中药治疗宫颈上皮内瘤变临床疗效的Meta分析

A Meta-analysis of clinical efficacy of TCM medicine on cervical intraepithelial neoplasia

目的:探讨中药治疗与西医常规治疗对宫颈上皮内瘤样病变的临床疗效。方法:通过对中国知网、万方数据知识服务平台、中国生物医学文献数据库、Embase、PubMed进行检索,整理并分析各数据库建库以来至2021年8月采用中药治疗宫颈上皮内瘤变的随机对照试验。结果:最终纳入41项试验,共4725例受试者。分析显示,中药治疗的加入比西医常规治疗提高宫颈上皮内瘤变临床疗效更加显著(P<0.00001),同时提高试验组人乳头状瘤病毒(Human Papillomavirus,HPV)转阴率(P<0.00001),并能通过缩短宫颈切除治疗术后的创面愈合时间、减少术后并发症(宫颈出血、宫颈粘连等)促进切除治疗术后宫颈恢复(P<0.00001)。结论:中药治疗能够有效提高宫颈上皮内瘤变的临床疗效。但本研究所采用的文献总体方法学质量偏低,关于中医辨证论治和具体中药的选择仍需要进一步研究。

bjective:To compare advantages and disadvantages of TCM medicine in the treatment of cervical intraepithelial neoplasia with Western medicine regular treatment.Methods:In the databases such as CNKI,Wanfang Data,SinoMed,Embase and PubMed,the randomized controlled trials of treating cervical intraepithelial neoplasia TCM medicine from the establishment of each database to August 2021 were retrieved.Results:Forty-one studies with 4725 subjects were included finally.The evidence showed that compared with Western medicine conventional treatment,TCM medicine on cervical intraepithelial neoplasia could effectively improve the clinical efficacy(P<0.00001),improve the negative rate of HPV in the test group(P<0.00001),promote postoperative cervical recovery by shortening the wound healing time after cervical resection and reducing postoperative complications(cervical bleeding,cervical adhesion,etc.).(P<0.00001).Conclusion:TCM medicine on cervical intraepithelial neoplasia can effectively improve the clinical efficacy.However,the overall methodological quality of the included literature is low,and more high-quality further research is still needed on TCM syndrome differentiation and treatment and the selection of specific TCM medicines.