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系统评价和元分析中药复方治疗子宫内膜异位症引起的不孕症。

Systematic review and meta-analysis of traditional Chinese medicine compound in treating infertility caused by endometriosis.

机构信息

Department of Reproductive Immunology, Tongde Hospital of Zhejiang Province, Hangzhou, China.

出版信息

Ann Palliat Med. 2021 Dec;10(12):12631-12642. doi: 10.21037/apm-21-3425.

Abstract

BACKGROUND

To perform meta-analysis to investigate the efficacy and safety of traditional Chinese medicine (TCM) compound in the treatment of endometriosis (EMS)-induced infertility.

METHODS

The databases of PubMed, Embase, Cochrane Library, Chinese Journal Full-text Database (CNKI), VIP, Wanfang Science and Technology Journal Full-text Database, and Chinese Biomedical Literature (CBM) were used to search for articles on the treatment of EMS-induced infertility with TCM compound from database establishment to September 2021. Endnote X9 software was used to screen the articles. Stata 15.1 and RevMan 5.3 software were used to record the data, and a meta-analysis was performed on the effective rate, pregnancy rate, abortion rate, incidence of adverse reactions, luteinizing hormone (LH) level, and estradiol (E2) level of TCM compound in the treatment of EMS-induced infertility. Finally, the reliability of the results was assessed by sensitivity analysis. A funnel plot was used to evaluate the publication bias of the articles.

RESULTS

A total of 11 articles were included. Meta-analysis showed that when TCM compound was used to treat EMS-induced infertility, the effective rate of the trial group was significantly higher than that in the control group [odds ratio (OR) =1.26; 95% confidence interval (CI): 1.00 to 1.60; P=0.049], and the difference was statistically significant; the pregnancy rate of the trial group was significantly higher than that in the control group (OR =1.94; 95% CI: 1.50 to 2.50; P<0.05), and the difference was statistically significant; the abortion rate of the trial group was significantly lower than that in the control group (OR =0.16; 95% CI: 0.06 to 0.48; P=0.01), and the difference was statistically significant; and the incidence of adverse reactions in the trial group was not significantly different from the control group (OR =0.48; 95% CI: 0.17 to 1.34; P=0.162); the LH level of the trial and control group [standardized mean difference (SMD) =0.51; 95% CI: -1.73 to 2.75; P=0.658], and the E2 level (SMD =1.65; 95% CI: -0.77 to 4.07; P=0.182) had no statistical difference.

DISCUSSION

Chinese herbal compound is effective in the treatment of endometriotic infertility and has a positive effect on improving the pregnancy rate.

摘要

背景

旨在进行荟萃分析,以调查中药复方治疗子宫内膜异位症(EMS)所致不孕的疗效和安全性。

方法

从数据库建立到 2021 年 9 月,使用 PubMed、Embase、Cochrane 图书馆、中国期刊全文数据库(CNKI)、VIP、万方科技期刊全文数据库和中国生物医学文献(CBM)数据库检索中药复方治疗 EMS 所致不孕的文章。使用 Endnote X9 软件筛选文章。使用 Stata 15.1 和 RevMan 5.3 软件记录数据,并对中药复方治疗 EMS 所致不孕的有效率、妊娠率、流产率、不良反应发生率、黄体生成素(LH)水平和雌二醇(E2)水平进行荟萃分析。最后,通过敏感性分析评估结果的可靠性。使用漏斗图评估文章的发表偏倚。

结果

共纳入 11 篇文章。荟萃分析显示,当使用中药复方治疗 EMS 所致不孕时,试验组的有效率明显高于对照组[比值比(OR)=1.26;95%置信区间(CI):1.00 至 1.60;P=0.049],差异具有统计学意义;试验组的妊娠率明显高于对照组(OR=1.94;95%CI:1.50 至 2.50;P<0.05),差异具有统计学意义;试验组的流产率明显低于对照组(OR=0.16;95%CI:0.06 至 0.48;P=0.01),差异具有统计学意义;试验组不良反应发生率与对照组无显著差异(OR=0.48;95%CI:0.17 至 1.34;P=0.162);试验组和对照组的 LH 水平[标准化均数差(SMD)=0.51;95%CI:-1.73 至 2.75;P=0.658]和 E2 水平(SMD=1.65;95%CI:-0.77 至 4.07;P=0.182)无统计学差异。

讨论

中药复方治疗子宫内膜异位性不孕有效,对提高妊娠率有积极作用。

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