维生素D、维生素E联合矿物质复合剂辅助治疗多囊卵巢综合征Meta分析

Meta-analysis of Vitamin D and Vitamin E Combined with Mineral Compound in Adjuvant Treatment of Polycystic Ovary Syndrome

目的:采用Meta分析法系统评价维生素D、维生素E联合矿物质复合剂辅助治疗多囊卵巢综合征(PCOS)有效性,以期为临床提供循证医学参考。方法:通过检索中英文医学数据库随机对照试验(RCTs),检索时间自建库以来到2021年10月,对符合标准的文献在RevMan 5和ADDIS软件中进行评价分析。结果:最终纳入7篇RCTs,共627例PCOS患者。在Meta分析结果中,空腹血糖[MD=-4.61,95%CI(-6.79,-2.42),P<0.0001],胰岛素抵抗[MD=-0.34,95%CI(-0.58,-0.11),P=0.004],低密度脂蛋白[MD=-7.08,95%CI(-13.28,-0.88),P=0.03]观察组治疗效果优于对照组;高密度脂蛋白[MD=-0.30,95%CI(-2.38,1.79),P=0.78]差异无统计学意义;在网状Meta分析结果中,空腹血糖、LDL-C水平最佳用药方式为维生素E+ω-3脂肪酸;胰岛素抵抗、高密度脂蛋白最佳用药方式为维生素D、维生素E联合镁/钙。结论:维生素D、维生素E联合矿物质复合剂辅助治疗多囊卵巢综合征在血糖、血脂有效性指标方面可能具有显著的效果,但由于纳入文献样本量较少,还需更大样本量、质量高的随机对照双盲试验进一步加以验证。

【Objective】 Meta-analysis was used to systematically evaluate the effectiveness of vitamin D and vitamin E combined mineral complex in the adjuvant treatment of PCOS to provide evidence-based medical reference for clinical practice.【Method】 In terms of searching RCTs of Chinese and English medical databases,the search time was from the establishment of the database to October 2021,and the documents that meet the standards were evaluated and analyzed in RevMan 5 and ADDIS software.【Result】 A total of 627 patients were included in 7 RCTs.In meta-analysis,fasting blood glucose[MD=-4.61,95%CI(-6.79,-2.42),P<0.0001],insulin resistance[MD=-0.34,95%CI(-0.58,-0.11),P=0.004],LDL-C[MD=-7.08,95%CI(-13.28,-0.88),P=0.03],the treatment effect of observation group was better than control group.There was no significant difference in HDL-C[MD=-0.30,95%CI(-2.38,1.79),P=0.78].In mesh meta-analysis,vitamin E+ω-3 fatty acids were the best medication for FPG and LDL-C levels.The best treatment for insulin resistance and HDL-C was vitamin D or E combined with magnesium/calcium.【Conclusion】 Vitamin D and vitamin E combined with mineral compound adjuvant treatment of PCOS blood glucose,lipid efficiency index has significant effect.However,due to the small sample size of the included literature,further verification is required by a larger sample size and high-quality randomized controlled double-blind trial.