中药周期疗法联合促排卵方案治疗多囊卵巢综合征不孕症Meta分析

Meta Analysis of Chinese Medicine Periodic Therapy Combined with Ovulation Induction Protocol for Treatment of Infertility Caused by Polycystic Ovary Syndrome

目的:系统评价中药周期疗法联合促排卵方案治疗多囊卵巢综合征(PCOS)不孕症的临床疗效及安全性。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库,检索时限为建库至2024年2月,纳入中药周期疗法治疗PCOS不孕症的随机对照试验。由2位研究人员独立按照纳入、排除标准进行文献筛选和数据收集。采用RevMan5.4软件进行Meta分析。结果:最终纳入15项研究,涉及患者1171例,其中治疗组594例,对照组577例。Meta分析结果显示,与对照组比较,治疗组妊娠率[RR=1.80,95%CI(1.58,2.04),P<0.00001]、排卵率[RR=1.10,95%CI(1.06,1.14),P<0.00001]和总有效率[RR=1.25,95%CI=(1.15,1.37),P<0.00001]升高,子宫内膜厚度增厚[MD=1.12,95%CI(0.94,1.29),P<0.00001],雄激素[MD=-0.39,95%CI(-0.52,-0.26),P<0.00001]、促黄体生成激素[MD=-1.49,95%CI(-1.93,-1.05),P<0.00001]水平及卵巢过度刺激征发生率[RR=0.25,95%CI(0.08,0.79),P=0.02]与不良反应发生率[RR=0.36,95%CI(0.19,0.67),P=0.001]降低。结论:中药周期疗法联合促排卵方案治疗PCOS不孕症疗效优于单纯促排卵方案治疗,能够促进生育,调节性激素水平,安全性较高。

Objective:To systematically evaluate the clinical effects and safety of Chinese medicine periodic therapy combined with ovulation protocol induction in the treatment of infertility caused by polycystic ovary syndrome(PCOS).Methods:Randomized controlled trials of Chinese medicine periodic therapy for treating infertility caused by PCOS were included in the study after the search at PubMed,Embase,Web of Science,the Cochrane Library,Chinese BioMedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database,with a search period from the establishment of these databases to February 2024.Two researchers independently screened literature and collected data according to inclusion and exclusion criteria.Meta analysis was conducted using RevMan5.4 software.Results:Finally,15 studies were included,involving 1171 patients,including 594 cases in the treatment group and 577 cases in the control group.The Meta-analysis results showed that,compared with the control group,the treatment group had increases in pregnancy rate[RR=1.80,95%CI(1.58,2.04),P<0.00001],ovulation rate[RR=1.10,95%CI(1.06,1.14),P<0.00001],total effective rate[RR=1.25,95%CI=(1.15,1.37),P<0.00001],and endometrial thickness[MD=1.12,95%CI(0.94,1.29),P<0.00001],and decreases in androgen[MD=-0.39,95%CI(-0.52,-0.26),P<0.00001],luteinizing hormone[MD=-1.49,95%CI(-1.93,-1.05),P<0.00001],the incidence of ovarian hyperstimulation[RR=0.25,95%CI(0.08,0.79),P=0.02],and the incidence of adverse reactions[RR=0.36,95%CI(0.19,0.67),P=0.001].Conclusion:Chinese medicine periodic therapy combined with ovulation induction protocol in the treatment of infertility caused by PCOS has better curative effects than simple treatment scheme of ovulation induction protocol,which can promote fertility,regulate hormone levels,and has high safety.