针灸联合二甲双胍与单独使用二甲双胍治疗多囊卵巢综合征的妊娠率：系统评价和荟萃分析。
Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis.
机构信息
College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Front Endocrinol (Lausanne). 2022 Aug 29;13:978280. doi: 10.3389/fendo.2022.978280. eCollection 2022.
OBJECTIVE
The aim of this study was to evaluate the comparison between acupuncture combined with metformin versus metformin alone in improving the pregnancy rate of people with polycystic ovary syndrome (PCOS).
METHODS
A literature search of eight databases resulted in nine randomized controlled trials (RCTs) that assessed the effect of acupuncture combined with metformin on pregnancy rate in PCOS patients compared with metformin alone. Subsequently, data extraction and analysis were conducted to evaluate the quality and risk of bias of the methodological design of the study, and meta-analysis was conducted on the RCT data.
RESULTS
Nine RCTs and 1,159 women were included. Acupuncture can improve pregnancy rate. It was analyzed according to the diagnostic criteria of PCOS [ = 2.72, = 0.007, relative risk (RR) 1.31, 95% CI 1.08 to 1.60, = 0.15, = 41%]. Analysis was performed according to different diagnostic criteria of pregnancy ( = 3.22, = 0.001, RR 1.35, 95% CI 1.13 to 1.63, = 0.12, = 42%). Acupuncture can improve ovulation rate. Subgroup analysis was performed according to the number of ovulation patients ( = 2.67, = 0.008, RR 1.31, 95% CI 1.07 to 1.59, = 0.04, = 63%) and ovulation cycle ( = 3.57; = 0.0004, RR 1.18, 95% CI 1.08 to 1.29, = 0.57, = 0%). Statistical analysis also showed that acupuncture combined with metformin could improve homeostatic model assessment of insulin resistance (HOMA-IR) [mean difference (MD) -0.68, 95% CI -1.01 to -0.35, = 0.003, = 83%].
CONCLUSIONS
Based on the results of this study, compared with metformin alone, acupuncture combined with metformin has a positive effect on pregnancy rate, ovulation rate, and insulin resistance in PCOS. However, due to the limitations regarding the number and quality of the included studies, the above conclusions need to be verified by further high-quality studies.
SYSTEMATIC REVIEW REGISTRATION
目的
本研究旨在评估针灸联合二甲双胍与单独使用二甲双胍相比，对多囊卵巢综合征（PCOS）患者妊娠率的改善作用。
方法
通过对 8 个数据库进行文献检索，共纳入 9 项随机对照试验（RCT），评估了针灸联合二甲双胍治疗 PCOS 患者的妊娠率与单独使用二甲双胍的疗效。随后，对研究方法的设计质量和偏倚风险进行数据提取和分析，并对 RCT 数据进行荟萃分析。
结果
共纳入 9 项 RCT 和 1159 名女性。针灸可以提高妊娠率。根据 PCOS 的诊断标准进行分析[RR=2.72， =0.007，相对风险（RR）1.31，95%CI 1.08 至 1.60， =0.15， =41%]。根据不同的妊娠诊断标准进行分析[RR=1.35，95%CI 1.13 至 1.63， =0.12， =42%]。针灸可以提高排卵率。根据排卵患者的数量进行亚组分析[RR=1.31，95%CI 1.07 至 1.59， =0.04， =63%]和排卵周期[RR=1.18，95%CI 1.08 至 1.29， =0.57， =0%]。统计分析还表明，针灸联合二甲双胍可改善稳态模型评估的胰岛素抵抗（HOMA-IR）[平均差值（MD）-0.68，95%CI-1.01 至-0.35， =0.003， =83%]。
结论
根据本研究结果，与单独使用二甲双胍相比，针灸联合二甲双胍对 PCOS 患者的妊娠率、排卵率和胰岛素抵抗有积极作用。然而，由于纳入研究的数量和质量有限，上述结论还需要进一步的高质量研究来验证。
系统评价注册
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