摘要
目的:系统评价他莫昔芬对多囊卵巢综合征(PCOS)患者促排卵治疗的有效性。方法:检索万方数据库、维普数据库、中国期刊全文数据库(CNKI)、Pubmed、EMbase、WebofScience、Cochrane系统评价和临床试验数据库,收集相关临床对照试验,用RevMan5.1软件进行Meta分析。结果:共纳入6项临床对照试验,共762名妇女,4项随机对照试验(RCT),2项非随机对照试验(Non-RCT)。Meta分析结果显示,他莫昔芬组的排卵率低于枸橼酸氯米芬组(CC)[OR=0.60,95%C(I0.39,0.90),P=0.01],而人绒毛膜促性腺激素(HCG)注射日子宫内膜厚度优于CC[WMD=0.80,95%C(I0.74,0.86),P<0.00001]。而在妊娠率[OR=0.63,95%CI(0.37,1.05),P=0.08]、流产率[OR=1.50,95%CI(0.35,6.38),P=0.58]、HCG注射日血清雌二醇(E2)水平[SMD=-0.59,95%CI(-2.81,1.62),P=0.60]及≥18mm卵泡数方面[WMD=-0.46,95%CI(-1.54,0.62),P=0.40],他莫昔芬组和枸橼酸氯米芬组比较差异无统计学意义。在CC抵抗PCOS患者中,他莫昔芬联合CC的疗效显著优于CC单独应用[OR=12.36,95%C(I2.68,57.14),P=0.001]。尚无二药不良事件的具体报道。结论:在治疗PCOS患者中,他莫昔芬的疗效与CC无显著性差异,然而在CC抵抗的PCOS患者中,CC联合他莫昔芬的疗效显著优于单独应用CC,但尚需高质量的RCT进一步确证。
OBJECTIVE：To evaluate the effectiveness and safety of tamoxifen for polycystic ovarian syndrome（PCOS）patients systematically.METHODS：Retrieved from Pubmed,EMbase,Cochrane Library,Web of SCI,CNKI,Wanfang database,VIP,relevant clinical control trials were collected and Meta-analyses were conducted by RevMan 5.1 software.RESULTS：A total of 6 clinical controlled trials were collected,involving in 762 women,4 RCT and 2 Non-RCT.Meta-analysis showed that tamoxifen was inferior to clomiphene citrate（CC）in ovulation rate [OR=0.60,95%CI（0.39,0.90）,P=0.01],but human chorionic gonadotrophin（HCG）was better than CC in endometrial thickness [WMD=0.80,95%CI（0.74,0.86）,P0.000 01].There was no significant differences between tamoxifen and CC in pregnancy rate [OR=0.63,95%CI（0.37,1.05）,P=0.08],miscarriage rate [OR=1.50,95%CI（0.35,6.38）,P=0.58],serum E 2 [SMD=-0.59,95%CI（-2.81,1.62）,P=0.60] and number of follicles≥ 18 mm [WMD=-0.46,95%CI（-1.54,0.62）,P=0.40].In CC-resistant PCOS women,the efficacy of tamoxifen combined CC was better than CC alone [OR=12.36,95% CI（2.68,57.14）,P=0.001].No adverse event of 2 drugs was reported.CONCLUSION：Tamoxifen is similar to CC for PCOS women,but tamoxifen combined with CC is better than CC alone in CC-resistant PCOS women.Further high quality RCT are needed to confirm.
出处
《中国药房》
CAS
CSCD
2013年第4期359-362,共4页
China Pharmacy
