桂枝茯苓丸防治米非司酮配伍米索前列醇药物流产后阴道出血的系统评价

Guizhi Fuling pill using for vaginal hemorrhage after drug abortion by Mifepristone concomitant with Misoprostol: a systematic review and meta- analysis

目的评估桂枝茯苓丸防治米非司酮配伍米索前列醇药物流产后阴道出血的临床疗效和安全性。方法检索Medline（1978—2015）、CBMdisc（1978～2015）、CNKI（1980—2015）、VIP（1989～2015）文献资料，治疗组采用桂枝茯苓丸，对照组采用缩宫剂或空白对照。纳入试验的方法学质量由两位评价员独立评价，采用RevMan4．2．10软件作Meta分析。结果共纳入10篇随机对照试验，Meta分析显示，与空白对照相比，桂枝茯苓丸能够显著提高完全流产率[RR=1．09，CI95％（1．06，1．12）]（P〈0．05）；能够显著减少阴道流血时间[WMD=-4．82，CI95％（-5．89，-3．75）]（P〈0．05）。有研究显示，桂枝茯苓丸较催产素更能提高完全流产率，有恶心、呕吐不良反应报道。结论在服用米索前列醇之后服用桂枝茯苓丸能够提高药流完全流产率、减少完全流产后阴道出血时间。

Objective To evaluate the clinical efficacy and safety of Guizhi Fuling pill in treatment of vaginal hemorrhage after drug abortion by Mifepristone and Misoprostol. Methods Literatures in MEDLINE（ 1978 -2015）, CBM disc （1978 -2015 ） , CNKI （1980 - 2015）, VIP （1989 - 2015） were searched. Treatment group were treated by Guizhi Fuling pill, control group using oxytocin or blank control. The methodological quality of the included studies was evaluated independently by two reviewers, using RevMan4.2. 10 software for Meta analysis. Results A total of 10 randomized controlled trials were included in the study, Meta analysis showed that compared with the blank control, Guizhi Fuling pill can significantly improve the rate of complete abortion [ RR = 1.09, CI 95 % （ 1.06, 1.12） ], （P 〈 0. 05） and significantly reduce the time of vaginal bleeding 9WMD = - 4. 82, CI95 % （ - 5.89, - 3.75 ） ], （P 〈 0. 05）. One research shows Guizhi Fuling pill can increase the rate of complete abortion compared with Oxytocin. There were nausea and vomiting adverse reactions being reported. Conclusion Guizhi Fuling pill appeared to increase the complete abortion rate and shorten the vaginal bleeding time.