中西医结合治疗多囊卵巢综合征患者慢性低度炎症的Meta分析

Meta-analysis of clinical efficacy of integrated traditional Chinese and Western medicine on inflammatory factors in polycystic ovarian syndrome patients

目的:系统评价中西医结合治疗多囊卵巢综合征(Polycystic Ovarian Syndrome,PCOS)患者慢性低度炎症的有效性。方法:检索国内外主要期刊数据库中有关中西医结合治疗对比单纯西药治疗PCOS的临床随机对照试验,采用Cochrane手册中的偏倚风险评估工具评价文献质量,采用RevMan 5.4统计软件进行Meta分析,以评价其有效性。结果:共纳入13项研究,包括1124例患者。Meta分析结果显示,与单纯西药治疗相比,中西医结合治疗PCOS患者总有效率较好[OR=4.00,95%CI(2.72,5.89),P<0.00001];能有效降低患者血清白细胞介素-6(Interleukin-6,IL-6)[MD=-4.94,95%CI(-6.26,-3.63),P<0.00001]、C反应蛋白(C-reactive Protein,CRP)[MD=-1.20,95%CI(-1.67,-0.74),P<0.00001]和肿瘤坏死因子-α(Tumor Necrosis Factorα,TNF-α)[MD=-8.64,95%CI(-11.34,-5.94),P<0.00001]水平,显著优于单纯西药治疗(P<0.05)。结论:中西医结合治疗PCOS及其慢性低度炎症较单纯西医治疗具有一定的优势,且安全不良反应小,值得运用与推广。

Objective:To systematically review the efficacy of integrated traditional Chinese and western medicine on inflammatory factors in polycystic ovarian syndrome(PCOS)patients.Methods:We searched the the main domestic and oversea databases to collect randomized controlled trials(RCTs)on the efficacy of integrated traditional Chinese and Western medicine on inflammatory factors in PCOS.Tools for analysis of bias recommended by Cochrane Reviewer’s Handbook was used for the evaluation of the quality of the literatures,and RevMan 5.4 was adopted for the data extract and meta-analysis.Results:A total of 13 RCTs involving 1124 patients were included.The results of meta-analysis showed that compared with controlled group,integrated traditional Chinese and Western medicine therapy could reduce the level of IL-6[MD=-4.94,95%CI(-6.26,-3.63),P<0.00001],CRP[MD=-1.20,95%CI(-1.67,-0.74),P<0.00001]and TNF-α[MD=-8.64,95%CI(-11.34,-5.94),P<0.00001],there were significant differences between two groups,and the total effective rate[OR=4.00,95%CI(2.72,5.89),P<0.00001]was better.Conclusion:Current evidence indicates that integrated traditional Chinese and Western medicine therapy can significantly reduce the level of IL-6,CRP and TNF-α,and exert certain clinical efficacy and safety for PCOS patients.