中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
25期
3089-3095
,共7页
不孕症%输卵管阻塞%中西医结合疗法%Meta 分析
不孕癥%輸卵管阻塞%中西醫結閤療法%Meta 分析
불잉증%수란관조새%중서의결합요법%Meta 분석
Sterlity%Fallopian tube obstruction%TCM WM therapy%Meta - analysis
目的:系统评价中西医结合治疗输卵管阻塞性不孕症的有效性和安全性。方法计算机检索 PubMed、EMBase、Cochrane 图书馆对照试验资料库、中国期刊全文数据库(CNKI)、中国生物医学文献服务系统( CBM)、维普信息资源系统(ⅤIP)中关于中西医结合治疗输卵管阻塞性不孕症有效性和安全性的文献。检索时间均为建库至2014年5月。采用 RevMan 5.1统计软件对符合纳入及排除标准的文献进行统计学分析。结果共纳入文献19篇,共计患者数2503例。Meta 分析结果显示:中西医治疗组和西医治疗组的妊娠率比较,差异有统计学意义〔OR(95% CI)=1.42(1.30,1.56),P <0.01〕;非腹腔镜手术亚组中,两组妊娠率比较,差异有统计学意义〔 OR(95% CI)=1.47(1.30,1.66),P <0.01〕;腹腔镜手术亚组中,两组妊娠率比较,差异有统计学意义〔OR(95% CI)=1.36(1.18,1.56),P <0.01〕。中西医治疗组和西医治疗组的总有效率比较,差异有统计学意义〔RR(95% CI)=1.39(1.29,1.50),P <0.01〕;非腹腔镜手术亚组中,两组总有效率比较,差异有统计学意义〔 RR(95% CI)=1.41(1.29,1.55),P <0.01〕;腹腔镜手术亚组中,两组总有效率比较,差异有统计学意义〔 RR(95% CI)=1.34(1.16,1.54),P <0.01〕。中西医治疗组和西医治疗组的输卵管再通率比较,差异有统计学意义〔 RR(95% CI)=1.34(1.20,1.50),P <0.01〕。中西医治疗组和西医治疗组的异位妊娠率比较,差异有统计学意义〔OR(95% CI)=0.32(0.15,0.68),P <0.01〕;非腹腔镜手术亚组中,两组异位妊娠率比较,差异有统计学意义〔 OR(95% CI)=0.23(0.08,0.68),P <0.01〕。中西医治疗组和西医治疗组的术后再粘连率比较,差异有统计学意义〔 RR (95% CI)=0.38(0.25,0.59),P <0.01〕。仅有3篇文献对患者治疗期间的不良反应进行了描述,且不良反应症状均较轻,休息后可自行缓解。结论与单纯西医治疗相比,中西医结合治疗可以提高输卵管阻塞性不孕症患者的妊娠率、总有效率及输卵管再通率,降低其术后再粘连率和非腹腔镜手术治疗患者的异位妊娠率,不良反应较少,有效性和安全性较高。
目的:繫統評價中西醫結閤治療輸卵管阻塞性不孕癥的有效性和安全性。方法計算機檢索 PubMed、EMBase、Cochrane 圖書館對照試驗資料庫、中國期刊全文數據庫(CNKI)、中國生物醫學文獻服務繫統( CBM)、維普信息資源繫統(ⅤIP)中關于中西醫結閤治療輸卵管阻塞性不孕癥有效性和安全性的文獻。檢索時間均為建庫至2014年5月。採用 RevMan 5.1統計軟件對符閤納入及排除標準的文獻進行統計學分析。結果共納入文獻19篇,共計患者數2503例。Meta 分析結果顯示:中西醫治療組和西醫治療組的妊娠率比較,差異有統計學意義〔OR(95% CI)=1.42(1.30,1.56),P <0.01〕;非腹腔鏡手術亞組中,兩組妊娠率比較,差異有統計學意義〔 OR(95% CI)=1.47(1.30,1.66),P <0.01〕;腹腔鏡手術亞組中,兩組妊娠率比較,差異有統計學意義〔OR(95% CI)=1.36(1.18,1.56),P <0.01〕。中西醫治療組和西醫治療組的總有效率比較,差異有統計學意義〔RR(95% CI)=1.39(1.29,1.50),P <0.01〕;非腹腔鏡手術亞組中,兩組總有效率比較,差異有統計學意義〔 RR(95% CI)=1.41(1.29,1.55),P <0.01〕;腹腔鏡手術亞組中,兩組總有效率比較,差異有統計學意義〔 RR(95% CI)=1.34(1.16,1.54),P <0.01〕。中西醫治療組和西醫治療組的輸卵管再通率比較,差異有統計學意義〔 RR(95% CI)=1.34(1.20,1.50),P <0.01〕。中西醫治療組和西醫治療組的異位妊娠率比較,差異有統計學意義〔OR(95% CI)=0.32(0.15,0.68),P <0.01〕;非腹腔鏡手術亞組中,兩組異位妊娠率比較,差異有統計學意義〔 OR(95% CI)=0.23(0.08,0.68),P <0.01〕。中西醫治療組和西醫治療組的術後再粘連率比較,差異有統計學意義〔 RR (95% CI)=0.38(0.25,0.59),P <0.01〕。僅有3篇文獻對患者治療期間的不良反應進行瞭描述,且不良反應癥狀均較輕,休息後可自行緩解。結論與單純西醫治療相比,中西醫結閤治療可以提高輸卵管阻塞性不孕癥患者的妊娠率、總有效率及輸卵管再通率,降低其術後再粘連率和非腹腔鏡手術治療患者的異位妊娠率,不良反應較少,有效性和安全性較高。
목적:계통평개중서의결합치료수란관조새성불잉증적유효성화안전성。방법계산궤검색 PubMed、EMBase、Cochrane 도서관대조시험자료고、중국기간전문수거고(CNKI)、중국생물의학문헌복무계통( CBM)、유보신식자원계통(ⅤIP)중관우중서의결합치료수란관조새성불잉증유효성화안전성적문헌。검색시간균위건고지2014년5월。채용 RevMan 5.1통계연건대부합납입급배제표준적문헌진행통계학분석。결과공납입문헌19편,공계환자수2503례。Meta 분석결과현시:중서의치료조화서의치료조적임신솔비교,차이유통계학의의〔OR(95% CI)=1.42(1.30,1.56),P <0.01〕;비복강경수술아조중,량조임신솔비교,차이유통계학의의〔 OR(95% CI)=1.47(1.30,1.66),P <0.01〕;복강경수술아조중,량조임신솔비교,차이유통계학의의〔OR(95% CI)=1.36(1.18,1.56),P <0.01〕。중서의치료조화서의치료조적총유효솔비교,차이유통계학의의〔RR(95% CI)=1.39(1.29,1.50),P <0.01〕;비복강경수술아조중,량조총유효솔비교,차이유통계학의의〔 RR(95% CI)=1.41(1.29,1.55),P <0.01〕;복강경수술아조중,량조총유효솔비교,차이유통계학의의〔 RR(95% CI)=1.34(1.16,1.54),P <0.01〕。중서의치료조화서의치료조적수란관재통솔비교,차이유통계학의의〔 RR(95% CI)=1.34(1.20,1.50),P <0.01〕。중서의치료조화서의치료조적이위임신솔비교,차이유통계학의의〔OR(95% CI)=0.32(0.15,0.68),P <0.01〕;비복강경수술아조중,량조이위임신솔비교,차이유통계학의의〔 OR(95% CI)=0.23(0.08,0.68),P <0.01〕。중서의치료조화서의치료조적술후재점련솔비교,차이유통계학의의〔 RR (95% CI)=0.38(0.25,0.59),P <0.01〕。부유3편문헌대환자치료기간적불량반응진행료묘술,차불량반응증상균교경,휴식후가자행완해。결론여단순서의치료상비,중서의결합치료가이제고수란관조새성불잉증환자적임신솔、총유효솔급수란관재통솔,강저기술후재점련솔화비복강경수술치료환자적이위임신솔,불량반응교소,유효성화안전성교고。
Objective To conduct systematic analysis of the effectiveness and safety of the treatment of sterility caused by oviduct barrage by combined therapy of Chinese and western medicine. Methods We made a computer - based retrieval from PubMed,EMBase,Cochrane library,CNKI,CBM and ⅤIP for literatures relevant with the effectiveness and safety of the treatment of sterility caused by oviduct barrage by integrated Chinese - western therapy. The retrial time range was set from database establishment to May 2014. The RevMan 5. 1 statistical software was used to conduct statistic analysis of the literatures that accorded with inclusion and exclusion criteria. Results A total of 19 pieces of literature were included,concerning 2 503 patients. The meta - analysis showed the following results,The TCM/ WM group and WM group were significantly different in the rate of pregnancy〔OR(95% CI) = 1. 42(1. 30,1. 56),P < 0. 01〕;in the non - laparoscope subgroup,the TCM/ WM group and WM group were significantly different in the rate of pregnancy〔OR(95% CI) = 1. 47(1. 30,1. 66),P < 0. 01〕;in the laparoscope subgroup,the TCM/ WM group and WM group were significantly different in the rate of pregnancy〔 OR (95% CI) = 1. 36(1. 18,1. 56),P < 0. 01〕. The TCM/ WM group and WM group were significantly different in the total effective rate〔RR(95% CI) = 1. 39(1. 29,1. 50),P < 0. 01〕;in the non - laparoscope subgroup,the TCM/ WM group and WM group were significantly different in the total effective rate〔RR(95% CI) = 1. 41(1. 29,1. 55),P < 0. 01〕;in the laparoscope subgroup,the TCM/ WM group and WM group were significantly different in the total effective rate〔 RR (95% CI)= 1. 34 ( 1. 16,1. 54 ),P < 0. 01 〕 . The TCM/ WM group and WM group were significantly different in the recanalization rate of fallopian tube〔RR(95% CI)= 1. 34(1. 20,1. 50),P < 0. 01〕. The TCM/ WM group and WM group were significantly different in the rate of ectopic gestation〔 OR(95% CI) = 0. 32 ( 0. 15,0. 68 ),P < 0. 01 〕;in the non - laparoscope subgroup,the TCM/ WM group and WM group were significantly different in the rate of ectopic gestation〔OR (95% CI) = 0. 23(0. 08,0. 68),P < 0. 01〕;the TCM/ WM group and WM group were significantly different in the rate of postoperative re - adhesion〔RR(95% CI) = 0. 38(0. 25,0. 59),P < 0. 01〕. There were only 3 pieces of literatures in which the adverse reactions during treatment were recorded,and these adverse reactions were slight and recovered automatically after rest. Conclusion Compared with pure west medicine,the integrated Chinese - western therapy could increase the pregnancy rate of patients with sterility caused by oviduct barrage,the over effective rate and the recanalization rate of fallopian tube,and decrease the rate of postoperative re - adhesion and the rate of ectopic gestation. The integrated Chinese - western therapy causes few adverse actions and has good effectiveness and safety.