补肾法治疗少弱精症的系统评价

Efficacy of Tonifying Kidney on Oligozoospermia and Asthenozoospermia Treatment: A Systematic Review

目的:系统评价补肾法治疗少弱精症的疗效及安全性。方法:检索建库至2016年9月CBM、CNKI、The Coc hrane Library、Pub Med等中英文数据库中补肾法治疗少弱精症的随机/半随机对照试验,运用Rev Man 5.3对临床结局指标进行Meta分析或描述性分析。结果:共纳入30项临床研究,共3699例患者。与对照组相比,在补肾填精法治疗基础上,分别加用肾阴阳双补法、温补肾阳法、补肾祛湿法、补益脾肾法或补肾活血法可显著提高患者临床有效率(P≤0.05),而补肾疏肝法则无明显差异(P>0.05);此外,在补肾填精法治疗基础上,加用肾阴阳双补法、温补肾阳或补肾祛湿法可显著提高患者配偶妊娠率(P≤0.05),而补肾活血和补肾疏肝法效果不明显(P>0.05)。在安全性方面,除1项临床试验外,其余治疗组不良反应发生率均低于对照组。结论:在补肾填精法基础上,加用肾阴阳双补法、温补肾阳法或补肾祛湿法治疗效果较佳,且安全性良好;其次为补益脾肾法或补肾活血法,而补肾疏肝法未显示出更多优势。

Objective： To investigate the clinical efficacy and safety of tonifying kidney for oligozoospermia and asthenozoospermia. Methods： Data bases including CBM, CNKI, The Cochrane Library and PubMed were searched until September, 2016. Rev Man 5.3 software was used for statistical analysis. Results： A total of 3699 patients from 30 studies were included eventually. Compared with control group, kidney-tonifying and essence-replenishing therapy combine with tonifying kidney Yin and Yang therapy, reinforcing kidney warming Yang therapy, eliminating dampness therapy, spleen and kidney reinforcing therapy, reinforcing kidney activating blood therapy separately improved the effective rate （P≤0.05）, but no significant difference in liver depression therapy （P〉0.05）. Tonifying kidney Yin and Yang therapy and reinforcing kidney warming Yang and eliminating dampness therapy improved the rate of spouses pregnancy （P≤0.05）, but reinforcing kidney activating blood and liver depression therapy showed no obvious effect （P〉0.05）. Treatment group showed lower adverse reactions than the control group, except one clinical trial. Conclusion： Kidney-tonifying and essence-replenishing therapy combine with tonifying kidney Yin and Yang therapy, reinforcing kidney warming Yang or eliminating dampness therapy are better, spleen and kidney reinforcing therapy, reinforcing kidney activating blood therapy may be efficacious, and safer than control group alone. But liver depression therapy did not show more advantages.