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口服活血化瘀类中成药治疗子宫内膜异位症的网络Meta分析

[Network Meta-analysis of peroral Chinese patent medicines for activating blood and resolving stasis in treatment of endometriosis].

作者信息

Wu Li-Zheng, Ke Yan, Huang Lei, Lin Li-Wen, Huang Ying-Jie, Pei Fang-Li, Zeng Cheng

机构信息

Guangzhou University of Chinese Medicine Guangzhou 510405, China.

Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine Shenzhen 518104, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2022 Jun;47(11):3073-3087. doi: 10.19540/j.cnki.cjcmm.20220224.501.

Abstract

Network Meta-analysis was performed to systematically compare the efficacy of different Chinese patent medicines for activating blood and resolving stasis in the treatment of endometriosis and to provide evidence-based references for clinical medication regimens. The relevant randomized controlled trials(RCTs) involving Chinese patent medicines combined with conventional treatment(experimental group) vs conventional treatment(control group) were retrieved from Chinese and English literature databases. The bias risk assessment tool recommended in Cochrane handbook 5.3 was used to evaluate the quality of the included studies. The result data of each outcome index was extracted for network Meta-analysis in Stata 15.0. A total of 44 RCTs were included in this study, involving 4 345 patients and 9 Chinese patent medicines. The network Meta-analysis revealed the following trends.(1)In terms of reducing the visual analogue scale(VAS) scores, Dan'e Fukang Plaster+conventional treatment>Xuefu Zhuyu Capsules+conventional treatment>Gongliuxiao Capsules+conventional treatment.(2)In terms of reducing cancer antigen CA125, Xiaojin Capsules+conventional treatment>Shaofu Zhuyu Granules+conventional treatment>Dan'e Fukang Plaster+conventional treatment.(3)In terms of reducing estradiol(E_2), Gongliuxiao Capsules+conventional treatment>Xiaojin Capsules+conventional treatment>Sanjie Zhentong Capsules+conventional treatment.(4) In terms of reducing recurrence rate, Guizhi Fuling Capsules+conventional treatment>Xuefu Zhuyu Capsules+conventional treatment>Dan'e Fukang Plaster+conventional treatment. The peroral Chinese patent medicines for activating blood and resolving stasis combined with conventional treatment have better efficacy in the treatment of endometriosis than conventional treatment. However, considering the low quality of the included literature, large-scale high-quality clinical trials are needed in the future research.

摘要

进行网状Meta分析,以系统比较不同活血化瘀类中成药治疗子宫内膜异位症的疗效,并为临床用药方案提供循证参考。从中文和英文文献数据库中检索有关中成药联合常规治疗(试验组)与常规治疗(对照组)的相关随机对照试验(RCT)。采用Cochrane手册5.3推荐的偏倚风险评估工具评估纳入研究的质量。提取各结局指标的结果数据,在Stata 15.0中进行网状Meta分析。本研究共纳入44项RCT,涉及4345例患者和9种中成药。网状Meta分析结果显示如下趋势:(1)在降低视觉模拟评分(VAS)方面,丹莪妇康煎膏+常规治疗>血府逐瘀胶囊+常规治疗>宫瘤消胶囊+常规治疗。(2)在降低癌抗原CA125方面,小金胶囊+常规治疗>少腹逐瘀颗粒+常规治疗>丹莪妇康煎膏+常规治疗。(3)在降低雌二醇(E_2)方面,宫瘤消胶囊+常规治疗>小金胶囊+常规治疗>散结镇痛胶囊+常规治疗。(4)在降低复发率方面,桂枝茯苓胶囊+常规治疗>血府逐瘀胶囊+常规治疗>丹莪妇康煎膏+常规治疗。口服活血化瘀类中成药联合常规治疗在子宫内膜异位症治疗中比常规治疗疗效更佳。然而,考虑到纳入文献质量较低,未来研究需要开展大规模高质量的临床试验。

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