Qu Hai Bo, Dengfeng Wang, Wu Taixiang, Marjoribanks Jane, Ying Sun, Haijun Jia, Zhang Jing, Hu Lina
Department of Radiology, West China Second University Hospital Sichuan University, No. 20, Section there, Ren Min Nan Lu Avenue, Chengdu, China, 610041.
Cochrane Database Syst Rev. 2011 Jul 6(7):CD006224. doi: 10.1002/14651858.CD006224.pub3.
Traditionally Chinese herbal medicine (CHM) has been used widely in Chinese hospitals to treat ectopic pregnancy. Many studies have been published supporting its use but the evidence has not been systematically reviewed. This is and update of the review published in 2007.
To determine the effectiveness and safety of CHM in the treatment of ectopic pregnancy.
Computerised databases (CENTRAL (The Cochrane Library), MEDLINE, EMBASE, Chinese Biomedical Database, China National Knowledge Infrastructure, VIP, Traditional Chinese Medicine Database System) were searched from their inception to November 2010 for relevant trials.
Randomised controlled trials (RCT) on the use of CHM for the treatment of ectopic pregnancy.
Original authors of the identified studies were contacted to determine the trial design and identify authentic RCTs. Two review authors extracted and analysed the data.
The search identified 281 trials. Only two studies involving a total of 157 participants were confirmed to be authentic RCTs (Li 2004c; Zhao 2000). Both were of poor methodological quality with a high risk of conflicted interest and potential for bias in favour of the intervention. We could not reach a definitive conclusion from the results. The pooled result showed that adding a Western medicine to CHM resulted in a significantly higher treatment success rate than with CHM alone (RR 1.33, 95% CI 1.08 to 1.63). When CHM plus Western medicine was compared to CHM alone for the time to disappearance of abdominal pain, again the results favoured the arm that included Western medicine (RR -2.09, 95% CI -4.14 to -0.04). Results were inconsistent for the time required for human chorionic gonadotropin (beta-hCG) to return to normal. One study favoured CHM plus Western medicine over Western medicine (with or without placebo) (MD -6.68, 95% CI -11.49 to -1.87); when CHM plus Western medicine was compared to CHM alone the results favoured the arm that included Western medicine (MD -8.12, 95% CI -10.89 to -5.53).
AUTHORS' CONCLUSIONS: We have not found any well-designed trials investigating Chinese herbal medicines in the treatment of ectopic pregnancy. We cannot support or refute any CHM preparation for clinical use on the basis of evidence from randomised controlled trials.
传统上，中药在中国医院中被广泛用于治疗异位妊娠。许多支持其使用的研究已经发表，但证据尚未得到系统评价。这是对2007年发表的综述的更新。
确定中药治疗异位妊娠的有效性和安全性。
检索计算机化数据库（Cochrane图书馆CENTRAL、MEDLINE、EMBASE、中国生物医学数据库、中国知网、维普、中医药数据库系统），从建库至2010年11月，以查找相关试验。
关于使用中药治疗异位妊娠的随机对照试验（RCT）。
联系已识别研究的原始作者，以确定试验设计并识别真实的RCT。两名综述作者提取并分析数据。
检索共识别出281项试验。仅两项研究（共157名参与者）被确认为真实的RCT（Li 2004c；Zhao 2000）。两项研究的方法学质量均较差，存在利益冲突的高风险以及有利于干预措施的潜在偏倚。我们无法从结果中得出明确结论。汇总结果显示，在中药中添加西药的治疗成功率显著高于单纯使用中药（RR 1.33，95%CI 1.08至1.63）。当比较中药加西药与单纯中药治疗腹痛消失时间时，结果同样有利于包含西药的组（RR -2.09，95%CI -4.14至-0.04）。人绒毛膜促性腺激素（β-hCG）恢复正常所需时间的结果不一致。一项研究显示，中药加西药优于西药（加或不加安慰剂）（MD -6.68，95%CI -11.49至-1.87）；当比较中药加西药与单纯中药时，结果有利于包含西药的组（MD -8.12，95%CI -10.89至-5.53）。
我们未发现任何设计良好的试验来研究中药治疗异位妊娠的情况。基于随机对照试验的证据，我们无法支持或反驳任何用于临床的中药制剂。
