柴胡疏肝散治疗乳腺增生临床Meta分析

Meta Analysis of Chaihu Shugan Powder in the Treatment of Hyperplasia of Mammary Glands

目的：探讨柴胡疏肝散治疗乳腺增生的临床循证医学分析。方法：研究检索2005年12月—2016年12月发表的关于柴胡疏肝散治疗乳腺增生的随机对照研究,通过电子与手工检索,以＂柴胡疏肝散＂为关键词初步检索,再以＂乳腺增生＂或＂乳癖＂为关键词二次检索,检索范围：中国期刊全文数据库CNKI、维普、万方、pubmed等数据库,制定研究文献的纳入、排除标准,采用改良Jadad量表评定文献质量,确定本次研究疗效判定指标为临床痊愈和有效,采用Co-chrane协作网Review Manager 5.3软件进行统计分析。结果：本次研究最终得到8篇关于柴胡疏肝散治疗乳腺增生的随机对照研究,临床痊愈率方面：异质性检验χ2=8.47,P=0.29〉0.05,I2=17%,说明同质性较好,故采用固定效应模型,合并效应量OR=2.13,Z=5.23（P〈0.00001）,95%CI（1.60,2.82）,说明柴胡疏肝散治疗乳腺增生时,临床痊愈率具有明显的优势;临床有效率方面：异质性检验χ2=1.71,P=0.97〉0.05,I2=0,说明同质性较好,故采用固定效应模型,合并效应量OR=4.24,Z=6.43（P〈0.00001）,95%CI（2.73,6.58）,说明柴胡疏肝散治疗乳腺增生时,临床有效率具有明显的优势。结论：临床数据证明柴胡疏肝散治疗乳腺增生时,临床痊愈率和有效率显著增高,由于随机对照试验研究质量普遍较低,样本量有限,确切疗效仍需更多设计合理、高质量的RCT文献来进一步验证。

Objective：To investigate the Meta analysis of Chaihu Shugan powder in the treatment of hyperplasia of mammary glands. Methods：Literature of randomized and controlled of treatment of breast hyperplasia from December 2005 to December 2016 were selected by electronic or manual,and＂Chaihu Shugan San＂as keywords preliminary retrieval,and＂hyperplasia＂or＂Rupi＂as keywords as keywords retrieval in the scope of Chinese Journal Full-text Database,VIP,CNKI,Wan Fang,Pub Med and other databases,making the research literature inclusion and exclusion criteria,using a modified Jadad scale evaluation of literature quality,determine the research outcome for clinical cure and effective,by the Co-chrane collaboration Review Manager 5.3 software for statistical analysis. Results：8 literatures of randomized and controlled of treatment of breast hyperplasia were selected,and the comparison of heterogeneity test in clinical cure rate was χ2=8.47,P=0.290.05,I2=17%,shows good homogeneity,so we use the fixed effect model,the combined effect of the amount of OR=2.13,Z=5.23（P〈0.00001）,95% CI（1.60,2.82）,that CHSGS treatment of breast hyperplasia,has obvious advantages in clinical cure rate. The comparison of clinical efficiency of heterogeneity test was χ2=1.71,P=0.970.05,I2=0,showed homogeneity,so we use the fixed effect model,the combined effect of the amount of OR=4.24,Z=6.43（P〈0.00001）,95%CI（2.73,6.58）,means clinical efficiency has obvious advantages. Conclusion：The clinical data demonstrate that CHSGS treatment of breast hyperplasia,clinical cure rate and effective rate increased significantly,due to the quality of the randomized controlled trial is generally low,limited sample size,the exact efficacy still needs more reasonable design,high quality RCT documents to verify.