针灸与西药治疗多囊卵巢综合征疗效比较的Meta分析

目的：采用Meta分析的方法比较针灸与西药对多囊卵巢综合征的治疗作用。方法：电子检索1980年至2013年公开发表在国内外杂志的以针灸为主治疗多囊卵巢综合征的相关文献。在排除重复、无关及非随机对照试验后，筛选出符合纳入标准的针灸治疗多囊卵巢综合征的随机对照试验，用Jadad 评分对这些文献进行质量评价，疗效评价采用Review Manage 5.0软件。以RR值作为效应指标计算针灸相对于西药对排卵障碍性不孕症的治疗优势，并进行异质性检验，并根据异质性检验结果采用固定或随机效应模型合并RR值，P值95%CI。结果：符合本次纳入标准的随机对照文献10篇，共计823例患者。针灸组与西药组相比较，相对危险度（relative risk，RR）=1.54，95%CI可信区间为（1.27，1.86），总体效应检验Z=4.38，P〈0.00001，差异有统计学意义，提示针灸组优于西药组。针灸加中药组与西药组比较，合并效应量RR=1.48，95%CI可信区间为（1.25，1.76），总体效应检验Z=4.49，P〈0.0001，差异有统计学意义，提示针灸联合中药组优于西药组。结论：针灸为主治疗多囊卵巢综合征的疗效优于西药，但纳入评价的文献质量普遍不高，期待更多大样本、随机对照方法严谨规范的高质量文献。

Meta Analysis of Acupuncture and Western Medicine in the Treatment of Polycystic Ovarian Syndrome

Objective：Use Meta analysis to compare the therapeutic effect of acupuncture and western medicine in the treatment of poly-cystic ovarian syndrome. Methods：Use electronic retrieval of published in the magazine at home and abroad about acupuncture literature for the treatment of polycystic ovary syndrome from 1980 to 2013. In the exclusion of repetition and after a randomized controlled trial, screen into standard randomized controlled trials of acupuncture treatment of polycystic ovary syndrome with the Jadad score evaluating quality evaluation of the literature and Manage 5. 0 software for curative effect evaluation. Use RR value as an index of effect,compared the advantage of acupuncture with western medicine treatment of ovulation disorder infertility and heterogeneity inspection. According to the heterogeneity test results,use fixed or random effects model combined with RR values,P values 95% CI. Results：In accordance with the inclusion criteria of a randomized controlled with 10 references,a total of 823 patients. Compared acupuncture group with the western medicine group,the relative risk was 1. 54,95% CI（1. 27,1. 86）,the overall effect inspection Z=4. 38,P〈0. 000 01,the difference was statistically significant,suggesting acupuncture treatment group was superior to western medicine in control group. Compared acu-puncture plus Chinese medicine and western medicine group,combined effect was 1. 48,95% CI（1. 25,1. 75）,the overall effect in-spection Z=4. 49,P〈0. 000 1,the difference was statistically significant,suggesting acupuncture combined with Chinese medicine treatment was superior to western medicine. Conclusion：The curative effect of acupuncture treatment in treating polycystic ovary syn-drome is superior to western medicine,but the quality of evaluation literature generally is not high,look forward to high quality papers with more sample,randomized controlled method and strict specification.