补肾活血中药治疗女性高催乳素血症随机对照试验的Meta分析
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摘要
系统评价补肾活血中药治疗高催乳素血症的安全性和有效性,为补肾活血中药治疗高催乳素血症提供循证医学证据。计算机全面检索PubMed,EMbase,Cochrane Library,CNKI,Wan Fang,VIP,CBM中关于补肾活血中药治疗高催乳素血症的随机对照试验并进行Meta分析。检索时间均为建库至2018年9月28日。根据纳入和排除标准遴选文章,提取数据,采用"偏移风险评估工具"进行质量评价,运用Review Manager 5. 3软件进行Meta分析。最终纳入13篇研究文献,合计816例高催乳素血症患者。Meta分析结果显示补肾活血中药与溴隐亭相比,在降低催乳素、提高妊娠率方面无统计学意义;在改善中医证候、降低疾病复发和减少副作用等方面补肾活血中药有明显优势。补肾活血中药治疗高催乳素血症临床疗效确切、安全可靠、远期复发率低,但因受到纳入文献质量限制,上述结论还需要更多大样本高质量的临床研究加以验证。
The clinical efficacy of Bushen Huoxue traditional Chinese medicine( TCM) in the treatment of hyperprolactinemia were systematically evaluated,which provided evidence-based medical evidence for the treatment of hyperprolactinemia with Bushen Huoxue traditional Chinese medicine. The randomized controlled trials on the treatment of hyperprolactinemia with Bushen Huoxue traditional Chinese medicine were comprehensively searched by computer in PubMed,EMbase,Cochrane Library,CNKI,Wan Fang,VIP,CBM and Meta-analysis was performed. The search time is from the time of self-built database to September 28,2018. A total of 816 patients with hyperprolactinemia met the inclusion criteria in 13 clinical studies. The results of Meta-analysis showed that compared with Western medicines,traditional Chinese medicine for tonifying kidney and activating blood circulation had a comparable effect in reducing prolactin and treating infertility,and had obvious advantages in improving of TCM syndromes,disease recurrence and reducing of side effects.
The clinical efficacy of Bushen Huoxue traditional Chinese medicine( TCM) in the treatment of hyperprolactinemia were systematically evaluated,which provided evidence-based medical evidence for the treatment of hyperprolactinemia with Bushen Huoxue traditional Chinese medicine. The randomized controlled trials on the treatment of hyperprolactinemia with Bushen Huoxue traditional Chinese medicine were comprehensively searched by computer in PubMed,EMbase,Cochrane Library,CNKI,Wan Fang,VIP,CBM and Meta-analysis was performed. The search time is from the time of self-built database to September 28,2018. A total of 816 patients with hyperprolactinemia met the inclusion criteria in 13 clinical studies. The results of Meta-analysis showed that compared with Western medicines,traditional Chinese medicine for tonifying kidney and activating blood circulation had a comparable effect in reducing prolactin and treating infertility,and had obvious advantages in improving of TCM syndromes,disease recurrence and reducing of side effects.
引文
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[26]刘二伟,吴帅,樊官伟.川续断化学成分及药理作用研究进展[J].中华中医药学刊,2010,28(7):1421.
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[28] Shen M M,Tang Z J,Jaime A,et al. Induction and proliferation of axillary shoots from in vitro culture of Paeonia lactiflora Pall.mature zygotic embr-yos[J]. New Zeal J Crop Hort,2015,43(1):42.
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[2]曹泽毅.中华妇产科[M].北京:人民卫生出版社,1999.
[3]李留霞,乔玉环.泌乳及高催乳素血症108例临床研究[J].河南医科大学学报,2000,35(1):74.
[4]范晓迪,马堃,单婧,等.补肾活血促卵方治疗排卵障碍性不孕症的疗效观察[J].中国中药杂志,2013,38(1):119.
[5]范晓迪,马堃,单婧,等.补肾活血中药治疗排卵障碍性不孕的系统评价[J].中国中药杂志,2013,38(9):28.
[6]单婧,马堃.运用补肾活血法治疗排卵障碍性不孕[J].中国中药杂志,2014,39(4):748.
[7]马堃,刘雁峰,何军琴,等.补肾活血方案治疗排卵障碍性不孕不育的多中心随机双盲对照临床研究[J].中国中药杂志,2015,40(20):3911.
[8]马堃,李敏.补肾促卵冲剂治疗排卵障碍性不孕“肾虚血瘀”作用机制的研究[J].中国中药杂志,2017,42(23):4445.
[9]张碧霞.补肾理肝法治疗高催乳激素血症临床观察[D].南宁:广西中医药大学,2013.
[10]陈丽霞.补肾疏肝法治疗肾虚肝郁型高催乳素血症疗效观察[J].山西中医,2008(7):25.
[11]何剑豪.补肾疏肝方治疗肝郁肾虚证高催乳素血症患者的临床研究[D].南宁:广西中医药大学,2017.
[12]李省江,李锐凌.补肾疏肝汤治疗女性高催乳素血症54例临床研究[J].河北中医,2016,38(4):519.
[13]吴芸芳.补肾疏肝抑乳汤治疗高催乳素血症的临床研究[D].济南:山东中医药大学,2007.
[14]刘菊芳,王俊玲,陈新,等.补肾调肝敛乳方治疗高催乳素血症的临床研究[J].中国中西医结合杂志,1998(3):142.
[15]申小静.补肾养血疏肝汤加减治疗高催乳素血症致月经后期的临床效果观察[J].河南医学研究,2018(16):1.
[16]张芸娜.从PRL/PRLR-JAK2/STAT5信号传导通路角度探讨疏肝补肾法治疗高催乳素血症月经后期的实验及临床研究[D].北京:北京中医药大学,2015.
[17]陈难.补肾活血方对肾虚血瘀型高催乳素血症患者的影响[J].光明中医,2017,32(24):3587.
[18]陈难.疏肝补肾方对肝郁肾虚型高催乳素血症患者的影响[D].郑州:河南中医学院,2015.
[19]魏芳.疏肝补肾方治疗肝郁肾虚型高催乳素血症的临床研究[D].济南:山东中医药大学,2013.
[20]刘淑君,张占波.益肾调肝方治疗特发性高催乳素血症临床研究[J].辽宁中医药大学学报,2013,15(6):176.
[21]刘淑君,张占波.益肾调肝方治疗特发性高催乳素血症性闭经临床研究[J].辽宁中医杂志,2014,41(3):493.
[22]夏卉芳.菟丝子的药理研究进展[J].现代医药卫生,2012,28(3):402.
[23]徐何方,杨颂,李莎莎,等.菟丝子醇提物对肾阳虚证模型大鼠免疫功能的影响[J].中药材,2015,38(10):2163.
[24]罗鹏.川续断化学成分及药理作用研究进展[J].化工管理,2015(19):199.
[25]苗明三,孙艳红,史晶晶,等.熟地黄粗多糖对血虚模型小鼠胸腺和脾脏组织形态的影响[J].中华中医药杂志,2007,22(5):318.
[26]刘二伟,吴帅,樊官伟.川续断化学成分及药理作用研究进展[J].中华中医药学刊,2010,28(7):1421.
[27]陈方,向阳,朱立彬,等.当归药材质量标准提升研究[J].中国药师,2018,21(10):1861.
[28] Shen M M,Tang Z J,Jaime A,et al. Induction and proliferation of axillary shoots from in vitro culture of Paeonia lactiflora Pall.mature zygotic embr-yos[J]. New Zeal J Crop Hort,2015,43(1):42.
[29]龚爱芳.中药白芍的研究进展[C].哈尔滨:中国商品学会第五届全国中药商品学术大会,2017.
[30]胡栋宝,陆卓东,伍贤学.中药香附子化学成分及药理活性研究进展[J].时珍国医国药,2017,28(2):430.