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健脾补肾化痰法治疗肥胖型多囊卵巢综合征：网络荟萃分析及中药方剂规律总结

Method of invigorating spleen and replenishing kidney and resolving phlegm for obesity-type polycystic ovary syndrome: a network meta-analysis and summary of herbal prescription regularity.

作者信息

Lyu Yueqiao, Cai Lian, Li Mingzhu

机构信息

School of Integrated Chinese and Western Medicine, Anhui University of Chinese Medicine, Hefei, China.

School of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China.

出版信息

Front Med (Lausanne). 2025 Jul 28;12:1609131. doi: 10.3389/fmed.2025.1609131. eCollection 2025.

DOI:10.3389/fmed.2025.1609131
PMID:40792299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12336145/
Abstract

OBJECTIVE

This study aimed to evaluate the therapeutic efficacy of Invigorating Spleen and Replenishing Kidney and Resolving Phlegm Prescription (ISRKRPP) in treating obesity-type polycystic ovary syndrome (PCOS) and to analyze the prescription regularity through data mining technology.

METHODS

Databases were retrieved up to September 30, 2024. RCTs on obesity-type PCOS treated with ISRKRPP and Western medicine (WM) were included. The Risk of Bias 2 tool was used for quality assessment. Network meta-analysis was performed using Stata 14.0. After standardizing herb names, a corresponding herbal database was built in Excel. Based on Excel and R language, the core drugs and prescription rules used in the treatment of obese PCOS were analyzed and visualized.

RESULTS

A total of 14 articles, involving 1,163 patients and 7 prescriptions, were included. Network meta-analysis indicated the following: Qihuang Zengmin Decoction + WM may be optimal for overall efficacy (Confidence in Network Meta-Analysis [CINeMA]: moderate confidence); Cangfu Daotan Decoction + WM showed superiority in reducing BMI (CINeMA: moderate confidence); Method of Regulating and Supplementing Spleen and Kidney + WM most effectively improved HOMA-IR (CINeMA: moderate confidence); Cangfu Daotan Decoction + WM best regulated LH (CINeMA: moderate confidence); Heshi Powder + WM medicine most effectively reduced testosterone (CINeMA: moderate confidence). Herbal Regularity analysis revealed core herbs for the treatment included Rhizoma atractylodis, Poria cocos, Angelica sinensis, , and Epimedium. The herbal cluster, including Epimedium, Poria cocos, Angelica sinensis, Citrus, Spina gleditsiae, Salviae miltiorrhizae, Rhizoma atractylodis, , and Rhizoma cyperi may be the core prescription for the treatment of obesity-type PCOS.

CONCLUSION

Based on the results of the present studies, ISRKRPP combined with WM can improve the effect of obesity-type PCOS. Due to the limitations of the present studies, more clinical studies are needed for further validation.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024594257.

摘要

目的

本研究旨在评价健脾补肾化痰方治疗肥胖型多囊卵巢综合征（PCOS）的疗效，并通过数据挖掘技术分析该方的用药规律。

方法

检索截至2024年9月30日的数据库。纳入健脾补肾化痰方联合西药治疗肥胖型PCOS的随机对照试验（RCT）。采用偏倚风险2工具进行质量评估。使用Stata 14.0进行网络荟萃分析。对中药名称进行标准化后，在Excel中建立相应的中药数据库。基于Excel和R语言，分析并可视化治疗肥胖型PCOS所用的核心药物和用药规律。

结果

共纳入14篇文章，涉及1163例患者和7个方剂。网络荟萃分析结果显示：芪黄增敏汤联合西药可能对总体疗效最佳（网络荟萃分析可信度[CINeMA]：中度可信度）；苍附导痰汤联合西药在降低体重指数方面具有优势（CINeMA：中度可信度）；脾肾双补法联合西药最有效地改善了胰岛素抵抗指数（HOMA-IR）（CINeMA：中度可信度）；苍附导痰汤联合西药对促黄体生成素（LH）的调节效果最佳（CINeMA：中度可信度）；和氏散联合西药最有效地降低了睾酮水平（CINeMA：中度可信度）。用药规律分析显示，治疗的核心药物包括白术、茯苓、当归、淫羊藿。以淫羊藿、茯苓、当归、陈皮、皂角刺、丹参、白术、香附为核心的中药聚类方可能是治疗肥胖型PCOS的核心方剂。

结论

基于本研究结果，健脾补肾化痰方联合西药可提高肥胖型PCOS的治疗效果。由于本研究存在局限性，需要更多的临床研究进行进一步验证。

系统评价注册

https://www.crd.york.ac.uk/PROSPERO/，标识符CRD42024594257。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d4/12336145/85caaac4df7b/fmed-12-1609131-g009.jpg
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