中药治疗女童性早熟有效性及安全性的系统评价

A Systematic Review on Treatment of Female Precocious Puberty with Traditional Chinese Medicine

目的:评价应用中医疗法治疗女童性早熟的有效性及安全性。方法:通过计算机检索Cochrane Library、Pub Med、Web of Science(ISI)、中国生物医学数据库(CBM)、中国期刊全文数据库(CNKI)、维普数据库(VIP)和万方数据知识服务平台,搜集所有国内外有关中药治疗女童性早熟的随机病例对照研究(RCT)相关文献并进行Meta分析。结果:符合纳入标准的文献共12篇,合计921例女童性早熟患儿。中药治疗组在总有效率(OR=1.14,95%CI=0.19~3.13,P=0.51)、子宫发育水平(SMD=0.16,95%CI=-0.56~0.88,P=0.66)、卵巢发育水平(SMD=-0.24,95%CI=-1.02~0.53,P=0.54)、乳腺发育水平(SMD=1.02,95%CI=-0.12~2.17,P=0.08)、卵泡刺激素(FSH)(SMD=-0.89,95%CI=-2.15~0.37,P=0.17)和雌二醇(E2)(SMD=0.22,95%CI=0.00~0.44,P=0.05)的疗效与西药对照组比较差异无统计学意义。两组在骨龄差/年龄差(SMD=-1.83,95%CI=-0.22^-0.68,P=0.002)和黄体生成素(LH)(SMD=-1.36,95%CI=-2.60~0.13,P=0.03)的疗效合并效应量差异有统计学意义,中药治疗组疗效优于西药对照组。两组不良反应均较少,且在停药或对症处理后均可恢复正常。结论:中药治疗女童性早熟疗效确切,安全可靠。

Objective： To evaluate the effect and security on treatment of female precocious puberty with traditional chinese medicine （TCM）. Methods： Computer was used to search Cochrane Library, PubMed, Web of Science （ISI）, Chinese Bio-medicine Database （CBM）, China Journal Full-text Database （CNKI） , VIP database （VIP） and Wanfang database. All of the randomized controlled trials （RCTs） at home and abroad about TCM in the treatment of female precocious puberty were collected and carried out by Meta-analysis. Resets： Twelve RCTs were included and totally 921 patients. There were no statistic differences between the TCM group and Western medicine （WM） group about the total effective rate （ OR = 1.14, 95% CI = 0.19 - 3.13, P = 0.51 ）, the uterine development level （SMD =0.16, 95% CI = -0.56 - O. 88, P = 0.66）, the ovarian development level （ SMD = -0.24, 95% CI = - 1.02 - 0.53, P = 0. 54）, the breast development level （ SMD = 1.02, 95 % CI = -0.12 - 2.17, P = 0.08 ）, the follicle-stimulating hormone （ FSH ） in serum （SMD =-0.89, 95% CI = - 2. 15 ～ 0.37, P = 0. 17 ） and the content of estradiol （ E2 ） in serum （ SMD = O. 22, 95% CI = O. 130 ～ 0.44, P = 0.05）. Between the two groups, the therapeutic effect was better than treatment before on the bone age difference/ chronological age difference value （SMD =- 1.83, 95% CI=-0.22 ～-0.68, P = 0. 002） and the content of luteinizing hormone （LH） in serum （SMD =- 1.36, 95% CI =-2.60 ～ 0.13, P = O. 03 ）, and there were significant statistical differences between them. There were few side effects in the two groups. By symptomatic treatment or stopping drugs, almost all of the side effects in the two groups can be recovered. Conclusion： It＇s safe and effective to treat female precocious puberty with TCM.