补肾化瘀法联合米非司酮治疗子宫内膜异位症有效性和安全性的系统评价和Meta分析  

The systematic evaluation and Meta-analysis of the efficacy and safety of the tonifying kidney and removing blood stasis method plus mifepristone in the treatment of endometriosis

作　　者：吕银鑫 黄灿灿 刘冰玉 曾燕 武权生[1] LYU Yinxin

机构地区：[1]甘肃中医药大学,甘肃兰州730030

出　　处：《中医临床研究》2023年第29期128-133,共6页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金:p38 MAPK-MSK1/2-CREB信号通路关键分子在EMT痛经小鼠宫腔微环境中的响应及少腹逐瘀汤的干预作用(No.81760879);2023年研究生“创新之星”项目:基于“祛瘀生新”探讨益气化膜调周法治疗子宫内膜增生型崩漏的临床研究(2023CXZX-747)。

摘　　要：目的:系统评价补肾化瘀法联合米非司酮治疗子宫内膜异位症(Endometriosis,EMT)的有效性和安全性。方法:检索Cochrane Library、PubMed、Embase、Web of Science以及中国知网、中国生物医学文献数据库、维普数据库、万方数据库中已发表的相关文献。获得文献时限均为建库至2022年7月。按照纳入排除标准进行严格筛选,将提取后的文献根据Cochrane系统评价方法评估质量,并利用RevMan 5.4软件完成数据分析。结果:本研究共纳入临床文献14篇,共1265例患者,Meta分析显示:试验组总有效率优于对照组,治疗后试验组盆腔包块小于对照组,血清糖类抗原125(Carbohydrate Antigen 125,CA125)明显低于对照组,治疗后血清肿瘤坏死因子(Tumor Necrosis Factor,TNF)水平低于对照组,不良反应发生率低于对照组。结论:补肾化瘀法联合米非司酮治疗可以显著提高EMT患者的临床疗效,其主要不良反应为恶心、多汗,其他不良反应发生率低,但该结论仍需高质量、大样本的随机对照试验进一步验证。Objective:To systematically evaluate the efficacy and safety of the tonifying kidney and removing blood stasis method plus mifepristone in the treatment of endometriosis.Methods:In Cochrane Library,PubMed,Embase,Web of Science,CNKI,CBMdisc,VIP database and Wanfang database,the studies on treating endometriosis by the tonifying kidney and removing blood stasis method plus mifepristone published from the establishment of each database to July 2022 were searched and selected.TheO studies were strictly screened according to the inclusion and exclusion criteria,the quality of extracted literature was assessed according to Cochrane systematic evaluation method,and a data analysis was completed by RevMan 5.4 software.Results:A total of 14 clinical studies with 1265 cases were included finally.The Meta-analysis showed that the total efficiency in the test group was better than that in the control group.After treatment,the pelvic mass in the test group was smaller than the control group,the serum CA125 in the test group was significantly lower than the control group,the serum TNF level in the test group was lower than the control group,and the incidence of adverse reactions in the test group was lower than the control group.Conclusion:The tonifying kidney and removing blood stasis method plus mifepristone can significantly improve the clinical efficacy on EMT.Its main adverse reactions are nausea and hyperhidrosis,and the incidence of other adverse reactions is low.However,this conclusion still needs to be further verified by high-quality and large-sample randomized controlled trials.

关 键 词：补肾化瘀法 米非司酮 子宫内膜异位症 随机对照试验 系统评价 

分 类 号：R271.1[医药卫生—中医妇科学]