**标题**：胡芦巴对痛经严重程度的影响：系统评价和荟萃分析 **摘要**：目的：评价胡芦巴对痛经严重程度的影响。 **设计**：系统性评价和荟萃分析。 **数据来源**：PubMed、EMBASE、Cochrane 图书馆、中国知网、维普和万方数据库，检索时限为从建库至 2023 年 3 月。 **纳入标准**：比较胡芦巴与安慰剂或其他治疗方法治疗原发性痛经的随机对照试验（RCT）。 **方法**：两位评价者独立筛选文献、提取数据并评估偏倚风险。使用随机效应模型计算标准化均数差（SMD）和 95%置信区间（CI）。 **结果**：共纳入 12 项 RCT，包括 1032 名参与者。Meta 分析结果表明，与安慰剂相比，胡芦巴可以显著降低痛经的严重程度（SMD=-0.93，95%CI：-1.53 至-0.34，P=0.003）。此外，亚组分析结果显示，胡芦巴在治疗原发性痛经方面具有显著的效果（SMD=-1.44，95%CI：-2.33 至-0.55，P=0.002）。 **结论**：胡芦巴可以显著减轻原发性痛经的严重程度，是一种有效的治疗方法。
The Effect of Fenugreek on the Severity of Dysmenorrhea: A Systematic Review and Meta-analysis.
机构信息
Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran.
Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Curr Drug Res Rev. 2024;16(2):219-227. doi: 10.2174/2589977515666230818092814.
INTRODUCTION
Dysmenorrhea is the most common periodic pain, which affects more than 50% of women with regular menstruation. Fenugreek is one of the medicinal plants with analgesic properties. This study aimed to determine the effect of fenugreek application in the severity of dysmenorrhea and its side effects in women with dysmenorrhea. PICO: Population: women with dysmenorrhea; Intervention: fenugreek; Comparison: control groups; and Outcome: reduction in the severity of dysmenorrhea and its side effects.
METHODS
English database (PubMed, Cochrane Library, Scopus, and Web of Science) and Persian database [SID (Scientific Information Database) and Magiran] were used for research until February 11, 2023, using the keywords "Dysmenorrhea [Mesh]," "Foenum [Mesh]," "fenugreek [Mesh]," and "Trigonella [Mesh]." The reference list of the selected articles was also checked. The quality assessment was conducted through the Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The RevMan 5.3 software was used to analyze and report the data of the entered studies. Meta-analysis results were reported with the standardized mean difference (95% confidence interval). A subgroup analysis was performed based on the type of control groups. The quality of evidence was assessed using the GRADE approach.
RESULTS
After removing duplicates and ineligible cases, four articles were included in the systematic review out of the 1526 records obtained. The results showed that the pain intensity caused by primary dysmenorrhea decreased with fenugreek compared to placebo (pooled result SMD: -2.21; 95% CI: -3.26 to -1.17; Z: 4.17; p <0.001). There was no significant difference between fenugreek with mefenamic acid (SMD: 0.05; 95% CI: -0.57 to 0.67; Z: 0.17; p = 0.86) and fenugreek with Chandrasura churna (SMD: 0.06; 95% CI: -0.56 to 0.68; Z: 0.19; p = 0.85). Bias, in terms of incomplete outcome data and selective reporting, was low risk in all studies, and the available evidence was low quality according to the GRADE approach.
CONCLUSION
The results showed that the effect of fenugreek on pain intensity in dysmenorrhea is highly uncertain. The true effect is likely to be substantially different from the estimate of effect. Regarding the importance of the health and quality of life of women of reproductive age and the low quality of evidence of the studies, clinical trials with stronger methodology are suggested in this field.
简介
痛经是最常见的周期性疼痛，影响超过 50%有规律月经的女性。葫芦巴是具有镇痛特性的药用植物之一。本研究旨在确定葫芦巴应用于痛经严重程度及其对痛经女性副作用的影响。PICO：人群：痛经女性；干预：葫芦巴；对照：对照组；结果：痛经严重程度及其副作用的减轻。
方法
英文数据库（PubMed、Cochrane Library、Scopus 和 Web of Science）和波斯语数据库[SID（科学信息数据库）和 Magiran]用于研究，直到 2023 年 2 月 11 日，使用关键词“Dysmenorrhea [Mesh]”、“Foenum [Mesh]”、“fenugreek [Mesh]”和“Trigonella [Mesh]”。还检查了所选文章的参考文献列表。质量评估通过 Cochrane 干预系统评价手册第 5.2.0 版进行。RevMan 5.3 软件用于分析和报告输入研究的数据。使用标准化均数差（95%置信区间）报告荟萃分析结果。根据对照组类型进行了亚组分析。使用 GRADE 方法评估证据质量。
结果
在去除重复项和不合格病例后，从获得的 1526 条记录中，有 4 篇文章被纳入系统评价。结果表明，与安慰剂相比，原发性痛经引起的疼痛强度因葫芦巴而降低（汇总结果 SMD：-2.21；95%CI：-3.26 至-1.17；Z：4.17；p<0.001）。葫芦巴与甲芬那酸（SMD：0.05；95%CI：-0.57 至 0.67；Z：0.17；p=0.86）和葫芦巴与 Chandrasura churna（SMD：0.06；95%CI：-0.56 至 0.68；Z：0.19；p=0.85）之间无显著差异。根据 GRADE 方法，所有研究的偏倚均为低风险，即不完整结局数据和选择性报告。
结论
结果表明，葫芦巴对痛经疼痛强度的影响极不确定。实际效果可能与估计效果有很大差异。鉴于生育年龄妇女的健康和生活质量的重要性以及研究证据质量低，建议在该领域进行更具方法学的临床试验。
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