妇科千金胶囊联合抗菌药治疗慢性宫颈炎的Meta分析

目的 系统评价妇科千金胶囊联合抗菌药治疗慢性宫颈炎的有效性和安全性。方法 计算机检索中文学术期刊全文数据库（CNKI）、维普中文期刊全文数据库（VIP）、万方数据库（Wanfang Data）、中国生物医学文献数据库（CBM）、PubMed、Cochrane Library、Embase和Web of Science数据库中妇科千金胶囊联合抗菌药治疗慢性宫颈炎的临床随机对照试验（RCT）,检索时间从各数据库建库至2023年1月。采用Cochrane协作网提供的RevMan 5.4软件进行Meta分析。结果 共纳入18项RCTs,共计1 946例患者（试验组972例、对照组974例）。Meta分析结果显示,妇科千金胶囊联合抗菌药治疗慢性宫颈炎的临床总有效率明显高于单独使用抗菌药［RR＝1.23,95% CI（1.18,1.27）,P＜0.000 01］;白细胞介素-6水平［MD＝-2.60,95% CI（-3.32,-1.88）］、超敏C反应蛋白（hs-CRP）水平［MD＝-3.78,95% CI（-4.46,-3.09）］均明显低于单独使用抗菌药（P＜0.000 01）;分泌物评分［MD＝-0.74,95% CI（-1.05,-0.43）］、宫颈病变评分［MD＝-0.89,95% CI（-1.07,-0.72）］均明显低于单独使用抗菌药物（P＜0.000 01）;不良反应发生率与单独使用抗菌药物相比,组间差异无统计学意义［RR＝0.78,95% CI（0.34,1.77）,P＝0.55］。结论 妇科千金胶囊联合抗菌药物治疗慢性宫颈炎的临床疗效较好,在血清学指标、治疗后评分方面也有较好表现,亚组分析认为该结果稳健。但纳入文献较少,其中血清学指标、治疗后评分结局指标存在显著异质性,尚需要更多高质量、大样本、多中心RCT进一步验证。

Meta-analysis of Fuke Qianjin Capsule combined with antibiotics in treatment of chronic cervicitis

Objective To evaluate the efficacy and safety of Fuke Qianjin Capsule combined with antibiotics in the treatment of chronic cervicitis. Methods CNKI, Wanfang Data, CBM, VIP, PubMed, Cochrane Library, Embase, and Web of Science database were searched by computer to collect the randomized controlled trial (RCT) of Fuke Qianjin Capsule combined with antibiotics in the treatment of chronic cervicitis, the search deadline is from database establishment to January 2023. Meta-analysis performed by RevMan 5.4 software which is provided by Cochrane collaboration network. Results A total of 18 RCTs with 1 946 patients were included, 972 patients in trial group, and 974 patients in control group. The results of Meta-analysis showed that total effective rate of Fuke Qianjin capsule combined with antibiotics in the treatment of chronic cervicitis was significantly higher than that of antibiotics alone [RR = 1.23, 95%CI (1.18, 1.27), P < 0.000 01], IL-6 level [MD = -2.60, 95%CI (-3.32, -1.88)], hs-CRP level [MD = -3.78, 95%CI (-4.46, -3.09)] were significantly lower than that of antibiotics alone (P < 0.000 01). The secretion score [MD = -0.74, 95%CI (-1.05, -0.43)], cervical lesion score [MD = -0.89, 95%CI (-1.07, -0.72)] were significantly lower than that of antibiotics alone (P < 0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups compared with the use of antibiotics alone [RR = 0.78, 95%CI (0.34, 1.77), P = 0.55]. Conclusion Fuke Qianjin Capsule combined with antibiotics is effective in the treatment of chronic cervicitis, and it also has a good performance in serological index and symptom score after treatment. Subgroup analysis shows that the result is stable. However, there are few literatures, in which there is significant heterogeneity in serological index and symptom score outcome index after treatment, which may need more high-quality, large-sample, multicenter RCTs.