摘要
目的:通过文献研究阐述中药干预肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者代谢异常的有效性及安全性。方法:计算机检索国内外主流医药数据库中关于中医、中西医结合对比单纯西药治疗PCOS的随机对照试验(randomized controlled trial,RCT)。参照Cochrane系统评价手册对全文的设计方案进行质量评价,采用RevMan 5.4软件进行Meta分析。结果:纳入22项RCT进行Meta分析,中药或中西药联合治疗不仅在提升排卵率这一主要研究指标上优于单纯西药治疗(P<0.05),还在改善胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、空腹胰岛素(fasting insulin,FINS)、体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等方面优于单纯西药治疗(均P<0.05),但在调节空腹血糖(fasting blood glucose,FBG)和腰臀比(waist-to-hip ratio,WHR)方面与西药治疗差异无统计学意义(均P>0.05)。结论:中药或中西药联合干预肥胖型PCOS糖脂代谢异常,具有多途径、多靶点调控作用,无严重不良反应,优于单纯西药治疗。
Objective:To explore the efficacy and safety of traditional Chinese medicine(TCM)on the metabolic abnormalities in the patients with obese polycystic ovary syndrome(PCOS)through a Meta-analysis and literature review.Methods:The randomized controlled trials(RCTs)on the treatment of PCOS with TCM or/and the combination of TCM and western medicine(WM),and WM only as control,were searched by computer from the mainstream medical databases at home and abroad.The quality of the design scheme was evaluated by reference to the Cochrane Systematic Review manual,and Meta-analysis was performed by using RevMan 5.4 software.Results:In this study,22 RCTs were included for Meta-analysis.TCM or TCM plus WM was superior to WM alone not only in improving ovulation rate(P<0.05),but also in improving homeostasis model assessment of insulin resistance(HOMA-IR),fasting insulin(FINS),body mass index(BMI),triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL)and other aspects(all P<0.05).However,there was no difference in the regulation of fasting blood glucose(FBG)and waist-to-hip ratio(WHR)in the TCM or TCM plus WM groups when compared with the WM alone group(both P>0.05).Conclusions:TCM or TCM plus WM has better efficacy in the treatment of abnormal glucose and lipid metabolism in the patients with obese PCOS by multi-pathway and multi-target,without adverse outcomes,suggesting that TCM or TCM plus WM is superior to WM alone.
作者
高征
李梦元
李博
梁婧翘
张雅冬
许昕
GAO Zheng;LI Meng-yuan;LI Bo;LIANG Jing-qiao;ZHANG Ya-dong;XU Xin(Department of Gynecology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Clinical School of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2024年第5期368-377,394,共11页
Journal of International Reproductive Health/Family Planning
基金
全国名老中医药专家传承工作室建设项目[国中医办人教函(2021)270号]
北京中医医院院级课题暨两院合作项目(LYYB202203)。
关键词
多囊卵巢综合征
中药学
中西医结合
肥胖
腹部
葡萄糖代谢障碍
脂代谢障碍
META分析
Polycystic ovary syndrome
Chinese materia medica
Integrated traditional Chinese medicine&western medicine
Obesity,abdominal
Glucose metabolism disorders
Lipid metabolism disorders
Meta-analysis
作者简介
通信作者:许昕,E-mail:xuxin@bjzhongyi.com。
