摘要
目的:系统评价活血化瘀方与西药对比在预防子宫内膜息肉宫腔镜术后复发方面的有效性和安全性。统计纳入文献中的中药使用频次,探讨常用药物,为中医治疗子宫内膜息肉提供用药思路。方法:检索从建库至2023年4月20日中国知网、维普、万方数据库、中国生物医学文献数据库、PubMed及Cochrane Library数据库中收录的有关活血化瘀方预防子宫内膜息肉宫腔镜术后复发的临床随机对照试验(Randomized Controlled Trial,RCT)。依照原本制定的纳入和剔除标准,确认符合要求的文献。由2人使用Cochrane协作网制定的“偏倚风险评估工具”对文献质量进行评估后绘制图表。最后提取所需数据,导入RevMan 5.4软件进行分析。主要结局指标为子宫内膜息肉复发率,次要结局指标为不良反应发生率。用Q检验和I2检验对提取的数据进行异质性分析。复发率、不良反应发生率均为二分类变量,进行统计分析时选用相对危险度(RR),取95%可信区间(CI)。采用Excel表统计入选文献中的中药使用频次。结果:依据检索策略,检索到492篇可能符合标准的文献,再根据纳入与剔除标准,最终纳入17篇文献。活血化瘀方降低复发率的效果优于西药(P<0.00001)。中药组的不良反应发生率低于西药对照组(P<0.0001)。前10味常用药物的排序为当归、赤芍、川芎、桃仁、茯苓、丹参、炙/生甘草、白术、益母草、牡丹皮。结论:与西药治疗相比,在降低子宫内膜息肉宫腔镜术后复发率方面,中药活血化瘀方具有明显优势,而且不良反应少,比较安全。
Objective:To evaluate the effectiveness and safety of the Huoxue Huayu prescription(活血化瘀方)compared with Western medicine in preventing recurrence of endometrial polyps after hysteroscopic operation.To statistically count the frequency of the use of traditional Chinese medicine in the included literature,the commonly used drugs are discussed to provide medication ideas for the treatment of endometrial polyps with traditional Chinese medicine.Methods:CNKI,VIP,Wanfang database,Chinese Biomedical Literature Database,PubMed and Cochrane were searched from the establishment of the database to April 20,2023 for randomized controlled clinical trials(RCT)of the Huoxue Huayu prescription for preventing the recurrence of endometrial polyps after hysteroscopic operation.Papers that met the requirements were identified according to the established inclusion and exclusion criteria.The quality of the papers was assessed by two individuals using the Risk of Bias Assessment Tool developed by the Cochrane Collaboration.Finally,the required data were extracted and imported into RevMan 5.4 software for analysis.The primary outcome indicator was the recurrence rate of endometrial polyps,and the secondary outcome indicator was the incidence of adverse events.The extracted data were analyzed for heterogeneity using the Q test and I²test.The recurrence rate and the incidence of adverse events were dichotomous variables,and relative risk ratio(RR)was used for statistical analysis,including the 95%confidence interval.The use frequency of Chinese medicine in the selected literature was counted by Excel table.Results:According to the search strategy,492 literatures that may meet the criteria were retrieved,and 17 literatures were finally included according to the inclusion and exclusion criteria.The effect of the Huoxue Huayu prescription in reducing the recurrence rate of endometrial polyps was superior to that of western medicine(P<0.00001).The incidence of adverse reactions in the traditional Chinese medicine(TCM)group was lower than that in the western control group(P<0.0001).The order of the top 10 commonly used drugs was:Danggui(Angelica sinensis),Chishao(Radix Paeoniae),Chuanxiong(Ligusticum wallichii),Taoren(peach kernel),Fuling(poria),Danshen(Salvia miltiorrhiza),Zhi/Shenggancao(Grilled/raw licorice),Baizhu(Rhizoma Atractylodis Macrocephalae),Yimucao(Leonurus),and Mudanpi(peony bark).Conclusion:Compared with western medicine treatment,the Huoxue Huayu prescription demonstrates significant superiority in reducing the recurrence rate,causing fewer adverse reactions and it is safer.
作者
高慧
王君清
刘文琼
GAO Hui;WANG Junqing;LIU Wenqiong
出处
《中医临床研究》
2024年第21期89-93,共5页
Clinical Journal Of Chinese Medicine
基金
国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函【2022】1号)。
关键词
中药
活血化瘀方
子宫内膜息肉
宫腔镜术后
复发
系统评价
Traditional Chinese medicine
The Huoxue Huayu prescription
Endometrial polyp
Post hysteroscopy
Recurrence
Systematic evaluation
