摘要
目的系统评价中药联合孕激素治疗复发性流产的临床价值。方法采用循证医学的方法,计算机检索中国知网数据库(CNKI)、万方数据(Wanfang Data)、维普中文科技期刊数据库(Chongqing VIP)、中国生物医学文献数据库网络版(CBM)和PubMed数据库建库至2020年12月31日。根据文献纳入标准和排除标准严格筛选研究文献。对纳入文献的方法学质量通过Cochrane风险偏倚评估工具进行评价及通过RevMan 5.3软件进行Meta分析。结果纳入的14篇文献中,共有1487例复发性流产患者被纳入研究。Meta分析结果显示:(1)提高总有效率[RR=1.27,I2=0%<50%,95%CI=(1.20,1.34),Z=8.84,P<0.00001<0.05],提高妊娠成功率[RR=1.38,I2=0%<50%,95%CI=(1.22,1.56),Z=5.09,P<0.00001<0.05],改善中医证候积分[SMD=-5.19,95%CI=(-5.77,-4.62),Z=17.68,P<0.00001<0.05],缩短阴道流血时间[SMD=-2.67,95%CI=(-4.11,-1.22),Z=3.62,P=0.0003<0.05]等方面试验组(中西药组)优于对照组,两组比较,差异有统计学意义。(2)提高孕6周HCG水平[SMD=1743.28,95%CI=(-2357.89,5845.46),Z=0.83,P=0.40>0.05]、孕8周HCG水平[SMD=-456.27,95%CI=(-1053.97,141.44),Z=1.50,P=0.13>0.05]、孕10周HCG水平[SMD=-394.10,95%CI=(-905.47,117.26),Z=1.51,P=0.13>0.05],提高孕6周孕酮水平[SMD=-4.47,95%CI=(-57.21,48.27),Z=0.17,P=0.87>0.05]、8周孕酮水平[SMD=16.93,95%CI=(-20.41,54.27),Z=0.89,P=0.37>0.05]、孕10周孕酮水平[SMD=-0.20,95%CI=(-5.00,4.60),Z=0.08,P=0.93>0.05],缩短腰部胀痛症状消失时间[SMD=-2.27,95%CI=(-4.63,0.09),Z=1.89,P=0.06>0.05],缩短小腹胀痛症状消失时间[SMD=-2.01,95%CI=(-4.03,0.00),Z=1.96,P=0.05]等方面试验组(中西药组)与对照组(西药组)比较,差异无统计学意义。结论文章系统地检索中药联合孕激素治疗复发性流产的随机对照试验和半随机对照试验,总结临床研究的证据现状,并比较中西药与西药或中药的疗效和安全性,对复发性流产的治疗方法进行评估,以便为临床实践提供高水平的循证医学证
Objective To systematically evaluate the clinical value of Chinese medicine combined with progesterone in the treatment of recurrent abortion.Methods The author uses evidence-based medicine,the electronic databases retrieved by computer include full-text journal database of CNKI,WEIPU Chinese science and technology journal database,Wan fang database,Chinese biomedical literature database,Pub Med medical literature retrieval service system.Each database is searched from the database established until December 31,2020.According to the literature inclusion criteria and exclusion criteria,the research literature was strictly screened.(1)The methodological quality of the included 14 articles was evaluated by the Cochrane risk bias assessment tool;(2)The included randomized controlled trials were meta-analyzed by RevMan 5.3 software.Results Among the 14 articles included,a total of 1487 patients with recurrent miscarriage were included in the study.Meta analysis results showed:(1)Improve the total effective rate[RR=1.27,I2=0%<50%,95%CI=(1.20,1.34),Z=8.90,P<0.00001<0.05],and increase the pregnancy success rate[RR=1.38,I2=0%<50%,95%CI=(1.22,1.56),Z=5.09,P<0.00001<0.05],improve TCM syndrome score[SMD=-5.19,95%CI=(-5.77,-4.62),Z=17.68,P<0.00001<0.05],shorten vaginal bleeding time[SMD=-2.27,95%CI=(-4.11,-1.22),Z=3.62,P=0.0003<0.05].The test group(Chinese and Western medicine group)is better than the control group in other aspects,and the difference between the two groups is statistically significant.(2)Increase HCG level at 6 weeks of pregnancy[SMD=1743.28,95%CI=(-2357.89,5845.46),Z=0.83,P=0.40>0.05].HCG level at 8 weeks of pregnancy[SMD=-456.27,95%CI=(-1053.97,141.44),Z=1.50,P=0.13>0.05].HCG level at 10 weeks of pregnancy[SMD=-394.10,95%CI=(-950.47,117.26),Z=1.51,P=0.13>0.05],increase the level of progesterone at 6 weeks of gestation[SMD=-4.47,95%CI=(-57.21,48.27),Z=0.17,P=0.87>0.05],and increase the level of progesterone at 8 weeks[SMD=16.93,95%CI=(-20.41,54.27),Z=0.89,P=0.37>0.05],progesterone level at 10 weeks of gestat
作者
刘宇
韩松雪
王玉英
王慧杰
LIU Yu;HAN Song-xue;WANG Yu-ying;WANG Hui-jie(Department of Traditional Chinese Medicine,Chaoyang District Maternal and Child Health Hospital,Beijing 100021;Department of Guoyi Clinic,Beijing University of Chinese Medicine,Beijing 100029)
出处
《世界中西医结合杂志》
2021年第8期1411-1420,共10页
World Journal of Integrated Traditional and Western Medicine
基金
王玉英全国名老中医传承工作室。
关键词
复发性流产
中药
孕激素
系统评价
Recurrent Abortion
Traditional Chinese Medicine
Progesterone
Systematic Review
