五子衍宗方联合左卡尼汀治疗男性不育症的meta分析
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摘要
目的系统评价五子衍宗方联合左卡尼汀治疗男性不育症的临床疗效。方法通过检索PubMed数据库、Embase数据库、The Cochrane Library、EBSCO数据库、中国知网(CNKI)、维普数据库(VIP)、万方数据库(Wanfang)、中国生物医学数据库(CBM),收集五子衍宗方联合左卡尼汀治疗男性不育症的临床随机对照研究(randomizedcontrolledtrails,RCTs)。根据Cochrane5.1手册要求,分别选择研究、提取数据并评价纳入RCTs的质量,使用RevMan5.3软件进行meta分析。结果纳入5项研究,共441例患者。Meta分析显示,五子衍宗方联合左卡尼汀在有效率(P=0.0004)、△精子密度(P<0.00001)、△精子活率(P=0.005)、△a级精子率(P=0.002)、△a+b级精子率(P=0.003)均明显优于左卡尼汀,但△精液量(P=0.40)两者相当。结论五子衍宗方联合左卡尼汀方治疗男性不育症的疗效较为确定,但鉴于纳入研究有一定的局限性,仍需采用设计良好的大规模临床随机对照研究来验证。
OBJECTIVE To systematically evaluate the efficacy of Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility. METHODS Searched PubMed, Embase, The Cochrane Library, EBSCO, CNKI, VIP,Wanfang and CBM databases to collect randomized controlled clinical trials(RCTs) on the treatment of male infertility with Wuziyanzong prescription and levocarnitine. The data were extracted and the quality of the included RCTs literature were evaluated according to Cochrane 5.1 handbook, and meta-analysis was conducted using the Rev Man 5.3 software. RESULTS Five trials involving 441 patients were included. The results of meta-analysis showed that effectiveness rate(P=0.000 4), △sperm density(P<0.000 01), △sperm motility(P=0.005), △grade a sperm rate(P=0.002) and △grade a+b sperm rate(P=0.003) of Wuziyanzong prescription combined with levocarnitine were better than levocarnitine, but △semen volume(P=0.40)was not inferior to levocarnitine. CONCLUSION Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility is effective. However, due to the limitations of the included study, a well-designed large-scale clinical randomized controlled study is still needed to verify the efficacy.
OBJECTIVE To systematically evaluate the efficacy of Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility. METHODS Searched PubMed, Embase, The Cochrane Library, EBSCO, CNKI, VIP,Wanfang and CBM databases to collect randomized controlled clinical trials(RCTs) on the treatment of male infertility with Wuziyanzong prescription and levocarnitine. The data were extracted and the quality of the included RCTs literature were evaluated according to Cochrane 5.1 handbook, and meta-analysis was conducted using the Rev Man 5.3 software. RESULTS Five trials involving 441 patients were included. The results of meta-analysis showed that effectiveness rate(P=0.000 4), △sperm density(P<0.000 01), △sperm motility(P=0.005), △grade a sperm rate(P=0.002) and △grade a+b sperm rate(P=0.003) of Wuziyanzong prescription combined with levocarnitine were better than levocarnitine, but △semen volume(P=0.40)was not inferior to levocarnitine. CONCLUSION Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility is effective. However, due to the limitations of the included study, a well-designed large-scale clinical randomized controlled study is still needed to verify the efficacy.
引文
[1]中华医学会男科学分会.左卡尼汀在男性不育症中临床应用专家共识(2014版)[J].中华男科学杂志,2015,21(1):82-85.
[2]中国中西医结合学会男科专业委员会.男性不育症中西医结合诊疗指南(试行版)[J].中国中西医结合杂志,2015,35(9):1034-1038.
[3]AN Q,ZOU L.A meta-analysis of the Chinese medicine Wuziyanwan for treatment of oligospermia and asthenospermia[J].Chin J Human Sex(中国性科学),2015,24(1):84-89.
[4]ZHU H X,QIAO F Y,ZHANG Y.Effect of Bimin Kang decoction combined with ebastine tablets on the treatment of allergic rhinitis and serum levels of inflammatory factors analysis[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(2):266-270.
[5]SHI S,CHU Y G,ZHANG L M,et al.Systematic review on naoxintong capsule combined with statins in treatment of hyperlipidemia[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(4):566-572.
[6]SHANG X J,WANG L L,MO D S,et al.Effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia:A systemic review[J].Nat JAndrol(中华男科学杂志),2015,21(1):65-73.
[7]段晓明,徐计秀,赵双生.左旋肉碱加五子衍宗丸治疗少、弱精子症的临床疗效观察[C].全国性医学学术会议,2010:285-286.
[8]范凯,肖友平,王波,等.五子衍宗丸联合左卡尼汀治疗少弱精子症的临床观察[J].内蒙古中医药,2016,15(11):91.
[9]ZHANG X Y,LUO S B,ZHANG J Y,et al.Yijingfang for the treatment of asthenospermia:A randomized controlled clinical trial[J].Nat J Androl(中华男科学杂志),2017,23(4):361-366.
[10]CUI G,XU W H,WU G P.Effects of Wuziyanzong liquids combing with L-carnitine on oligospermia and asthenospermia[J].J Hainan Med Univ(海南医学院学报),2011,17(3):347-349.
[11]SUO J,LUO X H,LI T,et al.Wuziyanzong soft capsule joint left-carnitine oral treatment on asthenozoospermia[J].Chin JHuman Sex(中国性科学),2017,26(4):105-108.
[12]欧阳洪根,黄灵聪.中西医结合治疗少弱精子症45例临床观察[J].中国男科学杂志,2010,24(11):43-44.
[13]ZHANG L,DUAN X M,XU J X,et al.Treatment in men with oligoasthenospermia with L-carnitine and Wuziyangzong bolu[J].Chin J Surg Int Tradit Western Med(中国中西医结合外科杂志),2010,16(5):535-537.
[14]ZENG Q Q,SUN L,NIE C,et al.Research progress of Wuziyanzong pill[J].Chin Arch Tradit Chin Med(中华中医药学刊),2014,32(8):1935-1937.
[2]中国中西医结合学会男科专业委员会.男性不育症中西医结合诊疗指南(试行版)[J].中国中西医结合杂志,2015,35(9):1034-1038.
[3]AN Q,ZOU L.A meta-analysis of the Chinese medicine Wuziyanwan for treatment of oligospermia and asthenospermia[J].Chin J Human Sex(中国性科学),2015,24(1):84-89.
[4]ZHU H X,QIAO F Y,ZHANG Y.Effect of Bimin Kang decoction combined with ebastine tablets on the treatment of allergic rhinitis and serum levels of inflammatory factors analysis[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(2):266-270.
[5]SHI S,CHU Y G,ZHANG L M,et al.Systematic review on naoxintong capsule combined with statins in treatment of hyperlipidemia[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(4):566-572.
[6]SHANG X J,WANG L L,MO D S,et al.Effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia:A systemic review[J].Nat JAndrol(中华男科学杂志),2015,21(1):65-73.
[7]段晓明,徐计秀,赵双生.左旋肉碱加五子衍宗丸治疗少、弱精子症的临床疗效观察[C].全国性医学学术会议,2010:285-286.
[8]范凯,肖友平,王波,等.五子衍宗丸联合左卡尼汀治疗少弱精子症的临床观察[J].内蒙古中医药,2016,15(11):91.
[9]ZHANG X Y,LUO S B,ZHANG J Y,et al.Yijingfang for the treatment of asthenospermia:A randomized controlled clinical trial[J].Nat J Androl(中华男科学杂志),2017,23(4):361-366.
[10]CUI G,XU W H,WU G P.Effects of Wuziyanzong liquids combing with L-carnitine on oligospermia and asthenospermia[J].J Hainan Med Univ(海南医学院学报),2011,17(3):347-349.
[11]SUO J,LUO X H,LI T,et al.Wuziyanzong soft capsule joint left-carnitine oral treatment on asthenozoospermia[J].Chin JHuman Sex(中国性科学),2017,26(4):105-108.
[12]欧阳洪根,黄灵聪.中西医结合治疗少弱精子症45例临床观察[J].中国男科学杂志,2010,24(11):43-44.
[13]ZHANG L,DUAN X M,XU J X,et al.Treatment in men with oligoasthenospermia with L-carnitine and Wuziyangzong bolu[J].Chin J Surg Int Tradit Western Med(中国中西医结合外科杂志),2010,16(5):535-537.
[14]ZENG Q Q,SUN L,NIE C,et al.Research progress of Wuziyanzong pill[J].Chin Arch Tradit Chin Med(中华中医药学刊),2014,32(8):1935-1937.