系统评价活血化瘀中药治疗异位妊娠疗效观察

Systematic reviews on efficacy and safety of the Huoxue Huayu prescription on ectopic pregnancy

目的:系统评价活血化瘀中药联合甲氨蝶呤(MTX)治疗异位妊娠(EP)的临床疗效及安全性。方法:计算机检索相关中英文数据库关于活血化瘀中药联合MTX治疗EP的随机对照试验(检索时间为2010年1月-2016年9月)。对符合纳入和排除标准的文献进行数据提取及方法学质量评价,采用RevMan 5.3软件进行Meta分析。结果:最终纳入文献46篇,共4406例患者。Meta分析结果示:MTX联合活血化瘀中药与单用MTX相比,联合用药组总有效率更高,患者的血β-HCG转阴时间、包块吸收时间、住院时间均比单用MTX组更短,且不良反应发生率更低。结论:现有证据显示活血化瘀中药联合MTX治疗EP的临床疗效及安全性优于单用MTX。受纳入文献质量和数量限制,活血化瘀中药联合MTX治疗EP的疗效及安全性期待更多高质量的随机对照研究,以作进一步评价。

Objective:To evaluate the clinical efficacy and safety of the Huoxue Huayu prescription plus methotrexateon ectopic pregnancy.Methods:Published papers about randomized controlled trials(RCTs)of HHP plus methotrexate onectopic pregnancy from January2010to September2016were searched from various databases.The Cochrane risk of biasmethod was used to assess the quality of the included studies,and a Meta-analysis was conducted with Review Manager5.3software.Results:46articles were involved;4406patients were included.The Meta-analysis positive results showed thatcompared to conventional therapy with methotrexate alone,HHP plus methotrexate was more effective in increasing thetotal efficiency.Positive results were also obtained for the combination treatment,the time ofβ-HCG turned negative,massabsorbed and hospitalization was shorter than MTX.Additionally,the integrative therapy can also decrease the incidence ofadverse reactions.Conclusions:Although the data was limited by methodological flaws in many studies,the evidence indicatedthe potential superiority of HHP plus methotrexate compared to methotrexate alone on ectopic pregnancy.However,to obtainstronger evidence without the drawbacks of trail design and the quality of studies,we recommend more large-scale and doubleblindRCTs to test the ef ficacy and safety of integrative treatment.