中医药治疗抗磷脂综合征相关复发性流产的Meta分析

A Meta-analysis of the efficacy of TCM on antiphospholipid syndrome related recurrent abortion

目的:系统评价中西医结合治疗对比单纯西医治疗抗磷脂综合征(Antiphospholipid Syndrome,APS)相关复发性流产的疗效。方法:计算机检索中国期刊全文数据库、维普数据库、万方数据库、中国生物医学数据库、Pub Med数据库自建库起至2022年3月,中医药治疗APS相关复发性流产的随机对照试验;用改良后Jadad评分量表评价文献质量并提取数据;最后用Rev Man 5.4软件进行Meta分析。结果:9篇文献纳入研究。中西医结合治疗APS相关复发性流产,可降低抗β2糖蛋白Ⅰ抗体水平[MD=-4.37,95%CI(-6.12,-2.62),P<0.00001]、提高胎儿活产率[RR=1.27,95%CI(1.16,1.39),P<0.00001]、降低流产率[RR=0.30,95%CI(0.20,0.44),P<0.00001]、降低血小板聚集率[MD=-2.95,95%CI(-4.24,-1.66),P<0.00001]、降低D-二聚体水平[MD=-0.06,95%CI(-0.07,-0.05),P<0.00001]。结论:中西医结合治疗APS相关复发性流产疗效较单纯西医治疗更好。

Objective:To systematically evaluate the effectiveness of integrated Chinese and Western medicine compared with simple Western medicine in antiphospholipid syndrome related recurrent abortion and guide clinical medication.Methods:TCM treatment of antiphospholipid syndrome related recurrent abortion randomized controlled trial were searched in CNKI database,VIP database,Wanfang database,CBM database,PubMed database from the database establishment to March 2022.Modified Jadad score scale was Chosen to evaluate literature quality and extract data,and finally the Meta-analysis was made by RevMan 5.4 software.Results:Nine references were included in the study.The combination of Chinese and Western medicine with antiphospholipid syndrome related recurrent abortion showed lower antigIycoproteins-l levels[MD=-4.37,95%CI(-6.12,-2.62),P<0.00001],increased the fetal live birth rate[RR=1.27,95%CI(1.16,1.39),P<0.00001],reduced the abortion rate[RR=0.30,95%CI(0.20,0.44),P<0.00001],reduced the PAgT[MD=-2.95,95%CI(-4.24,-1.66),P<0.00001],decreased the D-D levels[MD=-0.06,95%CI(-0.07,-0.05),P<0.00001].Conclusion:Efficacy of integrated Chinese and Western medicine in antiphospholipid syndrome related recurrent abortion is better than that of Western medicine alone.