Thakker Divyesh, Raval Amit, Patel Isha, Walia Rama
Department of Pharmacology, SAL Institute of Pharmacy, Ahmadabad, Gujarat 380060, India.
Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
Obstet Gynecol Int. 2015;2015:817849. doi: 10.1155/2015/817849. Epub 2015 Jan 8.
Objective. To review the benefits and harms of N-acetylcysteine (NAC) in women with polycystic ovary syndrome (PCOS). Method. Literature search was conducted using the bibliographic databases, MEDLINE (Ovid), CINAHL, EMBASE, Scopus, PsyInfo, and PROQUEST (from inception to September 2013) for the studies on women with PCOS receiving NAC. Results. Eight studies with a total of 910 women with PCOS were randomized to NAC or other treatments/placebo. There were high risk of selection, performance, and attrition bias in two studies and high risk of reporting bias in four studies. Women with NAC had higher odds of having a live birth, getting pregnant, and ovulation as compared to placebo. However, women with NAC were less likely to have pregnancy or ovulation as compared to metformin. There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo. Conclusions. NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo. The findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in longer follow-up periods. Systematic review registration number is CRD42012001902.
目的。回顾N-乙酰半胱氨酸（NAC）对多囊卵巢综合征（PCOS）女性的益处和危害。方法。使用文献数据库MEDLINE（Ovid）、CINAHL、EMBASE、Scopus、PsyInfo和PROQUEST（从创刊至2013年9月）检索关于接受NAC治疗的PCOS女性的研究。结果。八项研究共910例PCOS女性被随机分为NAC组或其他治疗/安慰剂组。两项研究存在选择、实施和失访偏倚的高风险，四项研究存在报告偏倚的高风险。与安慰剂相比，接受NAC治疗的女性活产、怀孕和排卵的几率更高。然而，与二甲双胍相比，接受NAC治疗的女性怀孕或排卵的可能性较小。与安慰剂相比，NAC组在流产率、月经调节、痤疮、多毛症和不良事件发生率或体重指数、睾酮和胰岛素水平变化方面无显著差异。结论。与安慰剂相比，NAC在妊娠率和排卵率方面有显著改善。这些发现需要在设计良好的随机对照试验中进一步证实，以在更长的随访期内检验临床结局，如活产率。系统评价注册号为CRD42012001902。
