中西医结合治疗子宫内膜异位症系统评价

System Evaluation on Integrated Traditional Chinese and Western Medicine in Treatment of Endometriosis

目的:系统评价中西医结合方案治疗子宫内膜异位症的临床疗效。方法 :计算机检索维普数据库、清华同方数据库、万方数据库、VIP、CNKI数据库,并手工检索相关会议论文集及药厂资料等。按纳入与排除标准选择试验、提取资料并质量评价,采用Cochrane协作网提供的软件RevMan 5.0对数据进行Meta分析。结果 :对14篇研究的临床疗效合并效应量得检验:中西结合治疗组在痛经症状改善[WMD=3.50,95%CI(2.45,5.0),P<0.00001]、病灶结节的吸收[WMD=1.94,95%CI(1.41,2.67),P<0.0001]方面均优于单纯西药或中药治疗组,中西结合治疗组的不良反应明显少于单纯中药或西药组[RD=0.49,95%CI(0.37,0.66),P<0.00001]。结论 :现有临床研究表明,中西医结合方案治疗子宫内膜异位症有效改善痛经症状、促进病灶结节吸收,但由于纳入研究存在选择性偏倚和测量偏倚的高度可能性,势必影响结果的论证强度,因此期待更多高质量的随机双盲对照试验提供更高质量的证据。

Objective：To make a system evaluation on clinical curative effect of integrated traditional Chinese and Western medicine in treatment of endometriosis. Method： The computer retrieval in VIP database （ since data base established to 2012.8 ）, Qinghua Tongfang database （ since data base established to 2012.8 ）, Wanfang database （ since data bases established to 2012.8 ）, VIP （ since data bases established to 2012.8 ）, CNKI （ since data bases established to 2012.8 ）, and manual retrieval of relevant conference proceedings and pharmaceutical information were made.According to the inclusion and exchision criteria selection test, data extraction and Cochrane System Evaluation Handbook 5 editionwere used for RCT quality evaluation, and the Cochrane collaboration with software RevMan5.0 was used for data Meta-analysis.The results of the 14 studies clinical efficacy of effect of combination of Chinese traditional and Western medicine- inspection ： in the treatment group the symptoms of dysmenorrhea were improved[WMD=3.50,95%CI （ 2.45,5 ）, P〈0.00001], [WMD=1.94 lesions nodules on the absorption, 95%CI （ 1.41,2.67 ）, P〈0.0001]were better than that of simple western medicine or traditional Chinese medicine treatment group, treatment of Chinese and Western medicine group adverse reactions were significantly fewer than those of traditional Chinese medicine or western medicine group[RD=0.49,95%CI （ 0.37,0.66 ）, P〈0.00001]. Conclusion： The clinical studies show integrated traditional Chinese and Western medicine treatment of endometriosis dysmenorrheal and improve lesion nodules absorption, but due to the incorporation of selective bias and detection bias high probability, it is bound to affect the results proof, so more high quality randomized double-blind controlled trials are needed to provide more high quality evidence.