中药复方联合性激素治疗卵巢功能下降Meta分析  

Meta-analysis of TCM compound formulae combined with sex hormone for treating ovarian function decline

作　　者：范春美 马斯棋 丁克凡 文鑫邦 赵梓钦 陈淑慧 郭珊亦 杨毅坚 Fan Chunmei;Ma Siqi;Ding Kefan;Wen Xinbang;Zhao Ziqin;Chen Shuhui;Guo Shanyi;Yang Yijian(First Affiliated Hospital of Yunnan University of Chinese Medicine/First Clinical Medical College of Yunnan University of Chinese Medicine,Kunming Yunnan 650021)

机构地区：[1]云南中医药大学第一附属医院/云南中医药大学第一临床医学院,云南昆明650021

出　　处：《山西中医药大学学报》2024年第7期709-716,723,共9页Journal of Shanxi University of Chinese Medicine

基　　金：国家自然科学基金地区科学基金项目(81860853)。

摘　　要：目的:运用Meta分析系统评价中药复方联合性激素治疗卵巢功能下降的有效性和安全性,了解中药复方治疗卵巢储备功能下降的疗效。方法:检索中国知网(CNKI)、中文科技期刊全文数据库(VIP)、万方(WANFANG)数据库、Cochrane图书馆及PubMed数据库,时间自建库至2024年1月10日收录的中药复方联合性激素治疗卵巢功能下降的随机对照试验研究(randomized controlled trial,RCT),并进行方法学质量评价,使用RevMan 5.4.1软件进行Meta统计分析与发表偏倚评估。结果:共有13篇RCT文献纳入本研究,共计978例患者,其中试验组486例,干预措施为中药复方联合性激素治疗;对照组492例,干预措施为性激素治疗。试验组促卵泡生成素(FSH)(SMD=-1.71,95%CI:-2.14~-1.28)、促黄体生成素(LH)(SMD=-1.60,95%CI:-2.12~-1.08)、雌二醇(E_(2))(SMD=1.26,95%CI:0.49~2.02)、痊愈率(OR=0.40,95%CI:0.27~0.61)、显效率(OR=0.56,95%CI:0.41~0.76)、中医证候疗效评分(OR=3.94,95%CI:3.43~4.44)改善情况均优于对照组,差异具有统计学意义。两组患者在抗缪勒管激素(AMH)(SMD=-0.66,95%CI:-1.50~0.18)、有效率(OR=1.25,95%CI:0.93~1.69)方面比较,差异无统计学意义。结论:中药复方联合性激素治疗卵巢功能下降安全有效,特别是在调节性激素水平和改善临床症状方面疗效明显。Objective:To systematically evaluate the effectiveness and safety of combined TCM formulae and sex hor-mone therapy for ovarian function decline using meta-analysis,and to understand the efficacy of TCM formulae in treating declining ovarian reserve function.Methods:We searched the China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodicals Database(VIP),WANFANG database,Cochrane Library,and PubMed up to January 10,2024,for randomized controlled trials(RCTs)of TCM formulae combined with sex hormone therapy for ovarian function decline.Methodological quality was assessed,and meta-statistical analysis and publication bias assessment were conducted using RevMan 5.4.1 software.Results:A total of 13 RCTs involving 978 patients were included in this study.Compared with the control group,the trial group showed statistically significant improvements in follicle-stimulating hormone(FSH)(SMD=-1.71,95%CI:-2.14 to-1.28),luteinizing hormone(LH)(SMD=-1.60,95%CI:-2.12 to-1.08),estradiol(E_(2))(SMD=1.26,95%CI:0.49 to 2.02),cure rate(OR=0.40,95%CI:0.27 to 0.61),marked effective rate(OR=0.56,95%CI:0.41 to 0.76),and TCM syndrome efficacy score(OR=3.94,95%CI:3.43 to 4.44).No statistically significant differences were found between the two groups in terms of anti-Müllerian hormone(AMH)(SMD=-0.66,95%CI:-1.50 to 0.18)and effective rate(OR=1.25,95%CI:0.93 to 1.69).Conclusion:The combination of TCM formulae and sex hormone therapy is safe and effective in the treatment of ovarian function decline,particularly in regulating sex hormone levels and improving clinical symptoms.

关 键 词：中药复方 卵巢功能下降 性激素治疗 META分析 

分 类 号：R271[医药卫生—中医妇科学]