PCOS近五年文献研究概况及补肾活血法治疗的系统评价

发布时间：2018-05-26 19:09

本文选题：中医 + 中西医结合　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:本研究共分为两部分。第一部分分析和总结近五年治疗多囊卵巢综合征(PCOS)的文献,了解PCOS的研究近况,包括发病机制、辨证分型、使用药物三方面;第二部分对其中补肾活血法治疗PCOS的文献进行系统评价,评价其有效性和安全性,为临床治疗PCOS排卵障碍提供循证依据和诊疗思路。方法:第一部分检索中国学术期刊全文数据库(CNKI)2011年01月至2015年12月中医、中西医结合治疗PCOS的文献,运用Excel软件建立数据库,总结本病的病机、辨证分型、用药规律。第二部分依据Cochrane协作网提供的工作手册,对文献进行系统评价,Meta分析采用Revman5.3软件进行。结果:第一部分搜集到PCOS病机25种,总频次为540;涉及辨证分型57类(单一证型12类,兼夹证型45类),总频次为358;涉及273味中药,总频次为7734,使用频率较高的药物共29味。第二部分共纳入13篇文献,系统评价显示纳入文献质量有待进一步提高,Meta分析显示补肾活血药及其联合促排卵药可改善PCOS所致的排卵障碍,且未发现明显的副作用。发表性风险偏倚评估表明存在发表性偏倚。结论:近五年文献中涉及PCOS的病机主要有肾虚、肝郁、痰瘀互结、血瘀、脾肾亏虚等。证型主要有肾虚血瘀证、痰湿证、肾虚肝郁证、肾虚证、脾虚痰湿证等。药物应用以补虚药最多,其次是活血化瘀药、理气药、清热药、利水渗湿药;补虚药中补阳药应用最多,补阳药中补肾阳者出现次数居首位;药物归经于肝经者最多,入肾经、脾经的药物次之。系统评价显示纳入文献质量有待提高,Meta分析显示补肾活血药及其联合促排卵药治疗PCOS所致排卵障碍的疗效肯定,且未发现明显的副作用。
[Abstract]:Objective: this study is divided into two parts. The first part is to analyze and summarize the literature on the treatment of polycystic ovary syndrome (PCOS) in recent five years, and to understand the recent research situation of PCOS, including pathogenesis, syndrome differentiation and drug use. In the second part, the literature on the treatment of PCOS by tonifying kidney and activating blood circulation was systematically evaluated, and its efficacy and safety were evaluated, which provided evidence-based basis and diagnosis and treatment for clinical treatment of PCOS ovulation disorder. Methods: in the first part, we searched the Chinese academic journal full text database (CNKI) from January 2011 to December 2015. We used Excel software to establish the database of TCM and western medicine for PCOS treatment, and summarized the pathogenesis, syndrome differentiation and drug use law of the disease. In the second part, according to the work manual provided by Cochrane Cooperative Network, the systematic evaluation of the literature was carried out by Revman5.3 software. Results: in the first part, 25 kinds of PCOS pathogenesis were collected, the total frequency was 540, 57 kinds were involved in syndrome differentiation (12 types of single syndrome type, 45 types of clip syndrome type, the total frequency was 358), and 273 kinds of traditional Chinese medicine were involved, the total frequency was 7734, and there were 29 kinds of drugs in high frequency. In the second part, 13 articles were included. The systematic evaluation showed that the quality of the literature should be further improved. Meta-analysis showed that tonifying kidney and activating blood circulation drugs and combined ovulation promoting drugs could improve the ovulation disorder induced by PCOS, and no obvious side effects were found. The evaluation of published risk bias indicated the presence of publication bias. Conclusion: the pathogenesis of PCOS in recent five years is mainly kidney deficiency, liver depression, phlegm and blood stasis, deficiency of spleen and kidney and so on. The main syndromes are kidney deficiency and blood stasis syndrome, phlegm dampness syndrome, kidney deficiency liver depression syndrome, kidney deficiency syndrome, spleen deficiency phlegm dampness syndrome and so on. The drugs were mostly used as tonifying drugs, followed by the drugs of activating blood circulation and removing blood stasis, regulating qi, clearing heat, promoting water and infiltrating dampness; of the drugs of tonifying deficiency, the drugs of tonifying yang were the most, and those of tonifying yang of the drugs of tonifying yang were the first, the most of which were the meridians of the liver and the meridian of the kidney, Spleen meridian drugs followed. Systematic evaluation showed that the quality of literature should be improved. Meta-analysis showed that the therapeutic effect of tonifying kidney and activating blood and combined ovulation promoting drugs on ovulation disorder caused by PCOS was positive, and no obvious side effects were found.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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