温经汤加减治疗寒凝血瘀型原发性痛经随机对照试验分析
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摘要
目的:运用循证医学方法评价温经汤治疗寒凝血瘀型原发性痛经的临床疗效。方法:检索时间范围2008年1月至2018年1月,检索中国期刊全文数据库(CNKI)、维普全文期刊数据库、万方数据库,检索关键词:温经汤、寒凝血瘀、原发性痛经、经行腹痛,查找温经汤加减治疗寒凝血瘀型原发性痛经的随机对照试验,运用Jadad量表评分,筛选出符合纳入标准的试验,利用Revman 5.3对纳入试验进行荟萃分析,置信区间选取95%,评价温经汤治疗痛经的临床疗效,并绘制漏斗图分析发表性偏倚。结果:共纳入11篇文献,860名患者,对总有效率进行二分类变量分析:P=0.40,OR=3.39,合并检验:95%CI (2.31～4.98),Z=6.22,P<0.00001,差异具有统计学意义;纳入3篇文献在治疗后6～12个月分别对受试者、有效病例及治愈病例进行随访,以随访总体为结局指标,卡方分析结果:P=0.63,I2=0%,检验结果无异质性,OR=6.84,95%CI (2.87～16.26),合并效应量Z=4.35,P<0.0001,差异具有统计学意义。结论:温经汤加减治疗寒凝血瘀型原发性痛经效果明确。
Objective:To evaluate the clinical effect of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome by evidence-based medicine(EBM).Methods:The range of retrieval time was from January 2008 to January 2018. China Journal Full-text Database(CNKI),VIP Journal Full-text Database and Wanfang Data were retrieved. Retrieval keywords:Wenjing decoction,cold-coagulation and bloodstasis,primary dysmenorrhea,abdominal pain during menstruation. Randomized controlled trials of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome were sought out,and scored by Jadad scale.The trials that met the inclusion criteria were screened out. Meta-analysis of included trials was made by Revman 5.3,and 95% was selected as confidence interval.The clinical effect of Wenjing decoction on primary dysmenorrhea was evaluated. The funnel plot was drawn,and the publication bias was analyzed.Results:11 articles and 860 patients were included in total.Two-classifying variables of total efficiency were analyzed:P=0.40,OR=3.39.Merging test:95% CI(2.31～4.98),Z=6.22,P<0.00001,the difference was statistically significant. 3 articles were included.During 6 to 12 months after treatment,subjects,effective cases and cure cases were followed up. The totality of following-up was taken as outcomes indexes.The result of Chi-squared analysis:P=0.63,I2=0%.The examination result was without heterogeneity OR=6.84,95%CI(2.87～16.26). Merging effect quantity Z = 4.35,P < 0.0001,the difference was statistically significant. Conclusion:The clinical effect of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome is define.
Objective:To evaluate the clinical effect of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome by evidence-based medicine(EBM).Methods:The range of retrieval time was from January 2008 to January 2018. China Journal Full-text Database(CNKI),VIP Journal Full-text Database and Wanfang Data were retrieved. Retrieval keywords:Wenjing decoction,cold-coagulation and bloodstasis,primary dysmenorrhea,abdominal pain during menstruation. Randomized controlled trials of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome were sought out,and scored by Jadad scale.The trials that met the inclusion criteria were screened out. Meta-analysis of included trials was made by Revman 5.3,and 95% was selected as confidence interval.The clinical effect of Wenjing decoction on primary dysmenorrhea was evaluated. The funnel plot was drawn,and the publication bias was analyzed.Results:11 articles and 860 patients were included in total.Two-classifying variables of total efficiency were analyzed:P=0.40,OR=3.39.Merging test:95% CI(2.31～4.98),Z=6.22,P<0.00001,the difference was statistically significant. 3 articles were included.During 6 to 12 months after treatment,subjects,effective cases and cure cases were followed up. The totality of following-up was taken as outcomes indexes.The result of Chi-squared analysis:P=0.63,I2=0%.The examination result was without heterogeneity OR=6.84,95%CI(2.87～16.26). Merging effect quantity Z = 4.35,P < 0.0001,the difference was statistically significant. Conclusion:The clinical effect of modified Wenjing decoction on primary dysmenorrhea of cold-coagulation blood-stasis syndrome is define.
引文
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[13]徐丁洁,徐洪,董玉山,等.金匮温经汤对虚寒证原发性痛经患者子宫动脉血流动力学的影响[J].中医药导报,2016,22(13):36-38.
[2]冯金莲.温经汤治疗寒凝血瘀型原发性痛经30例临床观察[J].湖南中医杂志,2012,28(5):53-54.
[3]吴青燕.活血温经汤治疗原发性痛经51例[J].中国民间疗法,2015,23(11):31-32.
[4]唐卓,刘宇新.温经汤治疗原发性寒凝血瘀型痛经的疗效观察80例[J].中医临床研究,2015,7(31):95-97.
[5]李红梅,马志毅.温经汤加减治疗痛经46例[J].湖北中医杂志,2010,32(9):41.
[6]梅慧.温经汤治疗寒凝血瘀型原发性痛经疗效观察[J].广西中医药,2014,37(4):26-27.
[7]武卫红.温经汤加减治疗宫寒血瘀型痛经38例[J].中国现代药物应用,2012,6(16):65-66.
[8]籍艳秋.温经汤加减治疗原发性痛经(寒凝血瘀型)的临床观察[J].中国卫生标准管理,2015,6(26):110-111.
[9]荆晶.温经汤合失笑散加味治疗原发性痛经87例观察[J].实用中医药杂志,2016,32(4):318-319.
[10]郑玉燕,赵慧明,周志伟.温经汤加减治疗寒凝血瘀型痛经42例疗效观察[J].当代医学(学术版),2008,21(11):63-64.
[11]陈小娟.温经汤加减治疗原发性痛经60例疗效观察[J].大家健康(学术版),2016,10(6):51-52.
[12]鲁文珍.川乌温经汤治疗青春期原发性痛经45例[J].浙江中西医结合杂志,2008,18(8):501-502.
[13]徐丁洁,徐洪,董玉山,等.金匮温经汤对虚寒证原发性痛经患者子宫动脉血流动力学的影响[J].中医药导报,2016,22(13):36-38.