健脾益气法治疗功能失调性子宫出血的Meta分析

目的:对健脾益气法治疗功能失调性子宫出血的临床研究文献进行Meta分析,评价其疗效,为功能失调性子宫出血的中医药治疗提供理论依据和临床参考。方法:计算机检索Pub Med,CBM,CNKI数据库,收集健脾益气法治疗功能失调性子宫出血的随机对照试验。由两名研究者按照Rev Man5.3软件推荐研究方法独立选择文献、提取资料,并进行Meta分析。结果:纳入研究文献11篇,合计1 077例患者,其中试验组569例,西药对照组508例。Meta分析结果,按照结局指标分亚型,以中医证候疗效为结局指标,中药与西药组相比OR=3.64,95%CI(2.02,6.59),Z=4.28,P0.000 01];以月经总体疗效为结局指标,中药与西药相比OR=3.78,95%CI(2.49,5.74),Z=6.24,P0.000 01],以近期止血疗效为结局指标,中药与西药相比OR=1.47,95%CI(0.55,3.93),Z=0.77,P=0.44]。结论:健脾益气法治疗功能失调性子宫出血具一定的临床疗效,是可供临床选择的治疗方案。由于纳入文献的质量较低,尚存在一定的发表性偏倚,有待于今后开展高质量临床研究提供循证医学证据。

Meta-analysis on Effect of Spleen Invigorating and Qi Replenishing Therapy in Treating Dysfunctional Uterine Bleeding

Objective: To conduct a Meta-analysis on clinical study literatures for the effect of spleen invigorating and Qi replenishing therapy in treating dysfunctional uterine bleeding, in order to evaluate its efficacy and provide basis and clinical reference for traditional Chinese medicine(TCM) therapies in treating dysfunctional uterine bleeding. Method: PubMed, CBM, CNKI database were searched through computer to collect spleen invigorating and Qi replenishing therapy for dysfunctional uterine bleeding in randomized controlled trials. Two researchers independently selected literatures, extracted data and conducted a Meta-analysis according to the study method recommended by RevMan5.3 software. Result: Totally 11 study literatures involving 1 077 cases were selected, including 569 cases in the test group and 508 cases in the western medicine control group. According to the result of the Meta-analysis, the groups were subdivided by outcome indexes. The comparison between TCM and western medicine groups in the TCM syndrome efficacy showedOR=3.64, 95%CI(2.02,6.59), Z=4.28, P<0.000 01],the comparison between both groups in the overall menstruation efficacy showedOR=3.78, 95%CI (2.49, 5.74), Z=6.24,P<0.000 01],and the comparison between both groups in the recent hemostatic efficacy showedOR=1.47, 95%CI (0.55, 3.93), Z=0.77, P=0.44]. Conclusion: The spleen invigorating and Qi replenishing therapy showed a certain clinical efficacy in treating dysfunctional uterine bleeding and so can be used as a clinical therapeutic option. However, due to the low quality of the included literatures, there is still certain publication bias. The above results shall be further proved on the basis of the evidence-based medicine in high-quality clinical studies in the future.