高强度聚焦超声联合中医药治疗子宫腺肌病疗效及安全性Meta分析  

A Meta-analysis of safety and efficacy of high intensity focused ultrasound combined with TCM medicine on adenomyosis

作　　者：李若楠 郭静[1] 庞丽丽 赵婷婷 范玲秀 周奕含 文怡[1] LI Ruonan

机构地区：[1]成都中医药大学附属医院,四川成都610072

出　　处：《中医临床研究》2023年第29期138-144,共7页Clinical Journal Of Chinese Medicine

基　　金：四川省中医药管理局中医药专项课题(2021MS060);重庆市科技局超声医学工程国家重点实验室开放课题(2020KFA3006)。

摘　　要：目的:对高强度聚焦超声(High Intensity Focused Ultrasound,HIFU)联合中医药治疗子宫腺肌病(Adenomyosis,AM)的有效性及安全性进行评估,为AM的临床治疗提供参考。方法:检索中国知网、万方、PubMed等常用中英文数据库,收集所有关于HIFU联合中医药治疗AM的随机对照试验研究,利用RevMan 5.3软件行Meta分析。结果:最终确定9篇文献纳入研究,总计690例病例。所纳入的文献中有6篇采用的干预措施为使用HIFU联合中医药治疗VS.HIFU治疗,3篇采用的干预措施为在相同的西医治疗基础上,使用HIFU联合中医药治疗VS.HIFU治疗。Meta分析结果示:在6项HIFU联合中医药治疗VS.HIFU治疗研究中,联合中医药组在缩小子宫体积[MD=-17.82,95%CI=(-25.88,-9.76),P<0.00001]、改善血清糖类抗原125(CA125)水平[MD=-15.80,95%CI=(-16.29,-15.30),P<0.00001]及改善月经量评分[MD=-57.79,95%CI=(-66.55,-49.03),P<0.00001]方面优于未联合中医药组;在改善痛经视觉模拟评分法(VisualAnalogueScale,VAS)评分[MD=-1.18,95%CI=(-2.96,0.60),P=0.19]及缩小病灶体积[MD=-9.61,95%CI=(-20.35,1.13),P=0.08]方面与未联合中医药组相比无明显差异,在3项HIFU联合中医药+西医治疗VS.HIFU+西医治疗研究中,联合中医药组在缩小子宫体积[MD=-16.45,95%CI=(-18.60,-14.30),P<0.00001]及改善痛经VAS评分[MD=-0.33,95%CI=(-0.41,-0.26),P<0.00001]方面优于未联合中医药组;在改善血清CA125水平[MD=-4.20,95%CI=(-10.75,2.36),P=0.21]方面与未联合中医药组相比无明显差异;在缩小病灶体积及改善月经量评分方面,都是仅有1项研究纳入,难以进行统计分析;由于所纳入文献中样本量少且对于不良反应的描述方式有差异,所以并不能对其进行统计分析,但就纳入文献中的描述,HIFU联合中医药治疗AM并未出现严重并发症,也未增加不良发应发生率。结论:综合分析,HIFU联合中医药治疗AM在缩小子宫体积、减少月经量、缓解痛经、改善血清CA125水平方�Objective:To evaluate the efficacy and safety of high intensity focused ultrasound combined with TCM medicine in the treatment of adenomyosis,and to provide reference for the clinical treatment of adenomyosis.Methods:CNKI,Wanfang,PubMed and other commonly used Chinese and English databases were searched to collect all randomized controlled trials(RCTs)of high intensity focused ultrasound combined with TCM medicine in the treatment of adenomyosis,and the RevMan 5.3O software was used to conduct Meta-analysis.Results:Finally,nine RCTs were included in the study,with a total of 690 cases.Among the included RCTs,6 studies used high-intensity focused ultrasound combined with TCM medicine VS.high-intensity focused ultrasound,and 3 studies used high-intensity focused ultrasound combined with TCM medicine VS.high-intensity focused ultrasound on the basis of the same Western medicine treatment.The results of Meta-analysis showed that in the six studies of high-intensity focused ultrasound combined with TCM medicine VS.high-intensity focused ultrasound,the combined TCM group reduced the uterine volume[MD=-17.82,95%CI=(-25.88,-9.76),P<0.00001],the improvement of CA125 level[MD=-15.80,95%CI=(-16.29,-15.30),P<0.00001]and the improvement of menstrual volume score[MD=-57.79,95%CI=(-66.55,-49.03),P<0.00001]were better than those in the group without combination of TCM medicine.There was no significant difference in improving dysmenorrhea VAS score[MD=-1.18,95%CI=(-2.96,0.60),P=0.19]and reducing lesion volume[MD=-9.61,95%CI=(-20.35,1.13),P=0.08]compared with the group without combination of TCM medicine.In the three studies of high-intensity focused ultrasound combined with TCM plus Western medicine VS.high-intensity focused ultrasound plus Western medicine,combined TCM method reduced the uterine volume[MD=-16.45,95%CI=(-18.60,-14.30),P<0.00001],ameliorated dysmenorrhea VAS score[MD=-0.33,95%CI=(-0.41,-0.26),P<0.00001],which were better than those in the group without combination of TCM medicine.There was no significant differenc

关 键 词：中医药治疗 视觉模拟评分法 高强度聚焦超声 病灶体积 META分析 疗效及安全性 月经量 子宫腺肌病 

分 类 号：R271.1[医药卫生—中医妇科学]