摘要
目的系统评价中西药联合对比西药治疗复发性流产的综合疗效,为临床用药提供依据。方法通过计算机检索PubMed、Cochrane library、Embase、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库建库—2017年5月中西药联合治疗复发性流产患者的随机对照研究(RCT),对纳入文献进行质量评价,并用Revman 5.3软件进行Meta-分析。结果最终纳入43篇文献共3 298名患者。Meta-分析结果显示,中西药联合组的有效率明显高于西药组[OR=3.57,95%CI(2.73,4.67),P=0.98];针对不同中医症型,亚组分析显示补肾组、补肾健脾组、补气补血组以及补肾活血组疗效均优于单独使用西药[OR=3.47,95%CI(2.60,4.63),P=0.97];中西药联合使用能提高中医症候疗效[OR=4.54,95%CI(2.95,6.99),P=1.00],显著降低症状积分[MD=-3.46,95%CI(-4.32,-2.60),P<0.000 1];中西药联合使用组和西药组在孕8周[SMD=-0.65,95%CI(-0.10,1.40),P<0.000 01]、孕10周[SMD=0.10,95%CI(-0.78,0.98),P<0.000 01]血清β-HCG、IL-10[SMD=0.14,95%CI(-0.87,1.15),P<0.000 01]没有显著差异。结论与单独使用西药治疗相比,中西药联用增加了治疗有效率,改善了再次妊娠时的流产症状;针对不同中医症型的患者,均能够取得更好的疗效。中西药联用在血清β-HCG以及血清IL-10因子方面没明显改善。
Objective To compare the comprehensive curative effect of Chinese and western medicine combined with western medicine alone in the treatment of patients with recurrent spontaneous abortion. Methods Clinical control trials of patients with recurrent spontaneous abortion were conducted through the computer search of PubMed, Cochrane library, Embase, CBM, CNKI and Wanfang Data from inception to May 1, 2017. And then the quality of the included documents was evaluated, Revman 5.3 software was used to perform Meta-analysis of the eligible studies. Results A total of 3 298 patients with recurrent spontaneous abortion were included in 43 literatures. Meta-analysis showed that the effective rate of the combination group was significantly higher than that of the western medicine group [OR=3.57,95%CI(2.73, 4.67), P = 0.98];For different TCM types, the kidney group, bushenjianpi group, qixuejunbu group and bushenhuoxue group were all better than medicine alone [OR=3.57, 95%CI(2.73, 4.67), P = 0.98];At the same time, the combination of Chinese and western medicine can significantly improve the efficacy of TCM symptoms [OR=4.54, 95%CI(2.95, 6.99), P = 1.00], significant reduced symptom scores[MD=?3.46, 95%CI(?4.32, ?2.60), P < 0.000 1];However,there was no significant difference between the western medicine group and Chinese and western medicine for 8 weeks[SMD=?0.65, 95%CI(?0.10, 1.40), P < 0.000 01]and 10 weeks of[SMD=0.10, 95%CI(?0.78, 0.98), P < 0.000 01] serum β -HCG, serum IL-10[SMD=0.14, 95%CI(?0.87,1.15), P < 0.000 01]. Conclusions Compared with the use of western medicine alone in the treatment of recurrent spontaneous abortion, the effective rate of combined use of Chinese and western medicines has increased significantly, which has improved the symptoms of miscarriage when recurrent miscarriage occurs during re-pregnancy;and for the recurrent abortions of different TCM syndrome types, combined Chinese medicine treatment can achieve better efficacy. Analysis of serum β-HCG levels and serum IL-2 and IL-10 levels in the two groups showed no statistical significance.
作者
吴佳瑶
段蓉
李正翔
WU Jiayao;DUAN Rong;LI Zhengxiang(The General Hospital of Tianjin Medical University, Tianjin 300052, China)
出处
《药物评价研究》
CAS
2019年第1期149-158,共10页
Drug Evaluation Research
基金
北京市医学奖励基金资助项目(YJHYXKYJJ-502)
关键词
复发性流产
META-分析
临床研究
中西药联合
recurrent spontaneous abortion
Meta-analysis
clinical study
western and Chinese medicine
作者简介
第一作者:吴佳瑶,女,硕士研究生,研究方向为复发性流产的中药治疗的药理学评价。Tel:13132132702 E-mail:yaodski@163.com;通信作者:李正翔,男,主任药师,研究方向为临床药学、医院医学。E-mail:13820893896@163.com.
