补肾健脾法治疗少弱精子症临床有效性的Meta分析

目的 系统评价补肾健脾法治疗少弱精子症的临床疗效。方法 检索中国期刊全文数据库(CNKI)、维普资源系统(VIP)以及万方数据库,均从建库至2014年12月,收集数据库中有关补肾健脾法治疗少弱精子症的随机对照试验(RCT)。制定严格的文献纳入标准和排除标准及检索策略,并对纳入文献进行方法学质量评价,采用Revman5.3软件进行统计分析。结果 纳入8个RCT,共838例,根据对照不同分为单纯补肾组和西药组,但经过仔细筛选后,其中2项研究组间样本量差异较大,故针对单纯补肾组做敏感性分析。Meta分析显示,补肾健脾组在提高精子浓度及a级精子百分率方面优于单纯补肾组及西药组(P0.05)。结论 在提高精子浓度及a级精子百分率方面,健脾补肾法有优于单纯补肾法及西药治疗的趋势,但所纳入文献质量不高,部分数据差异性过大,且敏感性分析证实本研究结果稳定性不高,因此有待更为设计严谨、合理的RCT来证实补肾健脾法的临床疗效。

A Meta analysis on the effects of the treatment for oligoasthenozoospermia by the method of tonifying kidney and spleen

Objective To review the clinical effectiveness of the method of tonifying kidney and spleen on oligoasthenozoospemia by systematic review.Methods All randomized controlled trials (RCTs) which relate to the treatment on oligoasthenozoospermia by the method of tonifying kidney and spleen were searched from CNKI,VIP and Wanfang database,from database foundation to 2014.12.Strict inclusion criteria,search strategy and exclusion criteria about literature were established,methodological evaluation was taken on included literature in addition.All statistical analysis was performed with RevMan 5.0 software.Results Eight RCTs meeting the criteria were selected,including 838 cases totally,they were divided into the simple tonifying kidney subgroup and the western medicine subgroup according to the different reference drugs,but we found that there were two studies among included studies which there was a significant discrepancy between each group,therefore we made a sensitivity analysis in allusion to the simple tonifying kidney subgroup.Meta analysis showed that the clinical efficiency of tonifying kidney and spleen group were superior to the simple tonifying kidney group (P＜0.05) and the western medicine group (P＜0.05) on improving the sperm concentration and the percentage of a level sperm.Conclusion There was the tendency about the clinical efficacy of the method of tonifying kidney and spleen was superior to the simple tonifying kidney and the western medicine on improving the sperm concentration and the percentage of a level sperm,all included literatures were low in quality,there were large differences among the several data,and sensitivity analysis suggest the result of our study has a low stability,therefore we look forward to more rigorous and professional RCTs in order to prove the clinical efficacy of the method of tonifying kidney and spleen.