摘要
目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然妊娠结局的随机对照研究(RCT)。运用偏倚风险工具进行质量评估,使用RevMan软件进行Meta分析。结果共纳入14篇RCT。Meta分析结果显示:补肾方剂联合西药治疗在提高妊娠率[RR=1.71,95%CI(1.45,2.01),P<0.00001]、降低卵泡刺激素(FSH)水平[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008]、提高雌二醇(E_(2))水平[SMD=3.97,95%CI(1.76,6.17),P=0.0004]、增加排卵期子宫内膜厚度[SMD=2.12,95%CI(1.07,3.18),P<0.0001]方面均优于西药组;且补肾方剂单独使用在提高妊娠率[RR=1.94,95%CI(1.31,2.88),P=0.001]、降低FSH水平[SMD=-0.48,95%CI(-0.74,-0.22),P=0.0003]方面也具有显著疗效。结论与西医治疗比较,补肾方剂可以显著改善高龄女性自然妊娠结局,且不良反应较少,但仍需更多高质量、大样本、多中心的RCT予以验证。
Objective To systematically evaluate the clinical efficacy and safety of tonify kidney prescription(TKP)in improving natural pregnancy outcomes in women of advanced age.Methods Literature of randomized controlled trial(RCT)about TKP in improving natural pregnancy outcomes in women of advanced age in CNKI,Wanfang,VIP,SinoMed PubMed,Web of Science,Cochrane Library,Embase from the establishment to June 2022 were searched.The quality was assessed by using the Risk of Bias tool and Meta-analysis was performed using RevMan software.Results A total of 14 RCTs were included in this study.Meta-analysis results showed that TKP combined with western treatment was better than western medicine treatment group in increasing pregnancy rate[RR=1.71,95%CI(1.45,2.01),P<0.000,01],reducing follicle-stimulating hormone(FSH)level[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008],increasing estradiol(E_(2))level[SMD=3.97,95%CI(1.76,6.17),P=0.000,4]and increasing endometrial thickness during ovulation[SMD=2.12,95%CI(1.07,3.18),P<0.000,1].In addition,TKP alone has significant efficacy in terms of increasing pregnancy rate[RR=1.94,95%CI(1.31,2.88),P=0.001]and reducing FSH[SMD=-0.48,95%CI(-0.74,-0.22),P=0.000,3].Conclusions TKP can significantly improve natural pregnancy outcomes in women of advanced age with fewer adverse effects,when compared with western medicine treatment.However,more high-quality,large-sample,and multicenter RCTs are still needed for validation.
作者
闫菲
刘雁峰
赵琦
李影
刘星童
YAN Fei;LIU Yanfeng;ZHAO Qi;LI Ying;LIU Xingtong(Department of Gynecology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国性科学》
2024年第4期125-130,共6页
Chinese Journal of Human Sexuality
基金
国家自然科学基金面上项目(82074480,82274567)。
关键词
补肾方剂
高龄女性
自然妊娠结局
META分析
GRADE质量评价
Tonify kidney prescription
Women of advanced age
Natural pregnancy outcome
Meta-analysis
Grading of Recommendations Assessment,Development and Evaluation quality evaluation
