总有效率、缩小子宫肌瘤体积、提高雌二醇水平方面:血府逐瘀胶囊(口服液)+米非司酮效果最佳;在缩小子宫体积方面:桂枝茯苓丸(胶囊)+米非司酮效果最佳;在提高卵泡刺激素水平方面:丹鳖胶囊+米非司酮效果最佳;在提高促黄体生成素、孕酮水平方面:宫瘤宁胶囊+米非司酮效果最佳。用药期间血府逐瘀胶囊(口服液)+米非司酮的不良反应最少。结论7种中成药联合米非司酮治疗子宫肌瘤皆具有很好的临床疗效,以血府逐瘀胶囊(口服液)+米非司酮效果最好。不同的患者可根据不同需要选择用药,但因为研究数量和样本量过少,因此仍需要大样本量的研究加以证实。Objective To evaluate the efficacy and safety of different Chinese patent medicines combined with mifepristone in treatment of uterine fibroid by network Meta-analysis.Methods The randomized controlled trials(RCTs)of Chinese patent medicine combined with mifepristone in the treatment of uterine fibroid were searched by computer from Scopus,PubMed,Embase,Cochrane Library,Web of Science,Wanfang,VIP,China Biology Medicine Disc(CBM)and China National Knowledge Internet(CNKI)databases.The retrieval period was from the establishment of each database to March 2022.After two evaluators independently screened the literature,extracted the data and evaluated the risk of bias in the included study,network Meta-analysis and ranking diagram were performed by ADDIS 1.16.8 software,and used stata14.0 software to draw the funnel plot.Results A total of 43 studies with 4354 cases were included in the study.It involved seven kinds of Chinese patent medicines,including Gongliuning Capsules(宫瘤宁胶囊),Gongliuxiao Capsules(宫瘤消胶囊),Gongliuqing Capsules(宫瘤清胶囊),Guizhi Fuling Pills(Capsules)[桂枝茯苓丸(胶囊)],Xuefu Zhuyu Capsules(Oral Liquids)[血府逐瘀胶囊(口服液)],Danbie Capsules(丹鳖胶囊)and Xiaojin Pills(Capsules)[小金丸(胶囊)].The results of network Meta-analysis showed that in terms of total clinical effective rate,reducing uterine fibroid volume and improving estradiol level:Xuefu Zhuyu Capsules(Oral Liquids)+mifepristone had the best effect;In terms of reducing the size of the uterus:Guizhi Fuling Pills(Capsules)+mifepristone had the best effect;In terms of increasing the level of follicle stimulating hormone:Danbie Capsules+mifepristone had the best effect;In terms of increasing the levels of luteinizing hormone and progesterone:Gongliuning Capsules+mifepristone had the best effect.The adverse reactions of Xuefu Zhuyu Capsules(Oral Liquids)+mifepristone were the least during medication.Conclusion Seven Chinese patent medicines combined with mifepristone has good clinical efficacy i

关 键 词：中成药 米非司酮 子宫肌瘤 网状Meta分析 宫瘤宁胶囊 宫瘤消胶囊 宫瘤清胶囊 桂枝茯苓丸(胶囊) 血府逐瘀胶囊(口服液) 丹鳖胶囊 小金丸(胶囊) 

分 类 号：R285.4[医药卫生—中药学]