五积散治疗多囊卵巢综合征疗效的Meta分析  

A Meta-analysis of treating polycystic ovary syndrome with Wuji San

作　　者：李铭乐 骆淳 高天 黄平 LI Mingle

机构地区：[1]浙江中医药大学附属第一医院/浙江省中医院,浙江杭州310003 [2]浙江中医药大学附属第二医院,浙江杭州310005

出　　处：《中医临床研究》2024年第22期124-130,共7页Clinical Journal Of Chinese Medicine

基　　金：国家中医药管理局第三届国医大师传承工作室建设项目(国中医药办人教函[2018]119号);浙江省黄平名老中医专家传承工作室(GZS2020024)。

摘　　要：目的:系统评价五积散治疗多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)的临床疗效。方法:检索中国知网、PubMed、Embase等数据库自建库起至2023年2月18日发表的五积散治疗PCOS与单纯西医治疗PCOS的随机对照试验。提取试验数据,采用Cochrane文献质量评价工具进行质量评价,使用RevMan 5.4软件进行Meta分析。结果:共纳入随机对照试验研究11篇,总计患者893例。Meta分析结果显示,五积散治疗PCOS的有效率优于单纯西医组[相对危险度(RR)=1.22,95%置信区间(CI)(1.14,1.30),P<0.00001]。五积散能有效降低黄体生成素水平[均数差(MD)=-1.14,95%CI(-1.73,-0.54),Z=3.75,P=0.0002],降低睾酮水平[MD=-0.24,95%CI(-0.40,-0.08),Z=2.92,P=0.003],降低空腹胰岛素水平[MD=-2.66,95%CI(-4.91,-0.41),Z=2.31,P=0.02],增加妊娠数[RR=1.96,95%CI(1.53,2.52),Z=5.30,P<0.00001],降低中医证候积分[MD=-8.88,95%CI(-12.50,-5.26),Z=4.81,P<0.00001]。此外,五积散并不能有效提高卵泡刺激素水平。结论:五积散治疗PCOS总有效率优于单纯西医治疗,且能有效降低黄体生成素、睾酮、空腹胰岛素水平,增加妊娠数,改善患者中医证候。但在提高卵泡刺激素水平方面,本研究未发现五积散相比单纯西医治疗具有优势,期待将来更多大样本试验探明其潜在作用。Objective:To evaluate the clinical effect of Wuji San(五积散)on polycystic ovary syndrome(PCOS).Methods:The randomized controlled trials(RCT)of Wuji San in the treatment of polycystic ovary syndrome and Western medicine alone published from the establishment of the database to February 18,2023 in CNKI,Pub Med,EMBASE and other databases were retrieved.Data were extracted,and Cochrane literature quality evaluation tool was used for quality evaluation.Rev Man5.4 software was used for Meta-analysis.Results:A total of 11 RCT studies were included,with a total of 893 patients.The results of meta-analysis showed that the effective rate of Wuji San in the treatment of PCOS was better than that of Western medicine group[RR=1.22,95%CI(1.14,1.30),P<0.00001].Wuji San effectively reduced the level of luteinizing hormone[MD=-1.14,95%CI(-1.73,-0.54),Z=3.75,P=0.0002].Wuji San decreased the testosterone levels[MD=-0.24,95%CI(-0.40,-0.08),Z=2.92,P=0.003].Wuji San decreased the fasting insulin levels[MD=-2.66,95%CI(-4.91,-0.41),Z=2.31,P=0.02].Wuji San increased the number of pregnancies[RR=1.96,95%CI(1.53,2.52),Z=5.30,P<0.00001].Wuji San decreased the TCM syndrome score[MD=-8.88,95%CI(-12.50,-5.26),Z=4.81,P<0.00001].In addition,Wuji San could not effectively increase the level of follicle-stimulating hormone.Conclusion:This study shows that the total effective rate of Wuji San in the treatment of PCOS is better than that of western medicine alone,and it can effectively reduce the levels of luteinizing hormone,testosterone and fasting insulin,increase the number of pregnancies,and improve the TCM syndromes of patients.In terms of increasing follicle-stimulating hormone level,this study does not find that Wuji San is superior to Western medicine alone.More large-scale trials are expected to investigate its potential effects in the future.

关 键 词：多囊卵巢综合征 META分析 随机对照试验 有效率 

分 类 号：R271.1[医药卫生—中医妇科学]