摘要
目的分析针刺法联合微刺激促排卵治疗多囊卵巢综合征(PCOS)的疗效及其选穴规律。方法检索中国期刊全文数据库(CNKI)、维普信息资源系统(VIP)、万方学位论文数据库、PubMed数据库研究针刺联合克罗米芬(CC)促排卵治疗PCOS的临床文献,检索时间为2005年1月1日至2017年1月1日。建立PCOS患者针灸处方数据库并进行描述性分析及聚类分析;对针刺联合CC治疗与单纯CC治疗PCOS疗效比较的随机对照研究进行Meta分析。结果共纳入5篇随机对照研究,共861例患者。Meta分析结果显示,针灸联合CC治疗PCOS的排卵率(65.48%)及妊娠率(43.92%)均优于单纯CC治疗(52.42%、19.27%),差异有统计学意义[RR=0.15,95CI%(0.09,0.21),P<0.01;RR=0.25,95CI%(0.13,0.37),P<0.01]。纳入25篇文献进行描述性分析,结果显示,选择频次最高的穴位为气海、三阴交、中极;任脉的穴位及脾经、胃经穴位选用最多。聚类分析得出3个有效聚类群及6组常用对穴。结论针灸联合CC治疗的排卵率和妊娠率优于单纯CC治疗,常用穴位分布在病位局部,重视局部和下肢及背部的配合,可为临床治疗提供参考。
Objective To explore the efficacy of treatment with acupuncture therapy plus clomiphene citratre(CC)for ovulation induction in patients with polycystic ovary syndrome(PCOS),and analyse its acupoint selection rules.Methods Databases,including CNKI,VIP,Wanfang data and PubMed,were searched from 1 st January 2005 to 1 st January 2017 to collect clinical literatures about the treatment of ovulation induction in patients with PCOS by the combination therapy of acupuncture and CC.The acupuncture prescription database for patients with PCOS was established,and descriptive analysis and cluster analysis were performed to analyse the acupoint selection rules.The randomized controlled trails(RCTs)about efficacy comparison between combination therapy of acupuncture and CC and CC therapy were collected,and a meta analysis was carried out in RevMan5.3 software.Results A total 5 RCT studies were included,involving 861 cases.The meta analysis showed the rates of ovulation(65.48%)and pregnancy(43.92%)in patients with PCOS treated with combination therapy of acupuncture and CC were higher than those of patients only received CC therapy(52.42%,19.27%),there were statistically significant differences[RR=0.15,95 CI%(0.09,0.21),P〈0.01;RR=0.25,95 CI%(0.13,0.37),P〈0.01].A total of 25 literatures were collected for descriptive analysis.The results showed that Qihai,Sanyinjiao,Zhongji were the highest frequency acupoints selected in the treatment of ovulation induction in patients with PCOS.The acupoints from the Ren meridians and the stomach meridian were commonly used.Three effective clustering groups and six high frequency used paired points were obtained by cluster analysis.Conclusion The rates of ovulation and pregnancy of PCOS patients received combination therapy of acupuncture and CC are better than those of patients only treated with CC.Commonly used acupoints are distributed in lesions,combined with acupoints on lower limbs and back,which can provide references for clinical acupuncture therapy.
作者
王薇
付先芸
肖雅雯
杨玉松
WANG Wei;FU Xianyun;XIAO Yawen;YANG Yusong(Traditional Chinese Clinical Medical Science College,China Three Gorges University/Yichang Municipal Hospital of Traditional Chinese Medicine,Yichang,Hubei 443003,China;Medical College,China Three Gorges University,Yichang,Hubei 443000,China)
出处
《重庆医学》
CAS
2018年第18期2440-2443,2448,共5页
Chongqing medicine
基金
三峡大学人才科研启动基金项目(KJ2013B051)
湖北省卫生厅一般科研项目(KJ2017QT007)
关键词
针刺疗法
克罗米芬
排卵诱导
选穴规律
系统评价
polycystic ovary syndrome;acupuncture therapy;clomiphene citratre;ovulation induction;acupoint selection rule;systematic review