8种中成药治疗卵巢储备功能下降的网状Meta分析  

A Network Meta-Analysis of 8 Proprietary Chinese Medicines in the Treatment of Decreased Ovarian Reserve

作　　者：汪娟 王晨 黄进格 杨凤娜 魏志玲 王芳[2] 王婷[3] WANG Juan;WANG Chen;HUANG Jinge;YANG Fengna;WEI Zhiling;WANG Fangg;WANG Ting(School of Traditional Chinese and Western Medicine,Gansu University of Chinese Medicine,Lanzhou 730000;Department of Reproductive Medicine,The Second Hospital,Lanzhou University,Lanzhou 730000;Department of Obstetrics and Gynecology,Gansu Province Hospital Rehabilitation Center,Lanzhou 730000)

机构地区：[1]甘肃中医药大学,中西医结合学院,兰州730000 [2]兰州大学第二医院,生殖医学科,兰州730000 [3]甘肃省康复中心医院,妇产科,兰州730000

出　　处：《中药药理与临床》2025年第2期64-71,共8页Pharmacology and Clinics of Chinese Materia Medica

基　　金：兰州大学中国反复妊娠丢失临床诊断标准的建立多中心研究项目(编号:071100132);兰州大学第二医院项目中国反复妊娠丢失的真实世界研究(编号:YJS-BD-19)。

摘　　要：目的:运用网状Meta分析评价不同中成药治疗卵巢储备功能下降的有效性和安全性。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、万方(Wanfang)、维普(VIP)、中国生物医学文献数据库(CBM)和中国知网(CNKI)数据库中成药治疗卵巢储备功能下降的所有随机对照试验,检索期限为各数据库建库至2022年10月。由2位研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用ADDIS 1.16.8软件进行网状Meta分析及排序图的绘制,运用Stata16.0软件绘制漏斗图。结果:最终纳入25篇文献,共计1977例。涉及坤泰胶囊、滋肾育胎丸、复方玄驹胶囊、调经促孕丸、麒麟丸、定坤丹、左归丸、知柏地黄丸8种中成药。网状Meta分析结果显示,在临床有效率方面:西医常规+复方玄驹胶囊效果最好;在降低卵泡刺激素水平、促黄体生成素水平、提高窦卵泡数方面:西医常规+滋肾育胎丸效果最佳;在提高雌二醇水平方面:西医常规+调经促孕丸效果最佳;在提高抗缪勒氏管激素水平方面:定坤丹效果最佳。结论:8种中成药治疗卵巢储备功能下降具有较好的临床疗效,以西医常规+滋肾育胎丸效果最好。因此,不同的患者可根据病情需要选择不同的用药方案,但是,由于研究数量和样本量的限制,仍需要大样本量的研究加以证实。Objective:To assess the efficacy and safety of various Chinese patent medicines in the treatment of decreased ovarian reserve using net-work meta-analysis.Methods:PubMed,Embase,the Cochrane Library,Web of Science,Wanfang Data,China Scientific and Technological Journal Database(VIP),China Biology Medicine Disc(CBM),and China National Knowledge Infrastructure(CNKI)were searched for all randomized controlled trials(RCTs)on the treatment of decreased ovarian reserve with Chinese patent medicines from the inception of the da-tabases to October 2022.Two researchers independently screened the literature,extracted data,and evaluated the risk of bias of the included studies.Network meta-analysis and ranking diagrams were performed using ADDIS 1.16.8,while funnel plots were generated with Stata16.0.Results:Twenty-five articles were included,comprising 1,977 participants and covering eight Chinese patent medicines,namely Kuntai(坤泰)Capsule,Zishen Yutai(滋肾育胎)Pill,Compound Xuanju(玄驹)Capsule,Tiaojing Cuyun(调经促孕)Pill,Qilin(麒麟)Pill,Dingkun(定坤)Pill,Zuogui(左归)Pill,and Zhibai Dihuang(知柏地黄)Pill.Network meta-analysis indicated that in terms of clinical efficacy,conventional Western medicine+Compound Xuanju Capsule had the optimal effect.For reducing follicle-stimulating hormone and lu-teinizing hormone,and increasing antral follicle count,conventional Western medicine+Zishen Yutai Pill was superior.Conventional Western medicine+Tiaojing Cuyun Pill was most effective in elevating estradiol,while Dingkun Dan showed the optimal effect in increasing anti-Müllerian hormone.Conclusion:The eight Chinese patent medicines demonstrated considerable clinical efficacy in treating decreased ovarian reserve,and conventional Western medicine+Zishen Yutai Pill proved to be most beneficial.Therefore,patients could select different medica-tion regimens based on their needs.Nevertheless,due to the limited number of studies and sample sizes,large-scale studies were required for further validation.

关 键 词：中成药 卵巢储备功能下降 网状Meta分析 坤泰胶囊 滋肾育胎丸 复方玄驹胶囊 调经促孕丸 麒麟丸 定坤丹 左归丸 知柏地黄丸 

分 类 号：R271.9[医药卫生—中西医结合]