中药复方治疗绝经前后诸证的疗效评价与Meta分析  

Effects of Chinese Medicine Compound on Menopause Syndrome:Systematic Review and Meta-Analysis

作　　者：刘畅[1] 高靖茹 陈思圻 冯晓玲[2] LIU Chang;GAO Jingru;CHEN Siqi;FENG Xiaoling(First Clinical Medical College,Heilongjiang University of Chinese Medicine,Harbin 150000,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150000,China)

机构地区：[1]黑龙江中医药大学第一临床医学院,哈尔滨150000 [2]黑龙江中医药大学附属第一医院,哈尔滨150000

出　　处：《世界科学技术-中医药现代化》2024年第9期2399-2414,共16页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家中医药管理局中医标准化项目(GZY-FJS-2022-031):中医病证诊断疗效标准示范性修订-绝经前后诸证,负责人:冯晓玲。

摘　　要：目的系统评价中药复方治疗绝经前后诸证的临床疗效性。方法检索中国知网(CNKI)、重庆维普(VIP)、万方全文数据库,限定时间为1993年1月-2023年5月公开发表的与单纯中药复方治疗绝经前后诸证的疗效性相关的随机对照试验(Randomized controlled trial,RCT)。根据Cochrane手册评价文献质量,应用RevMan 5.4软件进行Meta分析。结果本研究共纳入131篇随机对照试验,Meta分析显示,与激素治疗相比,单纯中药复方治疗可提高临床有效率(OR=3.90,95%CI:3.50-4.34,P<0.00001)、降低Kupperman评分(MD=-3.69,95%CI:-4.79--2.58,P<0.00001)以及降低黄体生成素(LH)水平(MD=-2.79,95%CI:-4.65--0.92,P=0.003)。亚组分析结果表明,柴胡桂枝龙骨牡蛎汤、丹栀逍遥散、二仙汤、六味地黄丸(汤)、知柏地黄汤和滋水清肝饮这6类经方治疗绝经前后诸证患者的临床疗效优于激素治疗(OR=3.83,95%CI:3.13-4.68,P=0.002)。结论中药复方治疗能够显著提高临床有效率,同时缓解不适症状,降低Kupperman评分,改善LH水平。Objective To systematically evaluate the clinical efficacy of Chinese Medicine Compound(CHM)for menopause syndrome.Methods China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP)and Wanfang full-text database were searched for a randomized controlled trial(RCT)related to the efficacy of CHM therapy published from January 1993 to May 2023.Literature quality was evaluated according to the Cochrane manual and the Meta-analysis was performed using RevMan 5.4 software.Results A total of 131 RCTs were included in this study,and Meta-analysis showed that CHM improved clinical response rate(OR=3.90,95%CI:3.50-4.34,P<0.00001),reduced Kupperman score(MD=-3.69,95%9:-4.79--2.58,P<0.00001)and decreased LH level(MD=-2.79,95%CI:-4.65--0.92,P=0.003).The results of subgroup analysis showed that the clinical efficacy of menopausal patients treated by Gui-Zhi-Long-Gu-Mu-Li decoction,Dan-Zhi-Xiao-Yao-San,Er-Xian decoction,Liu-Wei-Di-Huang decoction,Zhi-Bai-Di-Huang decoction and Zi-Shui-Qing-Gan decoction was better than that of hormone therapy(OR=3.83,95%CI:3.13-4.68,P=0.002).Conclusion CHM treatment can significantly improve clinical efficiency,relieve discomfort symptoms,reduce Kupperman score and improve LH level.

关 键 词：中药复方 绝经前后诸证 激素治疗 META分析 

分 类 号：R-058[医药卫生]