目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位评价员独立筛...目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位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,采用RevMan 5.3软件对纳入研究进行Meta分析。结果共纳入13项研究,涉及1590例更年期综合征患者,其中观察组803例,对照组787例。按对照组的用药种类进行亚组分析,坤宝丸单用组的临床疗效显著高于氟桂利嗪+谷维素+维生素B1组[RR=1.75,95%CI(1.38,2.22),P<0.00001],坤宝丸联用组临床疗效显著高于戊酸雌二醇+甲羟孕酮组[RR=1.18,95%CI(1.03,1.34),P=0.01]和刺五加组[RR=1.20,95%CI(1.08,1.33),P=0.0007];坤宝丸单用组对更年期临床症状调查表(Kupperman)评分显著低于替勃龙组[MD=-6.00,95%CI(-7.72,-4.28),P<0.00001];坤宝丸联用组卵泡刺激素(FSH)显著低于刺五加组[MD=-25.70,95%CI(-33.22,-18.18),P<0.00001];坤宝丸联用组促黄体素(LH)显著低于刺五加组[MD=-11.20,95%CI(-12.05,-10.35),P<0.00001];坤宝丸单用组雌二醇(E2)显著高于替勃龙组[MD=-7.00,95%CI(-11.44,-2.56),P=0.002]。药品不良反应主要为腹胀、便秘、头晕、阴道出血、体质量增加等,患者均能耐受。结论坤宝丸对更年期综合征患者的临床疗效、Kupperman评分、激素指标等的改善效果与激素类药物相当,甚至更优。但由于纳入研究的质量不高,尚需更严格、高质量的临床研究进一步证实。展开更多
更年期综合征发病累及多个脏腑,病机复杂,临床中大多以补肾为主,而容易忽略心肝脾,导致治疗时顾此失彼,难奏全效。以“肾虚、肝郁化热、肝郁脾虚、心神失养”为病因,以“补肾清肝,疏肝健脾,养心安神”为治法,通过心肝脾肾同调治疗更年...更年期综合征发病累及多个脏腑,病机复杂,临床中大多以补肾为主,而容易忽略心肝脾,导致治疗时顾此失彼,难奏全效。以“肾虚、肝郁化热、肝郁脾虚、心神失养”为病因,以“补肾清肝,疏肝健脾,养心安神”为治法,通过心肝脾肾同调治疗更年期综合征,往往取得很好的疗效。The onset of menopausal syndrome involves multiple organs and has a complex pathogenesis. In clinical practice, most of the treatment focuses on tonifying the kidneys, while the heart, liver, and spleen are easily neglected, resulting in a loss of balance in treatment and difficulty in achieving full efficacy. Taking “kidney deficiency, liver depression and heat transformation, liver depression and spleen deficiency, and heart and mind loss of nourishment” as the causes, and “tonifying the kidney and clearing the liver, soothing the liver and strengthening the spleen, nourishing the heart and calming the mind” as the treatment methods, treating menopausal syndrome through the simultaneous regulation of the heart, liver, spleen, and kidney often achieves good results.展开更多
文摘更年期综合征发病累及多个脏腑,病机复杂,临床中大多以补肾为主,而容易忽略心肝脾,导致治疗时顾此失彼,难奏全效。以“肾虚、肝郁化热、肝郁脾虚、心神失养”为病因,以“补肾清肝,疏肝健脾,养心安神”为治法,通过心肝脾肾同调治疗更年期综合征,往往取得很好的疗效。The onset of menopausal syndrome involves multiple organs and has a complex pathogenesis. In clinical practice, most of the treatment focuses on tonifying the kidneys, while the heart, liver, and spleen are easily neglected, resulting in a loss of balance in treatment and difficulty in achieving full efficacy. Taking “kidney deficiency, liver depression and heat transformation, liver depression and spleen deficiency, and heart and mind loss of nourishment” as the causes, and “tonifying the kidney and clearing the liver, soothing the liver and strengthening the spleen, nourishing the heart and calming the mind” as the treatment methods, treating menopausal syndrome through the simultaneous regulation of the heart, liver, spleen, and kidney often achieves good results.
