Zhang Li-Jun, Hu Xiao-Qiang, Yu Jing-Jing, Wang Ying, Zhang Jia-Wei, Xu Xian-Rong, Yang Jun
Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University Hangzhou 311121, China.
Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University Hangzhou 311121, China Center for Uterine Cancer Diagnosis and Therapy Research, the Affiliated Women's Hospital, Zhejiang University Hangzhou 310006, China.
Zhongguo Zhong Yao Za Zhi. 2022 May;47(10):2811-2818. doi: 10.19540/j.cnki.cjcmm.20220218.501.
The present study evaluated the effect of Shenqi Jiangtang Granules(SJG) combined with western medicine on the adverse pregnancy outcomes in women with gestational diabetes mellitus(GDM). PubMed, Web of Science, CNKI, Wanfang, and VIP were searched for clinical randomized controlled trials(RCTs) of SJG combined with western medicine against GDM. The included RCTs were assessed for risks using the assessment criteria recommended by the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using Stata 12.0 and RevMan 5.3. Nineteen RCTs were included, with 1 647 patients involved, including 824 cases treated with western medicine alone, and 823 cases treated with SJG combined with western medicine. The course of treatment ranged from 2 to 12 weeks. As revealed by Meta-analysis results, compared with western medicine treatment alone, SJG combined with western medicine could reduce the incidence of postpartum hemorrhage(OR=0.23, 95%CI[0.10, 0.53], P=0.000 6), gestational hypertension(OR=0.24, 95%CI[0.13, 0.45], P<0.000 01), polyhydramnios(OR=0.24, 95%CI[0.12, 0.45], P<0.000 1), premature rupture of membranes(OR=0.20, 95%CI[0.09, 0.45], P<0.000 1), cesarean section(OR=0.40, 95%CI[0.29, 0.55], P<0.000 01), macrosomia(OR=0.19, 95%CI[0.08, 0.47], P<0.000 3), neonatal asphyxia(OR=0.22, 95%CI[0.12, 0.40], P<0.000 01), premature delivery(OR=0.19, 95%CI[0.12, 0.30], P<0.000 01), proteinuria(OR=0.19, 95%CI[0.06, 0.58], P=0.004) and hypoglycemia(OR=0.28, 95%CI[0.16, 0.50], P<0.000 1). The funnel plots and Egger's test showed that except macrosomia, there was no significant publication bias in the results of other indicators. Therefore, as indicated by the findings, SJG combined with western medicine can reduce the incidence of adverse pregnancy outcomes in GDM patients. However, due to the uneven quality of the included trials, the clinical application of this protocol requires caution.
本研究评估了参芪降糖颗粒（SJG）联合西药对妊娠期糖尿病（GDM）女性不良妊娠结局的影响。通过检索PubMed、Web of Science、中国知网、万方和维普，查找SJG联合西药治疗GDM的临床随机对照试验（RCT）。使用Cochrane干预措施系统评价手册推荐的评估标准对纳入的RCT进行风险评估。采用Stata 12.0和RevMan 5.3进行荟萃分析。共纳入19项RCT，涉及1647例患者，其中单纯西药治疗824例，SJG联合西药治疗823例。治疗疗程为2至12周。荟萃分析结果显示，与单纯西药治疗相比，SJG联合西药可降低产后出血发生率（OR=0.23，95%CI[0.10, 0.53]，P=0.000 6）、妊娠期高血压发生率（OR=0.24，95%CI[0.13, 0.45]，P<0.000 01）、羊水过多发生率（OR=0.24，95%CI[0.12, 0.45]，P<0.000 1）、胎膜早破发生率（OR=0.20，95%CI[0.09, 0.45]，P<0.000 1）、剖宫产率（OR=0.40，95%CI[0.29, 0.55]，P<0.000 01）、巨大儿发生率（OR=0.19，95%CI[0.08, 0.47]，P<0.000 3）、新生儿窒息发生率（OR=0.22，95%CI[0.12, 0.40]，P<0.000 01）、早产发生率（OR=0.19，95%CI[0.12, 0.30]，P<0.000 01）、蛋白尿发生率（OR=0.19，95%CI[0.06, 0.58]，P=0.004）和低血糖发生率（OR=0.28，95%CI[0.16, 0.50]，P<0.000 1）。漏斗图和Egger检验显示，除巨大儿外，其他指标结果无明显发表偏倚。因此，研究结果表明，SJG联合西药可降低GDM患者不良妊娠结局的发生率。然而，由于纳入试验质量参差不齐，该方案的临床应用需谨慎。
