活血化瘀法治疗子宫内膜异位症的Meta分析

Meta-analysis of Treatment of Endometriosis with Method of Promoting Blood Circulation and Removing Blood Stasis

目的通过Meta分析探讨活血化瘀法治疗子宫内膜异位症的有效性及安全性。方法计算机检索CNKI、Wanfang、VIP、CBM、PubMed、Embase等中英文数据库,检索时间为自建库至2020年9月。由2名研究者检索活血化瘀法治疗子宫内膜异位症的随机对照试验,并进行文献筛选、数据提取、质量评价,使用RevMan 5.3统计软件对数据进行分析。结果共纳入18篇文献,共计患者1744例。Meta分析结果显示活血化瘀法联合常规西药疗法对比单纯常规西药疗法在临床总有效率(RR=1.21,95%CI[1.16,1.27],P<0.00001)、妊娠率(RR=1.71,95%CI[1.39,2.11],P<0.00001)、复发率(RR=0.44,95%CI[0.30,0.66],P<0.0001)、痛经VAS评分(WMD=-1.18,95%CI[-2.14,-0.22],P=0.02)等方面,差异均具有统计学意义。结论中医活血化瘀法能有效提高子宫内膜异位症的临床总有效率、妊娠率,降低复发率,缓解痛经,有望进一步临床推广。

Objective To evaluate the effectiveness and safety of the method of promoting blood circulation and removing blood stasis in the treatment of endometriosis.Methods The articles were retrieved by computer from the databases of CNKI,Wanfang,VIP,CBM,PubMed and Embase,dated from the time of establishment to September 2020.The data was searched,screened,extracted and evaluated by two researchers according to the standard.The data was analyzed by using Rev Man 5.3 software.Results A total of 18 articles were included in this study,with a total of 1744 patients.Meta-analysis results showed the treatment group was superior to the control group in effective rate(RR=1.21,95%CI[1.16,1.27],P<0.00001),pregnancy rate(RR=1.71,95%CI[1.39,2.11],P<0.00001),recurrence rate(RR=0.44,95%CI[0.30,0.66],P<0.0001)and dysmenorrhea VAS score(WMD=-1.18,95%CI[-2.14,-0.22],P=0.02).Conclusion The method of promoting blood circulation and removing blood stasis in traditional Chinese medicine can effectively improve the total clinical effective rate and pregnancy rate of patients with endometriosis,reduce the recurrence rate and alleviate dysmenorrhea,which is expected to be further popularized in clinic.