定坤丹联合西药治疗多囊卵巢综合征不孕症的Meta分析

Meta-analysis of Dingkundan combined with Western medicine in the treatment of infertility with PCOS

目的基于Meta分析系统评价定坤丹联合西药治疗多囊卵巢综合征(PCOS)不孕症的有效性及安全性。方法计算机检索CNKI、万方、PubMed等数据库,收集定坤丹联合西药治疗PCOS不孕症的随机对照试验(RCT)文献。检索年限为建库至2023年10月,由两位研究者分别独立检索文献、收集数据及评估偏倚风险;提取数据后,应用RevMan 5.4.1软件完成统计分析,并进行敏感分析,用漏斗图评估可能存在的发表偏倚。结果共纳入18项研究,共1967例PCOS患者。Meta分析结果显示,相较于单用西药组,定坤丹联合西药组子宫内膜厚度[MD=1.90,95%CI(1.48,2.32),P<0.001]、成熟卵泡数[MD=0.81,95%CI(0.57,1.06),P<0.001)、排卵率[RR=1.25,95%CI(1.19,1.32),P<0.001]、妊娠率[RR=1.59,95%CI(1.45,1.75),P<0.001]、LH水平[MD=-2.21,95%CI(-2.77,-1.65),P<0.001]、总有效率[RR=1.29,95%CI(1.19,1.40),P<0.001]均有效改善。结论定坤丹联合西药能明显增加多PCOS不孕症患者的子宫内膜厚度、成熟卵泡数、排卵率、妊娠率、总有效率,降低激素水平、不良反应等,疗效优于单用西医组,是中西医结合治疗PCOS不孕症的有效方法。

Objective:To systematically evaluate the efficacy and safety of Dingkundan combined with Western medicine in the treatment of infertility with PCOS based on meta-analysis.Methods:CNKI,Wanfang,PubMed and other databases were searched by computer to collect the randomized controlled trial(RCT)literature of Dingkundan combined with Western medicine for PCOS-related infertility.The retrieval period was from the establishment of the databases to October 2023.Two researchers independently searched literature,collected data and assessed the risk of bias.After data extraction,statistical analysis was performed using RevMan5.4.1 software,and the sensitivity analysis was performed to evaluate possible publication bias with funnel plots.Results:A total of 18 studies were included,with a total of 1967 PCOS-related patients.The results of meta-analysis showed that,the endometrial thickness[MD=1.90,95%CI(1.48,2.32),P<0.001)],the number of mature follicles[(MD=0.81,95%CI(0.57,1.06),P<0.001)],the ovulation rate[RR=1.25,95%CI(1.19,1.32),P<0.001)],the pregnancy rate[RR=1.59,95%CI(1.45,1.75),P<0.001],luteinizing hormone level[MD=-2.21,95%CI(-2.77,-1.65),P<0.001],total effective rate[RR=1.29,95%CI(1.19,1.40),P<0.001]were significantly improved in the PCOS patients treated with Dingkundan combined with Western medicine,when compared with those in patients treated with Western medicine alone.Conclusions:Dingkundan combined with Western medicine can significantly increase the endometrial thickness,improve the number of mature follicles,the ovulation rate,the pregnancy rate as well as the total effective rate,and reduce LH level of PCOS-related infertility patients.The efficacy of these prescriptions is better than that of Western medicine treatment alone,and it is an effective method for the treatment of PCOS-related infertility.