枸橼酸氯米芬联合中药治疗少弱精子症疗效的Meta分析

The efficacy of clomiphene citrate combined with traditional Chinese medicine in the treatment of oligoasthenospermia:a Meta-analysis

目的系统评价枸橼酸氯米芬联合中药治疗少弱精子症的疗效。方法检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library等数据库中枸橼酸氯米芬联合中药治疗少弱精子症的随机对照试验(RCT)文献,检索时间为建库至2022年11月1日。采用Cochrane偏倚风险评估表对纳入文献进行质量评价,采用RevMan 5.4软件进行Meta分析。结果对纳入的12篇RCT文献,共1467例患者进行Meta分析,结果显示:枸橼酸氯米芬联合中药治疗少弱精子症可提高临床疗效(OR=3.08,95%CI:2.22~4.28,P<0.05)、精子密度(MD=9.71,95%CI:6.21~13.20,P<0.05)、a级精子百分率(MD=5.53,95%CI:3.82~7.25,P<0.05)和妊娠率(OR=2.43,95%CI:1.61~3.65,P<0.05)。Egger′s分析结果显示,有效率在各研究间存在的发表偏倚可能性较低(P=0.111),结果较为可靠。结论枸橼酸氯米芬联合中药治疗少弱精子症疗效显著。

Objective To systematically evaluate the efficacy of clomiphene citrate(CC)combined with traditional Chinese medicine in the treatment of oligoasthenospermia.Methods The clinical randomized controlled trials(RCTs)literature of CC combined with traditional Chinese medicine in the treatment of oligoasthenospermia were searched by China National Knowledge Infrastructure(CNKI),Wanfang,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM),PubMed,Cochrane Library and other databases from the establishment of the database to November 1,2022.The included literatures were evaluated by Cochrane bias risk assessment form,and Meta-analysis was conducted by RevMan 5.4 sof tware.Results Meta-analysis of 1,467 patients in 12 RCTs showed that CC combined with traditional Chinese medicine could improve the clinical efficacy of oligoasthenospermic(OR=3.08,95%CI:2.22-4.28,P<0.05),sperm density(MD=9.71,95%CI:6.21-13.20,P<0.05),percentage of grade-a sperm(MD=5.53,95%CI:3.82-7.25,P<0.05)and the pregnancy rate(OR=2.43,95%CI:1.61-3.65,P<0.05).Egger′s analysis showed a low probability of publication bias among the studies with effective rate and the result was relatively reliable.Conclusions CC combined with traditional Chinese medicine is effective in the treatment of oligoasthenospermia.