[中医治疗男性免疫性不育症的荟萃分析]

[Treatment of male immune infertility by traditional Chinese medicine: A meta-analysis].

作者信息

Fan Chun-Mei, Ma Si-Qi, Ding Ke-Fan, Yang Yi-Jian, Wen Xin-Bang, Zhao Zi-Qin, Chen Shu-Hui, Qin Guo-Zheng

机构信息

The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan 650021, China.

Department of Andrology / Reproductive Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650021, China.

出版信息

Zhonghua Nan Ke Xue. 2024 Jun;30(6):547-563.

PMID:39212365

Abstract

OBJECTIVE

To evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of male immune infertility (MII) by meta-analysis.

METHODS

We retrieved randomized controlled trial (RCT) on the treatment of male immune infertility with traditional Chinese medicine from the databases of WanFang, Chinese Biomedical Literature, Cochrane Library, Weipu, PubMed and CNKI, and performed methodological quality assessment of the RCTs identified and statistical analysis and evaluation of the publication bias using the RevMan5.4 software.

RESULTS

Totally, 25 RCTs (2 563 cases) were included in this study. Compared with Western medicine alone in the treatment of MII, TCM achieved a significantly higher total effectiveness rate (OR = 6.35, 95% CI: 4.96－8.13, P<0.000 01), negative conversion rate of seminal plasma anti-sperm antibodies (OR = 4.52, 95% CI: 2.72 － 7.51, P<0.000 01), negative rate of serum anti-sperm antibodies (OR = 2.98, 95% CI: 2.23－3.96, P<0.000 01), sperm concentration (MD = 15.56, 95% CI: 11.32－19.79, P<0.000 01), grade a sperm motility (MD = 3.85, 95% CI: 1.91－5.79, P=0.000 01), grade a+b sperm motility (MD = 13.77, 95% CI: 7.06－20.48, P<0.000 1), sperm viability (MD = 10.32, 95% CI: 6.78－13.86, P<0.000 01) and pregnancy rate (OR = 3.53, 95% CI: 2.68－4.63, P<0.000 01), but a lower rate of adverse reactions (OR = 0.06, 95% CI: 0.01－0.23, P<0.000 01). There was no statistically significant difference in the percentage of morphologically abnormal sperm between TCM and Western medicine alone in the treatment of MII (MD = －7.53, 95% CI: －15.50－0.44, P = 0.06).

CONCLUSION

TCM has a definite effectiveness and high safe in the treatment of male immune infertility.

摘要

目的

通过Meta分析评价中医药治疗男性免疫性不育症（MII）的疗效和安全性。

方法

从万方、中国生物医学文献数据库、Cochrane图书馆、维普、PubMed及CNKI数据库中检索中医药治疗男性免疫性不育症的随机对照试验（RCT），对纳入的RCT进行方法学质量评价，并采用RevMan5.4软件进行统计分析及发表偏倚评估。

结果

本研究共纳入25项RCT（2563例）。与单纯西药治疗MII相比，中医药治疗的总有效率显著更高（OR = 6.35，95%CI：4.96－8.13，P<0.000 01），精浆抗精子抗体转阴率（OR = 4.52，95%CI：2.72－7.51，P<0.000 01），血清抗精子抗体阴性率（OR = 2.98，95%CI：2.23－3.96，P<0.000 01），精子浓度（MD = 15.56，95%CI：11.32－19.79，P<0.000 01），a级精子活力（MD = 3.85，95%CI：1.91－5.79，P = 0.000 01），a + b级精子活力（MD = 13.77，95%CI：7.06－20.48，P<0.000 1），精子活率（MD = 10.32，95%CI：6.78－13.86，P<0.000 01）及妊娠率（OR = 3.53，95%CI：2.68－4.63，P<0.000 01），但不良反应发生率更低（OR = 0.06，95%CI：0.01－0.23，P<0.000 01）。在治疗MII时，中医药与单纯西药治疗的精子形态异常百分比差异无统计学意义（MD =－7.53，95%CI：－15.50－0.44，P = 0.06）。