达英-35与克罗米芬治疗多囊卵巢综合征(PCOS)疗效Meta分析

Meta-analysis on the Effect of Diane-35 and Clomiphene in the Treatment of Polycystic Ovar Syndrome(PCOS)

目的综合评估达英-35与克罗米芬对多囊卵巢综合征(PCOS)的治疗效果。方法通过检索国内外数据库2006年1月—2016年5月达英-35与克罗米芬治疗PCOS的病例对照研究文献,制定文献的纳入和剔除标准,对文献进行严格筛选,运用Meta分析对纳入文献进行定量综合分析。结果纳入文献13篇,克罗米芬与达英-35在降低睾酮(T)(WMD-3.19,CI95%-8.82,2.45)、黄体生成素(LH)(WMD-2.82,CI95%-7.54,1.90)、促卵泡激素(FSH)(WMD-0.34,CI95%-3.44,2.77)方面三者差异无统计学意义,但在受孕妊娠率方面达英-35(55%)优于克罗米芬(52.5%)。二者联合应用在降低T(WMD-1.35,CI95%-1.79,-0.91)、LH(WMD-4.31,CI95%-6.89,-1.72)、LH/FSH(WMD-0.70,CI95%-0.83.-0.56)和提高排卵率(80.93%)及妊娠率(63.15%)等方面优于单独使用克罗米芬(50.89%,31.87%),但在降低FSH(WMD-0.96,CI95%-2.45,0.62)、雌二醇(E2)(WMD-0.95,CI95%-7.04,5.13)水平两者差异无统计学意义。结论达英-35在提高妊娠率方面优于克罗米芬,但克罗米芬降低T方面效果更加显著,二者联合应用具有最佳效果。

Objective To evaluate the efficacy of Diane-35 and clomifene synthetically for treating polycystic ovary syndrome(PCOS). Methods Published studies about Diane-35 and clomifene for treating PCOS in recent 10 years January 2006 to May 2016 were collected by searching data base at home and aboard according to strict inclusion and exclusion criteria of Meta-analysis. And the studies were analyzed synthetically. Results Thirteen studies were adopted.Diane-35 and clomifene are no difference in reducing serum levels of testosterone(T)(WMD-3.19,CI95%-8.82,2.45)、luteinizing hormone(LH)(WMD-2.82,CI95%-7.54,1.90) and follicle-stimulating hormone(FSH)(WMD-0.34,CI95%-3.44,2.77),while Diane-35 is superior to increase pregnancy rate(55%) than clomifene(52.5%).Diane-35 combined with clomifene has obvious effect on reducing T(WMD-1.35, CI95%-1.79,-0.91)、LH(WMD-4.31,CI95%-6.89,-1.72)、LH/FSH(WMD-0.70,CI95%-0.83.-0.56) and increasing ovulation rate(80.93%)as well as pregnancy rate(80.93%) both better than clomifene(50.89%,31.87%)alone,while the combined one have no effective effect on reducing serum levels of FSH(WMD-0.96,CI95%-2.45,0.62) and estradiol(E2)(WMD-0.95,CI95%-7.04,5.13). Conclusion Diane-35 is superior in increasing pregnancy rate than clomifene, but inferior to in reducing T. And the combination could have more comprehensive efficacy.