中西医结合治疗先兆流产的系统评价

Efficacy and Safety of Integration of Traditional Chinese and Western Medicine for Treating Threatened Abortion: A Systematic Review

目的:评价中西医结合治疗先兆流产的疗效与安全性。方法:计算机检索中国学位论文全文数据库,维普数据库,MEDLINE;手工检索纳入试验的所有参考文献,比较中西医结合治疗与单纯用中药或西药治疗的随机对照试验。对纳入研究的文献质量进行方法学评价、Meta分析。结果:共纳入18个包括2517例病人的RCT,但其方法学质量均不高,且采用不同的中西医结合方法或对照,故对其进行单独描述。多数文献显示,中西医结合对总有效率的疗效优于单用西药或中药;个别文献显示中西医结合对β-HCG、P、E2值以及中医证候疗效的治疗效果优于单用西药或中药;共6篇文章报道了副作用这项指标,且均未发现明显毒副作用。结论:现有的临床资料表明,中西医结合治疗先兆流产更有效,但试验在随机、双盲、随访等方面有欠缺,要设计更加完善的随机对照试验进一步证实其疗效。

Objective To assess the efficacy and safety of integration of traditional chinese and western medicine for treat- ing threatened abortion. Methods Databases included：Full paper database of Chinese excellent dissertations by doctors and masters,VIP, MEDLINE.Reference lists of trials were handsearched.Published Randomized controlled trials（RCTs） whether blind or unblind.Treatment was integration of traditional chinese and western medicine.Controls were traditional chinese medicine （TCM）and western medicine.Data were extracted independently by two reviewers and meta-analysis was performed by RevMan 4.2 softwar. Results 18 RCTs involving 2517 patients were included,all of which were poor in methodological quality. Because of different therapies in the treatment and control groups,the results of outcome were described separately. Most of included studies suggested that the effects of integration of traditional chinese and western medicine on general effect were better than TCM and western medicine.A few studies showed that integration of traditional chinese and western medicine has better ef- fects in numerics of β-HCG,P,E2 and TCM efficacy.Six studies mentioned side-effects and no obvious side-effects were reported. Conclusions Integration of traditional chinese and western medicine may work well in treating threatened abortion. However,the evidence is to weak to draw a conclusion for there are deficiencies in strict randomization,blinding and follow- up,more strictly designed, randomized controlled trials are required.