补肾法对体外受精-胚胎移植长方案超促排卵患者子宫内膜容受性影响的Meta分析

Meta-Analysis of the Effect of Kidney-Tonifying Method on the Endometrial Receptivity of Patients with Long Program in IVF-ET Hyperstimulation

目的基于目前的证据系统评价补肾法对体外受精-胚胎移植(IVF-ET)长方案超促排卵患者子宫内膜容受性影响。方法检索中国知网(CNKI)、中文科技期刊数据库(维普)、中国学术期刊数据库(万方)、PubMed、EMbase、Ovid,纳入的RCT研究,试验组是补肾中药联合西药长方案超促排卵患者,对照组是西药长方案或安慰剂联合西药长方案超促排卵的患者,由两名评价员按Cochrane手册标准独立对文献资料进行提取、质量评价,采用RevMan5.3软件进行数据合成和Meta分析。结果入选文献12篇,共950病例。试验组与对照组子宫动脉血流阻力指数(RI)(MD=-0.05,95%CI:-0.06,-0.04,P<0.00001),子宫动脉血流搏动指数(PI)(MD=-0.20,95%CI:-0.34,-0.07,P=0.03),子宫内膜下血流RI(MD=-0.09,95%CI:-0.13^-0.06,P<0.00001),子宫内膜下血流PI(MD=-0.12,95%CI:-0.18^-0.07,P<0.0001),临床妊娠率(OR=2.31,95%CI:1.75~3.05,P<0.00001)。结论补肾法可增加IVF-ET长方案超促排卵患者的子宫内膜厚度,改善子宫内膜血流,从而提高子宫内膜容受性,提高临床妊娠率。

Objective Based on the current evidence,systematically evaluate the effect of the kidney-tonifying method on the endometrial receptivity of patients with in vitro fertilization-embryo transfer(IVF-ET)long-term hyperstimulation.Methods Search Chinese Knowledge Resource Database(CNKI),Chinese Science and Technology Periodical Database(VIP),Chinese Academic Journal Database(Wanfang),CBM China Biomedical Literature Database,Pubmed,Embase,Medline,Cochranelibrary.In the RCT study included,the experimental group was a patient with tonifying Chinese medicine combined with western medicine,and the control group was treated with Western medicine long-term regimen or placebo combined with Western medicine long program ovulation.Two reviewers independently extracted the literature data according to the Cochrane manual criteria,evaluated the quality,perform data synthesis and meta-analysis using Rev Man5.3 software.Results Twelve articles were selected,a total of 950 cases.The results shows that the uterine artery blood flow RI(MD=-0.05,95%CI:-0.06,-0.04,P<0.00001),uterine artery blood flow PI(MD=-0.20,95%CI:-0.34,-0.07,P=0.03),subendometrial blood flow RI(MD=-0.09,95%CI:-0.13^-0.06,P<0.00001),subendometrial blood flow PI(MD=-0.12,95%CI:-0.18^-0.07,P<0.0001),clinical pregnancy rate(OR=2.31,95%CI:1.75~3.05,P<0.00001).Conclusion The tonifying kidney method can increase the endometrial thickness of patients with long program in IVF-ET superovulation and improve endometrial blood flow,thereby improving endometrial receptivity and improving clinical pregnancy rate.