摘要
目的：系统评价补肾活血中药治疗早发性卵巢功能不全（POI）的有效性和安全性。方法：计算机检索Pub Med、Embase、Cochrane Library、中国知网数据库（CNKI）、万方数据库、维普中文期刊服务平台、中国生物医学文献数据库（CBM）,检索时间从各数据库建库至2017年9月,收集补肾活血中药治疗POI的随机对照临床研究文献,对临床总有效率、症状积分、月经恢复率、血清促卵泡生成激素（FSH）、黄体生成素（LH）、雌二醇（E2）的改善及不良反应进行Meta分析。采用＂偏倚风险评估工具＂进行质量评价,运用Rev Man 5. 3软件对结局指标进行Meta分析。结果：纳入12个随机对照试验,共计812例患者。Meta分析结果显示：与西药相比,补肾活血中药在提高临床总有效率[RR总有效率=1. 11,95%CI （1. 02,1. 21）,Z=2. 37 （P=0. 02）]、月经恢复率[RR月经改善率=1. 15,95%CI （1. 04,1. 27）,Z=2. 70 （P=0. 007）]及改善症状积分[WMD症状积分=-2. 14,95%CI （-2. 85,-1. 43）,Z=5. 88 （P 〈0. 000 01）]方面有明显优势,且不良反应发生率低[RR不良反应=0. 22,95%CI=（0. 11,0. 47）,Z=3. 95,P 〈0. 000 1]。而在卵巢内分泌激素的调节方面,因各研究间统计学异质性较大,尚不能确定其优势。结论：补肾活血中药治疗POI安全有效。
Objective： To evaluate the effectiveness and safety of Bushen Huoxue medicine in the treatment of premature ovarian insufficiency（ POI）. Methods： Databases such as CNKI,Wan Fang,VIP,CBM,Pub Med,Embase and Cochrane Library were searched for randomized controlled trial about Bushen Huoxue medicine in treating POI from inception to September 2017. Meta-analysis was carried out on the total clinical effective rate,symptom integral,menstruation recovery rate,adverse effect and the improvement of serum levels of FSH,LH and E2 in patients with POI after treatment.Risks of bias evaluation tools were adopted to conduct quality evaluation. Meta-analysis on outcome indicator was performed by Rev Man Version 5. 3 Software. Results：Twelve trials were included,containing 812 patients. Meta-analysis indicated that Bushen Huoxue medicine had advantages on the improvement of total clinical effective rate[RR = 1. 11,95% CI（1. 02,1. 21）,Z = 2. 37（ P = 0. 02）],menstruation recovery rate[RR = 1. 15,95% CI（1. 04,1. 27）,Z = 2. 70（P = 0. 007）]and symptom integral[WMD =-2. 14,95% CI（-2. 85,-1. 43）,Z = 5. 88（P〈0. 000 01）],with lower incidence of adverse reactions[RR = 0. 22,95% CI =（0. 11,0. 47） Z = 3. 95,（ P〈0. 000 01）]. While the advantages of Bushen Huoxue medicine were not clear on improving sex hormone,because of different outcomes compared with the different western medicine. Conclusions： It is safe and effective to reduce the symptoms of patients suffering from premature ovarian failure with Bushen Huoxue Chinese medicine.
作者
尚玉洁
陈赟
卢苏
SHANG Yujie;CHEN Yun;LU Su(Affiliated Hospital of Nanjing University of TCM,Nanjing 210029,Jiangsu,China)
出处
《中华中医药学刊》
CAS
北大核心
2018年第10期2448-2454,共7页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81574009)
江苏省自然科学基金项目(BK20151600)
江苏省研究生科研与实践创新计划项目(SJCX17-0404)
关键词
卵巢早衰
随机对照试验
补肾活血中药
系统评价
META分析
premature ovarian failure
Bushen Huoxue medicine
randomized controlled trial
systematic review
Meta- analysis
