补肾活血中药联合克罗米芬治疗多囊卵巢不孕症疗效的meta分析

Meta analysis of the treatment of infertility in polycystic ovary with Chinese herbal medicines for invigorating kidney and activating blood combined with Clomiphene Citrate

目的评价补肾活血中药联合克罗米芬治疗多囊卵巢不孕症的疗效。方法检索CNKI、Wan Fang Data、PubMed、CBM和VIP数据库,收集近15年补肾活血中药联合克罗米芬治疗多囊卵巢不孕症临床疗效观察的随机对照研究,由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行meta分析。结果纳入文献12篇,改良的Jadad评分波动在2～3分,累计可纳入918例(研究组466例,对照组452例);研究组为补肾活血中药联合克罗米芬,对照组单用克罗米芬治疗;研究组治疗多囊卵巢不孕症的周期排卵率、临床妊娠率明显优于对照组,差异有统计学意义(P<0.05),且治疗周期越长周期排卵率越高;研究组不良反应发生率较对照组明显降低,差异有统计学意义(P<0.05)。结论补肾活血中药联合克罗米芬治疗多囊卵巢不孕症可明显提高周期排卵率及临床妊娠率,降低促排卵所致不良反应发生率,具有较高的安全性。

Objective To evaluate the efficacy of kidney-invigorating and blood-activating herbs combined with clomiphene citrate in the treatment of polycystic ovary infertility.Methods To collect the randomized controlled trials(RCTs)in the last 15 years about the clinical effect of treatment of infertility of polycystic ovary with kidney-invigorating and blood-activating herbs combined with clomiphene citrate by retrieval of CNKI,Wan Fang Data,PubMed,CBM and VIP databases.Two evaluators separately screened the articles,extracted the data and evaluated the bias risk in the study,meta analysis was carried out by Rev Man 5.3 software.Results A total of 12 articles were included.The improved Jadad score fluctuated between 2 and 3 points,totally 918 cases were included(466 cases in the study group and 452 cases in the control group).Study groups in the twelve articles were treated with kidney-invigorating and blood-activating herbs combined with clomiphene citrate,and the control group was treated with clomiphene citrate alone.The periodic ovulation rate and the clinical pregnancy rate of study groups in treatment of infertility of polycystic ovary was better than the control group,the difference was statistically significant(P<0.05),and the longer the treatment cycle,the higher the periodic ovulation rate.The adverse reactions of study groups was significantly lower than that of control group,the difference was statistically significant(P<0.05).Conclusion The kidney-invigorating and blood-activating herbs combined with clomiphene citrate in the treatment of infertility caused by polycystic ovary can significantly improve the rate of periodic ovulation and the clinical pregnancy rate and reduce the incidence of adverse reactions caused by ovulation promotion,and have a high safety.