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益母草注射液联合卡前列甲酯栓预防产后出血的疗效及安全性:一项随机对照试验的荟萃分析

Efficacy and safety of motherwort injection add-on therapy to carboprost tromethamine for prevention of post-partum blood loss: A meta-analysis of randomized controlled trials.

作者信息

Meng Wenbin, Li Rui, Zha Nashunbayaer, E Lihua

机构信息

Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.

Department of Geratology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.

出版信息

J Obstet Gynaecol Res. 2019 Jan;45(1):47-56. doi: 10.1111/jog.13833. Epub 2018 Oct 4.

Abstract

Motherwort (YiMuCao), a traditional Chinese herb, has been shown beneficial effects for women's diseases. This meta-analysis aimed to evaluate the efficacy and safety of motherwort injection add-on therapy to carboprost tromethamine for prevention of post-partum blood loss. A systematic literature search was conducted in PubMed, Embase, Cochrane Library, CNKI, VIP and Wanfang from their inception to December 2017. Randomized controlled trials that determined the add-on effects of motherwort injection to carboprost for prevention of post-partum blood loss were eligible. Pooled risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were used to summarize the effect sizes. Eight trials including 1276 pregnant women fulfilled the inclusion criteria. Prophylactic use of motherwort injection add-on therapy significantly reduced the post-partum 2 h (MD -127.5 mL; 95% CI -149.13 to -105.88) and 24 h (MD -146.85 mL; 95% CI -179.77 to -113.94) blood loss and incidence of post-partum hemorrhage (RR 0.28; 95% CI 0.17-0.45) than carboprost. Moreover, adjunctive treatment with motherwort injection significantly decreased the length of the third stage of labor (MD -3.41 min; 95% CI -4.33 to -2.49) and duration of lochia (MD -7.13 days; 95% CI -8.49 to -5.76). There was no statistical significant difference in the incidence of adverse events (RR 0.76; 95% CI 0.50-1.16). Prophylactic use of motherwort injection add-on therapy to carboprost tromethamine could reduce post-partum blood loss. However, more well-designed trials are necessary to confirm the findings of this study due to the methodological flaws of the included trials.

摘要

益母草,一种传统的中药材,已被证明对妇科疾病有益。本荟萃分析旨在评估益母草注射液联合卡前列甲酯预防产后出血的疗效和安全性。从创刊至2017年12月,在PubMed、Embase、Cochrane图书馆、中国知网、维普和万方数据库中进行了系统的文献检索。确定益母草注射液联合卡前列甲酯预防产后出血附加效果的随机对照试验符合纳入标准。采用合并风险比(RR)和平均差(MD)及95%置信区间(CI)来汇总效应量。八项试验共纳入1276名孕妇,符合纳入标准。预防性使用益母草注射液联合治疗可显著减少产后2小时(MD -127.5 mL;95% CI -149.13至-105.88)和24小时(MD -146.85 mL;95% CI -179.77至-113.94)的失血量以及产后出血的发生率(RR 0.28;95% CI 0.17-0.45)。此外,益母草注射液辅助治疗可显著缩短第三产程(MD -3.41分钟;95% CI -4.33至-2.49)和恶露持续时间(MD -7.13天;95% CI -8.49至-5.76)。不良事件发生率无统计学显著差异(RR 0.76;95% CI 0.50-1.16)。预防性使用益母草注射液联合卡前列甲酯可减少产后出血。然而,由于纳入试验存在方法学缺陷,需要更多设计良好的试验来证实本研究结果。

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