针药结合治疗卵巢储备功能减退Meta分析

Meta-Analysis of Combined Acupuncture and Traditional Chinese Medicine in the Treatment of Diminished Ovarian Reserve

目的:通过评估针灸结合中药治疗卵巢储备功能减退的疗效,以期获得更有效的治疗方法。方法:检索Cochrane Library、Embase、PubMed、国家生物医疗文献(China Biology Medicine,CBM)、国家知识基础设施数据库(China National Knowledge Infrastructure,CNKI)、维普(China Science and Technology Journal Database),VIP和万方(WanFang Database),检索时间为建库至2023年1月,收集到7个采用针药结合方法改善卵巢储备功能的随机对照试验。经过2位研究人员的评估与审核,采用Review Manager 5.3分析工具,从174篇有效文章中,筛选出23项RCT,将1 635位DOR患者纳入研究。结果:针药结合治疗卵巢储备功能减退有效率远高于单纯西药或单纯中药治疗[RR=1.17,95%CI(1.12~1.23),P<0.01,I^(2)=26%]。针药结合治疗卵巢储备功能减退患者血清FSH水平优于单纯西药或单纯中药治疗[SMD=-0.93,95%CI(-1.04~-0.38),P<0.01]。结论:针药结合治疗卵巢储备功能减退比单独使用西药或单独使用中药具有更好的疗效。但该Meta分析存在纳入的文献质量较低、亚组分析异质性偏大等问题,研究结论有待更大样本量的高质量RCT验证。

Objective:This study aims to evaluate the efficacy of acupuncture combined with traditional Chinese medicine in the treatment of hypoovarian reserve,in order to obtain more effective treatment results.Methods:Cochrane Library,Embase,PubMed,CBM,CNKI,China Science and Technology Journal Database,VIP and WanFang Database provided 7 randomized controlled trials using acupuncture combined with medicine to improve ovarian reserve.Among the 174 valid articles,23 RCTs were screened out,and 1 635 DOR patients were included in the study.Results:The effective rate of combined acupuncture and medicine in the treatment of ovarian reserve decline was much higher than that of Western medicine or Chinese medicine alone [RR=1.17,95%CI(1.12~1.23),P<0.01,I_(2)=26%].Acupuncture combined with medicine in treating patients with impaired ovarian reserve has a better serum FSH level than simple western medicine or simple traditional Chinese medicine [SMD=-0.93,95%CI(-1.04~-0.38),P<0.01].Conclusion:Acupuncture combined with medicine has a better curative effect than western medicine or traditional Chinese medicine alone in the treatment of ovarian reserve.However,the meta-analysis has low quality of included literature and heterogeneity of subgroup analysis The conclusions of this study need to be verified by high-quality RCTs with larger sample sizes.