康妇消炎栓联合抗生素治疗慢性盆腔炎的系统评价和Meta分析

Systematic Review and Meta-analysis of Kangfu Xiaoyan Suppository Combined with Antibiotics in the Treatment of Chronic Pelvic Inflammatory Disease

目的:系统评价康妇消炎栓联合抗生素治疗慢性盆腔炎的有效性及安全性。方法:检索Embase,Cochrane Library,Medline,中国生物医学文献数据库(CBM),国家知识基础设施数据库(CNKI),中国学术期刊数据库(CSPD)和中文科技期刊数据库(CCD),筛选出康妇消炎栓联合抗生素治疗慢性盆腔炎的随机对照试验文献,检索时限均为从建库至2020年10月。由2名研究者按照纳入和排除标准独立进行文献筛选及资料提取,采用Cochrane系统评价手册进行质量评价,采用RevMan 5.3软件进行数据分析。结果:共纳入44个随机对照试验,共5143例患者。康妇消炎栓联合抗生素治疗慢性盆腔炎在提高总有效率(RR=4.84,95%CI为3.99~5.86,P<0.00001),缩短腹痛持续时间(MD=-2.61,95%CI为-3.12~-2.10,P<0.00001)、腹部坠胀时间(MD=-2.54,95%CI为-3.22~-1.85,P<0.00001)及白带异常持续时间(MD=-2.82,95%CI为-3.26~-2.39,P<0.00001)等方面优于单独使用抗生素。康妇消炎栓联合抗生素治疗可降低不良反应发生率(RR=0.67,95%CI为0.49~0.92,P=0.01<0.05)。结论:基于现有临床证据,康妇消炎栓联合抗生素治疗慢性盆腔炎优于单纯的抗生素治疗。

Objective:To systematically evaluate the efficacy and safety of Kangfu Xiaoyan Suppository combined with antibiotics in the treatment of chronic pelvic inflammatory disease(CPID).Methods:Embase,Cochrane Library,Medline,CBM,CNKI,CSPD,and CCD were searched for randomized controlled trials(RCTs)of Kangfu Xiaoyan Suppository combined with antibiotics in the treatment of CPID from the database inception to October 2020.Two investigators independently screened research articles according to inclusion and exclusion criteria and extracted data.Cochrane Handbook for Systematic Reviews of Interventions was used for quality evaluation and RevMan 5.3 software for data analysis.Results:Forty-four RCTs were included,involving 5143 patients.In the treatment of CPID,Kangfu Xiaoyan Suppository combined with antibiotics was superior to antibiotics alone in improving total effective rate(RR=4.84,95%CI 3.99 to 5.86,P<0.00001)and shortening the duration of abdominal pain(MD=-2.61,95%CI-3.12 to-2.10,P<0.00001),the duration of abdominal distention(MD=-2.54,95%CI-3.22 to-1.85,P<0.00001),and the duration of abnormal leukorrhea(MD=-2.82,95%CI-3.26 to-2.39,P<0.00001).Kangfu Xiaoyan Suppository combined with antibiotics could reduce the incidence of adverse reactions(RR=0.67,95%CI 0.49 to 0.92,P=0.01<0.05).Conclusion:Based on the existing clinical evidence,the efficacy of Kangfu Xiaoyan Suppository combined with antibiotics against CPID was superior to that of antibiotics alone.