中医辨证治疗卵巢储备功能减退临床随机对照试验的Meta分析

Meta-analysis of randomized controlled trials of traditional Chinese medicine in the treatment of Decline in ovarian reserve

关键词:  中医药  卵巢储备功能减退  疗效评价  Meta分析

Key words:  traditonal Chinese medicine  decline in ovarine reserve  systematic review  Meta-analysis

摘要:

[目的]系统评价中医药治疗卵巢储备功能减退的临床疗效。[方法]运用循证医学的方法，全面检索从建库至今发表的国内及国外文献库关于中医药治疗卵巢储备功能减退的临床随机对照试验。运用偏倚风险测量工具对纳入文献的质量进行评价。应用RevMan 5.1统计软件对纳入文献的结局指标进行Meta分析。[结果]最终纳入18项临床随机对照研究，分为中药对照西药激素及中药联合西药激素对照西药激素两个组别分别进行研究。同时采用辨证论治进行亚组分析，Meta分析结果显示中药联合西药激素在降低促卵泡生成激素（FSH）、改善中医证候疗效方面效果显著优于西药激素；在降低FSH/促黄体生成激素（LH）、升高抗苗勒管激素（AMH）方面，中药联合西药激素与西药激素的效果，无统计学意义。[结论]中药联合西药激素在改善卵巢储备功能减退方面具有一定的疗效。当然，本研究纳入文献的质量较低，因此，需要大量高质量的随机对照试验予以验证，提高其科学性及客观性。

Abstract:

[Objective] To systematically evaluate the clinical efficacy of traditional Chinese medicine in the treatment of decline in ovarian reserve.[Methods] Databases were searched in the treatment of decline in ovarian reserve. It includes many treatments of decline in ovarian reserve for clinical randomized controlled trials of the research object, or randomized controlled clinical trials in name. Risk of bias evalution tools of Cochrane were adopted to cinduct quality evalution. Meta-analysis on outcome indicator was performed by RevMan Version 5.1 Software.[Results] Finally, 18 clinical randomized controlled trials were included. These trials were divided into two groups:tradition Chinese medicine decoction or granule to Western medicine hormone and tradition Chinese medicine decoction or granule combined and Western medicine hormone to western medicine hormone. Besides, each group was divided as different subgroup analysis by syndrome differention and treatment. Traditional Chinese medicine or combined with Western medicine hormone had remarkable advantages over Western medicine hormone on reducing FSH and improving the Chinese medicine symptom curative effect; the advantages on reducing FSH/LH and increasing AMH were not clear. The trails showed less adverse reactions and follow-up reports, which reduced the quality of the literature demonstration. However, limited by the poor quantity of studies, these conclusions remain to be examined by more center, more sample and high-quality studies.[Conclusion] The meta-analysis showed that Chinese herbal decoction or granules (combined with western medicine hormones) had a certain effect in improving ovarian reserve dysfunction. Of course, the quality of the literature included in this study was not very high. Therefore, a large number of high-quality randomized controlled trials were needed to verify it and improve its scientificity and objectivity.