补肾化痰中药治疗多囊卵巢综合征胰岛素抵抗的Meta分析

A Meta-analysis on the treatment of insulin resistance in polycystic ovary syndrome by Bushen Huatan recipe

目的:系统评价补肾化痰中药对比二甲双胍治疗多囊卵巢综合征胰岛素抵抗的有效性及安全性。方法:网络检索知网数据库、维普网、万方数据知识服务平台、中国生物医学文献服务系统、考克兰数据库、Web of Science数据库、PubMed、Embase数据库,时间限定为从建库至2019年12月8日。查找补肾化痰中药与二甲双胍对比治疗多囊卵巢综合征胰岛素抵抗的随机对照试验。采用RevMan5.3软件进行Meta分析。结果:最终纳入5项随机对照试验,共285例PCOS合并胰岛素抵抗患者。本次Meta分析结果显示:(1)补肾化痰中药组与二甲双胍组在改善促黄体生成素(LH)[WMD=-2.68,95%CI(-6.21,0.84),P=0.14]、卵泡刺激素(FSH)[WMD=0.36,95%CI(-0.59,1.32),P=0.45]、LH/FSH[WMD=-0.29,95%CI(-1.06,0.48),P=0.46]、空腹血糖(FPG)[WMD=0.05,95%CI(-0.18,0.28),P=0.67]、空腹胰岛素(FINS)[WMD=-0.91,95%CI(-15.28,13.46),P=0.9]方面,差异无统计学意义;(2)中医证候评分:补肾化痰中药组[WMD=-3.10,95%CI(-5.39,-0.81),P=0.008]优于二甲双胍组;(3)临床总有效率:补肾化痰中药组[RR=1.50,95%CI(1.18,1.92),P=0.001]优于二甲双胍组。结论:相比较二甲双胍,补肾化痰中药能有效改善PCOS合并胰岛素抵抗患者的临床症状,降低中医证候评分,提高临床治疗总有效率,且安全性高,在改善性激素及糖代谢方面两者无显著差异,临床应用价值高。

Objective:To systematically evaluate the efficacy and safety of Bushen Huatan Recipe in the treatment of insulin resistance in polycystic ovary syndrome(PCOS).Methods:Researches were reviewed by searching the China National Knowledge Infrastructure(CNKI),VIP network,WanFang database,SinoMed,Cochrane Library,Web of Science,PubMed and Embase up to December 8,2019.We retrieved the RCTs of Bushen Huatan recipe and metformin in the treatment of insulin resistance in polycystic ovary syndrome and applied Revman5.3 software for meta analysis.Results:A total of 5 RCTS were included,with a total of 285 PCOS patients.The results of meta-analysis showed:①LH[WMD=-2.68,95%CI(-6.21,0.84),P=0.14],FSH[WMD=0.36,95%CI(-0.59,1.32),P=0.45],LH/FSH(WMD=-0.29,95%CI(-1.06,0.48),P=0.46),fasting blood glucose(FPG)[WMD=0.05,95%CI(-0.18,0.28),P=0.67],fasting insulin(FINS)[WMD=-0.91,95%CI(-15.28,13.46),P=0.9],the differences were not statistically significant.②TCM syndrome score:Bushen Huatan recipe group[WMD=-3.10,95%CI(-5.39,-0.81),P=0.008]was better than metformin group;③Total clinical effective rate:Bushen Huatan recipe group[RR=1.50,95%CI(1.18,1.92),P=0.001]was better than the Metformin group.Conclusion:Bushen Huatan recipe has the same effect as metformin in improving the sex hormones and glucose metabolism of patients with PCOS complicated with insulin resistance,and can effectively improve the clinical symptoms of patients,reduce TCM syndrome score,and improve the total therapeutic efficiency.