中西医结合治疗青春期多囊卵巢综合征疗效的Meta分析  

A Meta-analysis of the curative effect of the integrative medicine on adolescent polycystic ovary syndrome

作　　者：代杨 韩亚光[2] 朱小琳[3] 高艺媛 DAI Yang;HAN Yaguang;ZHU Xiaolin;GAO Yiyuan

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150006 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [3]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《中医临床研究》2024年第24期142-148,F0003,共8页Clinical Journal Of Chinese Medicine

摘　　要：目的:本研究系统评价中西医结合治疗青春期多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)的疗效及安全性,为诊治青春期PCOS的临床实践研究提供循证医学依据。方法:计算机检索中国知网、PubMed、The Cochrane Library、Embase、万方、CQVIP等数据库,收集从建库至2022年12月公开发表的有关中西医结合治疗青春期PCOS的随机对照试验(Randomized Controlled Trial,RCT)。对文献进行筛选后,采用Cochrane风险偏倚评估工具对原始研究进行质量评估,采用RevMan 5.3软件进行Meta数据分析。结果:共有18篇RCT研究,涉及1349例患者,其中试验组(中西医联合治疗)675例、对照组(单用西药治疗)674例。Meta分析发现:试验组疗效优于对照组[优势比(OR)=4.19,95%置信区间(CI)(3.00,5.84),P<0.00001],与单用西药组相比,试验组可有效降低青春期PCOS患者的促黄体生成素(Luteinizing Hormone,LH)水平[标准化均数差(SMD)=–1.15,95%CI(–1.64,–0.66),P<0.00001]、LH/促卵泡生成素(Follicle-stimulating Hormone,FSH)水平[SMD=–1.15,95%CI(–1.64,–0.66),P<0.00001]、雄激素睾酮(Testosterone,T)水平[SMD=–0.97,95%CI(–1.45,–0.49),P<0.0001]、胰岛素抵抗指数(Homa Insulin-resistance,HOMA-IR)水平[MD=–0.66,95%CI(–1.20,–0.12),P=0.02]及空腹胰岛素(Fasting Insulin,FINS)水平[MD=–1.72,95%CI(–2.44,–0.99),P<0.00001],可降低体质量指数(Body Mass Index,BMI)[MD=–1.47,95%CI(–2.51,–0.44),P=0.005]以及青春期PCOS患者的痤疮体征评分[MD=–0.70,95%CI(–0.94,–0.47),P<0.00001]和中医临床症状积分[MD=–2.53,95%CI(–3.25,–1.80),P<0.00001],有效减小卵巢体积[MD=–1.36,95%CI(–1.99,–0.74),P<0.0001]以及减少卵泡数目[MD=–1.58,95%CI(–2.74,–0.42),P=0.008]。但两组在FSH水平[SMD=–0.36,95%CI(–1.33,0.41),P=0.36]、空腹血糖(Glucose,GLU)水平[MD=–0.22,95%CI(–0.59,0.16),P=0.26]和雌二醇(Estradio,E2)水平[SMD=0.17,95%CI(–0.23,0.57),P=0.41]及不良反应[RR=–0.51,95%CI(0.26,1.01)Objective:This study systematically evaluates the efficacy and safety of the integrative medicine in the treatment of adolescent PCOS,in order to provide evidence-based medical evidence for the clinical practice of diagnosis and treatment of adolescent PCOS.Methods:Chinese National Knowledge Infrastructure(CNKI),PubMed,The Cochrane Library,Embase,WANGFANG,CQVIP and other databases were searched by computer to collect the randomized controlled trials(RCTS)on the treatment of adolescent polycystic ovary syndrome in the integrative medicine published from the establishment of the database to December 2022.After literature screening,Cochrane risk bias assessment tool was used to evaluate the quality of the original study,and Meta-analysis was performed using RevMan 5.3 software.Results:A total of 18 RCTS,involving 1349 patients were included in the study,including 675 cases in the crial group(took the treatment of the integrative medicine)and 674 cases in the control group(Western medicine alone).Meta-analysis revealed that the efficacy in the experimental group was better than the control group[OR=4.19,95%CI(3.00,5.84),P<0.00001].Compared with the Western medicine group,the crial group effectively reduced LH level[SMD=–1.15,95%CI(–1.64,–0.66),P<0.00001],LH/FSH level[SMD=–1.15,95%CI(–1.64,–0.66),P<0.00001],T level[SMD=–0.97,95%CI(–1.45,–0.49),P<0.0001],HOMA-IR level[MD=–0.66,95%CI(–1.20,–0.12),P=0.02]and FINS level[MD=–1.72,95%CI(–2.44,–0.99),P<0.00001],decreased BMI[MD=–1.47,95%CI(–2.51,–0.44),P=0.005],reduced acne sign scores[MD=–0.70,95%CI(–0.94,–0.47),P<0.00001]and TCM clinical symptom scores[MD=–2.53,95%CI(–3.25,–1.80),P<0.00001],which effectively reduced ovarian volume[MD=–1.36,95%CI(–1.99,–0.74),P<0.0001],and follicle number[MD=–1.58,95%CI(–2.74,–0.42),P=0.008]in adolescent PCOS patients.However,the two groups showed a decrease no statistically significant difference in FSH level[SMD=–0.36,95%CI(–1.33,0.41),P=0.36],GLU level[MD=–0.22,95%CI(–0.

关 键 词：青春期多囊卵巢综合征 中西医结合 META分析 

分 类 号：R271.1[医药卫生—中医妇科学]