中医药治疗人流术后月经过少的Meta分析

Meta analysis of TCM therapy for oligomenorrhea after induced abortion

目的系统评价中医药治疗月经过少的临床疗效及安全性。方法收集近10年来中医药治疗人流术后月经过少的随机临床对照试验文献,应用Meta分析方法的纳入、排除标准进行严格筛选,对纳入文献进行定量综合分析。结果共纳入文献12篇,包括903例人流术后月经过少患者,其中治疗组478例,对照组425例。Meta分析结果显示,中医药治疗组的总有效率明显高于西医药治疗组(OR为3.78,95%CI[2.29,6.23],Z=5.20,P<0.000 01);同样,在总有效率、治愈率、内膜厚度改善方面均比西医药治疗有优势(P<0.05),且中药不良反应较少,复发率较低。但这一结果是建立在纳入文献可能存在发表性偏倚和低质量研究的定量综合分析基础上的。结论 1)中医药治疗人流术后月经过少有较大的优势;2)现阶段研究文献可能欠严谨,需要更多高质量的临床随机对照文献。

Objective To evaluate the clinical effect and safety of Traditional Chinese medicine（ TCM） therapy for oligomenorrhea after artificial abortion. Methods The randomized controlled trials（ RCTs） literatures of TCM for Oligomenorrhea after artificial abortion within 10 years were collected. They were strictly screened according to the inclusion and exclusion criteria of Meta analysis. A comprehensive and quantitative analysis of the literature was made. Results There are 903 cases of oligomenorrhea after artificial abortion in all 12 documents,of which 478 cases in treatment group and 425 cases in control group. The Meta-analysis showed that the total effective rate of TCM treatment group was significantly higher than that of the Western medicine control group（ OR is 3. 78,95% CI [2. 29,6. 23],Z = 5. 20,P〈0. 000 01）; At the same time,TCM treatment is more effective than Western medicine treatment in terms of total efficiency,cure rate and improvement of endometrial thickness（ P〈0. 05） with fewer side reaction and lower recurrence rate. However,this result maybe based on the inclusion of publication bias and low quality research literature that are comprehensive quantitative analysis. Conclusion 1） TCM for oligomenorrhea after artificial abortion has a few higher advantages; 2） The current research literature may be not strict. We need more high quality RCTs research papers.