桂枝茯苓胶囊联合米非司酮治疗子宫内膜异位症随机对照试验的Meta分析

发布时间：2018-07-10 00:41

本文选题：桂枝茯苓胶囊 + 米非司酮　；参考：《中药新药与临床药理》2016年04期

【摘要】：目的系统评价桂枝茯苓胶囊联合米非司酮应用于子宫内膜异位症的疗效与安全性。方法检索Pubmed,Embase,Cochrane library、万方数据资源、相关期刊论文(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP),检索时限自建库起截至2016年3月,检索桂枝茯苓胶囊联合米非司酮应用于子宫内膜异位症的随机对照试验(RCT),按照设定标准筛选文献并进行数据提取,采用Rev Man5.3软件进行Meta分析。结果纳入11个RCTs,共971例患者。Meta结果分析显示:(1)总有效率:试验组总有效率优于对照组[OR=3.80,95%CI[2.57,5.62](P0.00001)]差异具有统计学意义;(2)血清性激素水平:试验组在降低雌二醇(Estrogen,E_2)水平[MD=-18.42,95%CI(-27.19,-9.65)]以及降低孕酮(Progestone,P)水平[MD=-0.15,95%CI(-0.23,-0.06)(P=0.0007)]优于对照组,而两组在促卵泡素(Follicle stimulating hormone,FSH)[MD=-0.07,95%CI(-0.39,-0.26)(P=0.68)]以及黄体生成素(Luteinizing hormone,LH)[MD=-0.05,95%CI(-0.39,0.29)(P=0.78)]这两个指标上差异无统计学意义(P0.05);(3)妊娠率:试验组妊娠率优于对照组[OR=2.85,95%CI(1.85,4.37)(P0.00001)],差异具有统计学意义(P0.05);(4)复发率:试验组复发率低于对照组[OR=0.29,95%CI(0.17,0.49)(P0.00001)],差异具有统计学意义(P0.05);(5)不良反应:试验组不良反应少于对照组[OR=0.45,95%CI(0.24,0.85)(P=0.01)],差异具有统计学意义(P0.05)。结论桂枝茯苓胶囊以及米非司酮联合应用于子宫内膜异位症具有更好的疗效。因为纳入研究数量较少以及现有研究质量偏低,仍需要更多设计严谨的大样本、高质量、多中心的随机双盲临床研究进一步证实本研究的可靠性。
[Abstract]:Objective to evaluate the efficacy and safety of Guizhi Fuling capsule combined with mifepristone in the treatment of endometriosis. Methods Pubmedus Embase Cochrane library, Wanfang data Resources, China Journal Full-text Database (CNKI), China Biomedical Literature Database (CBM) and Weip Database (VIP) were searched. A randomized controlled trial (RCT) of Guizhi Fuling capsule combined with mifepristone for endometriosis was searched. The literature was screened according to the set criteria and the data were extracted. The Meta-analysis was carried out with Rev Man5.3 software. Results the results showed that: (1) the total effective rate of the trial group was higher than that of the control group [OR-3.80 + 95CI [2.575.62] (P0.00001); (2) the serum sex hormone level: the experimental group was reducing the level of estradiol (Estrogen E2) [MD-18.42-95CI (-27.19-9.65)] in the analysis of 971 cases of RCTs.Meta results showed that: (1) the total effective rate of the trial group was higher than that of the control group [OR-3.80 + 95CI [2.575.62] (P0.00001)]; (2) the level of serum sex hormone: the experimental group was reducing the level of estradiol (Estrogen E2) And to reduce the level of progestoneone P [MD-0.1595 CI (-0.23 -0.06) (P0. 0007)] was superior to the control group. However, there was no significant difference between the two groups in follicle stimulating hormone FSH [MD-0.0795 CI (-0.39 卤0.26) (P0. 68)] and luteinizing hormone LH [MDO-0. 05 5 CI (-0. 399 0. 29) (P0. 78)] (P0.05); (3) pregnancy rate: the pregnancy rate in the trial group was higher than that in the control group [OR2. 855 95 CI (1. 855. 37 CI) (P0. 00001)], the difference was statistically significant (); (4): the relapse rate of the trial group was significantly higher than that of the control group (P0. 0001). The rate was lower than that in the control group (CI (0.170.49) (P0.00001), the difference was statistically significant (P0.05); (5): the adverse reaction in the trial group was less than that in the control group [OR0.45 ~ 95CI (0.240.85) (P0.01), the difference was statistically significant (P0.05). Conclusion Guizhi Fuling capsule and mifepristone have better curative effect on endometriosis. Because of the small number of studies included and the low quality of the existing studies, there is still a need for more well-designed large samples, high quality, multi-center randomized double-blind clinical studies to further confirm the reliability of this study.
【作者单位】：广州中医药大学第一临床医学院;广州中医药大学第二临床医学院;
【分类号】：R711.71

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