当归芍药散治疗慢性盆腔炎随机对照试验的Meta分析

Danggui Shaoyao San(当归芍药散) in the Treatment of Chronic Pelvic Inflammation:A Meta-analysis of Randomized Controlled Trials

目的在育龄期妇女中,患有慢性盆腔炎(CPID)的人数仍在不断增加,如何有效治疗该病仍然是学术界研究的热点之一。当归芍药散是张仲景《金匮要略》的经典方,其疗效已得到大部分学者的认同,因此研究其对CPID的具体疗效有较大的临床意义。方法电子检索当归芍药散治疗CPID有关临床观察的随机对照试验(RCT)的报导,同时测量CPID患者治疗前后的炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平,评价治疗效果。结果纳入研究的RCT总共有13个,治疗组给予当归芍药散或当归芍药散联合西药,对照组只使用西药治疗。Meta分析发现对照组有效率远低于治疗组。结论只运用当归芍药散或当归芍药散联合西药对比单纯西药治疗,前者更能改善患者的不适症状如月经或带下异常、下腹不适等,可以有效地治疗CPID;单纯当归芍药散的疗效亦优于单纯西药治疗CPID的疗效。由于研究受制于所选RCT文章,可能会使所得结果造成一定的影响,需要进一步探讨与发现。

Objective In the childbearing age women with chronic pelvic inflammatory disease(CPID),continues to increase in the number,how to effectively treat the disease is still a hot topic in the academia.Danggui Shaoyao San(当归芍药散)is a classic prescription in Synopsis of the Golden Chamber by Zhang Zhongjing.Its efficacy has been recognized by most scholars,so it has great clinical significance to study the specific efficacy of Danggui Shaoyao San on CPID.Methods RCTs on clinical observation of Danggui Shaoyao San in the treatment of CPID were searched electronically,and the levels of inflammatory factors(TNF-α,interleukin-6)in CPID patients before and after treatment were measured to evaluate the therapeutic effect.Results A total of 13 RCTs were included in the study.The treatment group was treated with Danggui Shaoyao San or Danggui Shaoyao San combined with western medicine,while the control group was treated with western medicine only.Meta-analysis showed that the effective rate of the control group was much lower than that of the treatment group.Conclusions Compared with the treatment with only Danggui Shaoyao San or Danggui Shaoyao San combined with western medicine,the former can better improve the patients’uncomfortable symptoms,such as abnormal menstruation or lower band,discomfort in the lower abdomen,and can effectively treat CPID.The efficacy of Danggui Shaoyao San alone was also better than that of western medicine alone in the treatment of CPID.As the study is limited to the selected RCT articles,the results may be affected to a certain extent,which needs further discussion and discovery.