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中药复方治疗青春期多囊卵巢综合征疗效及安全性的Meta分析

Therapeutic Effect and Safety of Traditional Chinese Medicine Compound in the Treatment of Adolescent Polycystic Ovary Syndrome: A Meta analysis

DOI：

中文关键词: 多囊卵巢综合征青春期中药复方 Meta分析随机对照试验

英文关键词:Polycystic ovary syndrome Adolescent Traditional Chinese medicine Meta analysis Randomized controlled trial

基金项目:湖北省高等学校优秀中青年科技创新团队项目（编号：T201708）

作者	单位
熊梦欣1 邓阿黎2,3 邓春1 詹妮1 李婷1	1.湖北中医药大学中医临床学院武汉 430061；2.湖北中医药大学第一临床学院；3.湖北省中医院妇产科

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中文摘要:

摘要目的：采用Meta分析的方法评价中药复方治疗青春期多囊卵巢综合征（PCOS）有效性。方法：计算机检索SinoMed、CNKI、VIP、WanFang Data、PubMed、Cochrane Library、Embase数据库中有关中药复方治疗青春期PCOS的随机对照试验（RCTs），检索时限均为1989年1月~2018年4月。由两名研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3软件进行Meta分析。结果：共纳入10个RCTs，共698例患者，其中中药复方组350例，单纯西药组348例。Meta分析结果显示，中药复方治疗青春期PCOS临床总有效率优于单纯西药组[OR=4.56，95%CI（2.68，7.76），P＜0.000 01]，中药复方在提高青春期PCOS患者月经周期恢复率[OR=4.73，95%CI（2.31，9.69），P＜0.000 1]、排卵率[OR=4.14，95%CI（1.77，9.67），P=0.001]优于西药组。并可有效改善患者卵巢平均体积[MD=-2.55，95%CI（-3.02，-2.08），P＜0.000 01]以及降低BMI指数[MD=-2.51，95%CI（-3.13，-1.90），P＜0.000 01]。中药复方组在治疗青春期PCOS患者时药品不良反应发生率低于单纯西药组[OR=0.03, 95%CI（0.01，0.10），P＜0.000 01]，但两者在改善青春期PCOS患者多毛症状无明显差异[MD=-3.63，95%CI（-7.79，0.53），P=0.09]。结论：中药复方治疗青春期PCOS患者临床有效率优于单纯西药治疗，可有效恢复其月经周期、促进排卵、缩小卵巢平均体积，以及降低其BMI指数，且中药复方有着更好的药物安全性。但在改善其多毛症状时，两者无明显差异。受纳入研究数量和质量所限，本研究结论尚待更多高质量研究予以验证。

英文摘要:

ABSTRACT Objective: To systematically review the influence of traditional Chinese medicine on the efficacy of adolescent polycystic ovary syndrome (PCOS). Methods:SinoMed, CNKI, VIP, WanFang Data, PubMed, Cochrane Library and Embase database were electronically searched to collect randomized controlled trials (RCTs) of traditional Chinese medicine compound in the treatment of PCOS from January 1989 to April 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, Meta analysis was conducted by RevMan 5.3 software. Results:A total of 10 RCTs were included, including 698 patients, 350 patients in the compound prescription group and 348 patients in the pure western medicine group. The results of Meta analysis showed that: the total clinical efficiency of TCM compounds in the treatment of pubertal PCOS was superior to that of the pure western medicine group (OR=4.56, 95%CI 2.68 to 7.76, P<0.000 01), and the traditional Chinese medicine compound was superior to the western medicine group in improving the recovery rate of menstrual cycle in adolescent PCOS patients (OR=4.73, 95%CI 2.31 to 9.69, P<0.000 1), ovulation rate (OR=4.14, 95%CI 1.77 to 9.67, P=0.001). It could also effectively improve the mean ovarian volume of patients (MD=-2.55, 95%CI -3.02 to -2.08, P<0.000 01) and lower BMI (MD=-2.51, 95%CI -3.13 to -1.90, P<0.000 01). The drug safety evaluation of the traditional Chinese medicine compound prescription group in the treatment of pubertal PCOS patients was better than that of the pure western medicine group (OR=0.03, 95%CI 0.01 to 0.10, P<0.000 01), but there was no significant difference in the improvement of pubertal PCOS patients' hairy symptoms (MD=-3.63, 95%CI -7.79 to 0.53, P=0.09). Conclusion:TCM are effective for treatment of PCOS compared with western medicine alone, which can effectively restore their menstrual cycle, promote ovulation, reduce the average volume of their ovaries, and reduce their BMI. Besides, TCM has better drug safety. However, there was no significant difference in the treatment of hairy signs. Due to limited quantity and quality of included studies, more high quality studies are required to verify above conclusions.

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