中医治疗产后恶露不绝的Meta分析

Meta Analysis of Traditional Chinese Medicine in the Treatment of Postpartum Lochia

目的对中医治疗产后恶露不绝的临床疗效进行系统评价。方法计算机检索中国知网、万方、维普、CBM数据库以及PubMed等中英文数据库中有关中医治疗产后恶露不绝的随机对照临床研究文献,检索时限为建库至2022年5月。由2位研究人员独立对纳入文献资料进行质量评价和资料提取后,采用RevMan5.3软件进行Meta分析。结果共纳入10篇文献,总计1170例患者。Meta分析显示,中医治疗产后恶露不绝的临床疗效优于单纯西医治疗,能提高总有效率(RR=1.21,95%CI:1.15~1.27,Z=7.56,P<0.00001);中医治疗相较于西医治疗可缩短恶露干净时间(I2=92%,MD=-2.83,95%CI:-3.46~2.19,P<0.00001),促进子宫复旧(I2=94%,MD=-3.33,95%CI:-4.09~-2.57,P<0.00001),加快子宫的恢复进程。结论中医治疗产后恶露不绝临床疗效优于单纯西药治疗,可提高总有效率,缩短恶露持续时间,促进子宫的恢复,但由于纳入文献质量较低,样本量较小,仍需大样本、多中心临床研究证实。

Objective To systematically evaluate the clinical efficacy of traditional Chinese medicine in the treatment of postpartum lochia.Methods Computer retrieval of China National Knowledge Infrastructure,Wanfang,Weipu,CBM database and PubMed and other Chinese and English databases on randomized controlled clinical research literature on traditional Chinese medicine treatment of postpartum lochia.The retrieval time limit is from the establishment of the database to May 2022.Two researchers independently evaluated the quality of the included literature and extracted the data.Meta-analysis was performed using RevMan5.3 software.Results A total of 10 articles were included,with a total of 1170 patients.Meta-analysis showed that the clinical efficacy of traditional Chinese medicine treatment of postpartum lochia was better than that of western medicine treatment,which could improve the overall efficiency(RR=1.21,95%CI:1.15-1.27,Z=7.56,P<0.00001).Compared with western medicine treatment,TCM treatment can shorten lochia clean time(I2=92%,MD=-2.83,95%CI:-3.46-2.19,P<0.00001),promote uterine involution(I2=94%,MD=-3.33,95%CI:-4.09--2.57,P<0.00001),and accelerate the recovery process of uterus.Conclusion The clinical efficacy of traditional Chinese medicine in the treatment of postpartum lochia is better than that of western medicine alone,which can improve the total effective rate,shorten the duration of lochia and promote the recovery of uterus.However,due to the low quality of the included literature and the small sample size,it still needs to be confirmed by large sample and multi-center clinical studies.