苍附导痰汤联合二甲双胍治疗脾虚痰湿型多囊卵巢综合征胰岛素抵抗的Meta分析  

Meta-analysis of the Treatment of Insulin Resistance in Polycystic Ovary Syndrome Patients with Spleen Deficiency and Phlegm-dampness by Cangfu Daotan Decoction Combined with Metformin

作　　者：刘婕[1] 姜敏[1] 冯兴中 倪青[3] LIU Jie;JIANG Min;FENG Xing-zhong;NI Qing(Department of TCM,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038;Tsinghua University Yuquan Hospital,Beijing 100040;Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053)

机构地区：[1]首都医科大学附属北京世纪坛医院中医科,北京100038 [2]清华大学玉泉医院,北京100040 [3]中国中医科学院广安门医院,北京100053

出　　处：《世界中西医结合杂志》2024年第10期1909-1914,1925,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：中医药循证能力建设项目(2019XZZX-JB004);国家中医药管理局、国家卫生计生委办公厅、中央军委后勤保障部卫生局重大疑难疾病中西医临床协作试点项目(国中医药医政发[2018]3号);首都卫生发展科研专项项目(2016-1-4151)。

摘　　要：目的评价苍附导痰汤治疗多囊卵巢综合征(Polycystic ovary syndrome,PCOS)胰岛素抵抗的有效性与安全性。方法按照Cochrane系统评价手册的要求电子检索2013年1月1日—2023年7月31日期间中国学术期刊全文数据库、维普中文科技期刊数据库、万方数据知识服务平台、The Cochrane Library、PubMed、BMJ等中英文电子数据库,收集关于苍附导痰汤治疗多囊卵巢综合征胰岛素抵抗(Polycystic ovary syndrome-Insulin resistance,PCOS-IR)随机对照研究,根据纳入、排除标准对文献进行筛选,并用Cochrane系统评价推荐的Rev Man 5.3软件对纳入研究进行Meta分析。结果共纳入9项研究,合计724例PCOS受试者。所有RCT治疗组采用苍附导痰汤联合盐酸二甲双胍,对照组采用盐酸二甲双胍或联合其他内分泌治疗的随机对照试验(Randomized Controlled Trial,RCT)。Meta分析结果显示苍附导痰汤治疗组在改善HOMA-IR方面优于对照组,差异有统计学意义[MD=-0.99,95%CI(-1.49,-0.50),Z=3.97,P<0.0001]。治疗组在改善高胰岛素血症、血脂水平、激素水平、排卵率及妊娠率方面,差异有统计学意义。结论与二甲双胍比较,苍附导痰汤能更有效地治疗PCOS-IR。但由于所纳入RCT方法学质量均较低,需要开展更为严格的RCT以提供充分证据支持临床应用苍附导痰汤治疗PCOS-IR。Objective To evaluate the efficacy and safety of Cangfu Daotan Decoction in treating insulin resistance in polycystic ovary syndrome(PCOS)patients.Methods According to the requirements of the Cochrane Handbook for Systematic Reviews of Interventions,the literature on the randomized controlled trials(RCTs)related to the treatment of polycystic ovary syndrome-insulin resistance(PCOS-IR)with Cangfu Daotan Decoction from January 1,2013 to July 31,2023 was retrieved on China National Knowledge Infrastructure(CNKI),VIP,Wanfang Data,Cochrane Library,PubMed,BMJ,etc.The literature was screened according to the inclusion and exclusion criteria,and the Rev Man 5.3 software recommended by Cochrane systematic reviews was used to conduct a meta-analysis of the included literature.Results A total of 9 studies(724 PCOS patients)were enrolled.All the treatment groups of the RCTs adopted Cangfu Daotan Decoction combined with metformin,while the control groups adopted metformin hydrochloride or the combination of it with other endocrine therapies.Meta-analysis showed that the treatment groups using the Cangfu Daotan Decoction are superior to the control groups in improving HOMA-IR,and the differences are statistically significant[MD=-0.99,95%CI(-1.49,-0.50),Z=3.97,P<0.0001].Statistically significant differences are also found in the improvement of hyperinsulinemia and the regulation of the blood lipid level and the hormone level.Conclusion The Cangfu Daotan Decoction is more effective in the treatment of PCOS-IR than metformin.However,because of the low methodological quality of the included RCTs,a strict RCT is required for providing adequate evidence to support the clinical application of Cangfu Daotan Decoction in treating PCOS-IR.

关 键 词：多囊卵巢综合征 胰岛素抵抗 苍附导痰汤 META分析 

分 类 号：R711.75[医药卫生—妇产科学]