手术联合浆乳方治疗浆细胞性乳腺炎效果评价的Meta分析

目的运用循证医学的方法,对手术联合浆乳方治疗浆细胞性乳腺炎患者的症状体征积分、总有效率及痊愈率进行系统评价和Meta分析。方法收集CNKI、维普、万方数据库和Pubmed中(2016年7月以前)手术联合浆乳方治疗浆细胞性乳腺炎的临床试验资料,用Cochrane系统评价的方法对文章的质量进行评估,利用Rev Man5.3软件对多个研究结果的总体效应进行固定效应模型/随机效应模型的Meta分析。结果共纳入3篇RCTs文献,Meta分析结果示:对术前症状体征积分相似的PCM患者[MD=0.22,95%CI(-1.50,1.95),P=0.80],经手术联合浆乳方治疗后,症状体征积分[MD=-0.08,95%CI(-1.78,1.61),P=0.92]、总有效率[RR=1.05,95%CI(0.92,1.20),P=0.46]和痊愈率[RR=1.15,95%CI(0.94,1.39),P=0.17]均较前改善,但与单纯手术治疗均无显著差异。结论手术联合浆乳方与单纯手术治疗PCM相比,短期未能在改善症状体征积分、总有效率及痊愈率中显出明显优势,可延长疗程,继续观察并报道复发率、激素水平等指标;由于纳入研究存在高偏倚风险,需更多高质量的GCT进一步支持。

Meta Analysis on the Effect Evaluation of Surgery Combined with Jiangru Decoction in the Treatment of Plasma Cell Mastitis

Objective To make the systematic review and Meta-analysis for the effect of surgery combined with Jiangru decoction on the signs and symptoms integral, total effective rate and recovery rate of treating patients with plasma cell mastitis (PCM).Method A systematic search of all trials related to the effects of surgery combined with Jiangru decoction for PCM were collected in CNKI, VIP, Wanfang database and PubMed (July 2016 ago).The quality of trials were assessed using cochrane systematic review, including selection bias, performance bias, measurement bias, attrition bias, reporting bias and so on.Multiple overall effects of the results were carried out Meta analysis of fixed effects model or random effects model with the RevMan 5.3 software.Result A total of 3 articles were included.According to the results of the Meta-analysis, there were no significantly different in signs and symptoms integral [MD=0.22,95%Cl(-1.50, 1.95), P=0.80] of the patients with PCM preoperative.After treatment, there were no significantly different in signs and symptoms integral [MD=-0.08, 95% Cl (-1.78, 1.61), P=0.92], total effective rate [RR=1.05, 95%Cl (0.92, 1.20)P=0.46] and recovery rate [RR=1.15, 95% Cl (0.94, 1.39), P=0.17] between pure surgical treatment and postoperative oral administration with Jiangru decoction for PCM.Conclusion Comparing with pure surgical treatment, postoperative oral administration with Jiangru decoction could not improve the signs and symptoms integral, the total effective rate and recovery rate of patients with PCM in short-term treatment.We suggested extending the course to observe the curative effect of Jiangru decoction and report more indicators, such as recurrence rate, hormone levels.Due to the high risks of bias of included studies, it remains to be further verified with high-quality GCT.