中医治疗不孕不育疗效的Meta分析

Meta-analysis of the Curative Effects of Traditional Chinese Medicine Therapy on Infertility

目的:评价中医治疗不孕不育的临床疗效及安全性。方法:计算机检索中国知识期刊网、万方数据库、Wiley、Pub Med中关于不孕不育中医治疗的随机对照试验(RCT),同时筛检纳入文献的参考文献。文献检索起止时间均从建库至2014年1月。由2名研究者按纳入与排除标准选择文献、评价质量、提取资料并交叉核对,采用Review Manager 4.2软件进行Meta分析,采用优势比(比值比)作为效应合并指标。结果:共纳入10个RCT,972例病例。质量评价结果显示,10个研究中4-7分2个,1-3分8个,试验质量普遍偏低,未发现双盲试验。Meta分析结果显示,中医治疗不孕不育患者后妊娠率、As Ab转阴率、治愈率及有效率与对照组比较,差异均有统计学意义(P<0.05)。结论:Meta分析提示中医药方法对治疗不孕不育患者有效。受纳入研究质量与数量的限制,上述结果尚待更多高质量的研究来证实。

Objective： To evaluate the clinical curative effects and its safety of traditional Chinese medicine therapy on in-fertility. Methods： All the randomized controlled trials（RCTs） of traditional Chinese medicine therapy for infertility from CNKI,Wan Fang database, Wiley and Pub Med were searched, from built-up time to January 2014. At the same time we screened into the references of the literature. The quality of the included RCTs was critically appraised and the data were extracted by two reviewers independently. Review Manager 4.2 was used in the statistical analysis.Meta-analysis was conducted combining the odd radios of the individual studies. Results：10 RCTs involving 972 patients met the inclusion criteria. Quality evaluation results showed that 2 were 4-7 scores, 8 were 1-3 scores. All of the trials were not adequate enough in methodological quality. None of them was double-blind trial. The result of Meta-analysis indicated that, compared with the control group, traditional Chinese medicine therapy could raise the pregnancy rate, negative conversion rate, cure rate and total clinical effective rate, the obvious effective rate and the effective rate. Conclusion： The clinical evidence derived from the analysis suggests that traditional Chinese medicine therapy is effective for infertility patients. But a final conclusion needs further exploration due to the lower quality of RCTs.