论文部分内容阅读
目的:基于目前的证据系统评估中药复方干预体外受精-胚胎移植(IVF-ET)的有效性和安全性。方法:计算机检索CNKI、万方、维普、中国生物医学文献数据库(CBM)、the Cochrane Library、Pub Med、Web of Science、Medline、EMbase、Alt Health Watch,以及部分妇产科相关杂志;纳入中药复方与空白、安慰剂或西药对照干预IVF-ET的随机对照试验(RCT),由2名研究者按照Cochrane Handbook Version 5.1.0标准独立评价文献质量、提取数据并交叉核对,使用Rev Man5.3软件进行Meta分析。结果:共纳入30个研究,合计2 385例患者。结果显示:中药复方干预IVFET相对于对照组而言能提高临床妊娠率(RR=1.45,95%CI:1.33~1.59)、受精率(RR=1.12,95%CI:1.08~1.15)、种植率(RR=1.36,95%CI:1.17~1.58)、优质胚胎率(RR=1.16,95%CI:1.06~1.26),增加子宫内膜厚度(MD=0.77,95%CI:0.18~1.37)及降低Gn使用量(SMD=-0.69,95%CI:-0.96~-0.42);在并发症的发生率上,中药组能降低流产率(OR=0.30,95%CI:0.13~0.69)和OHSS的发生率(OR=0.35,95%CI:0.17~0.73)。结论:在IVF-ET时施以中药复方干预能提高临床妊娠率以及卵子质量、胚胎质量和子宫环境质量,并能降低Gn使用量和流产率、OHSS的发生率。因此,基于目前的证据可以证明,中药复方干预IVF-ET具有良好的效果和安全性。
OBJECTIVE: To evaluate the effectiveness and safety of herbal compound in vitro fertilization-embryo transfer (IVF-ET) based on the current evidence system. Methods: The CNKI, Wanfang, VIP, CBM, the Cochrane Library, Pub Med, Web of Science, Medline, EMbase and Alt Health Watch were searched by computer, and some obstetrics and gynecology related magazines were included. Randomized controlled trials (RCTs) with IVF-ET versus blank, placebo, or Western control interventions were independently evaluated by two investigators in accordance with the Cochrane Handbook Version 5.1.0, data were extracted and cross-checked using Rev Man 5.3 software Meta-analysis. Results: A total of 30 studies were included, totaling 2,358 patients. The results showed that the IVF treatment group could improve the clinical pregnancy rate (RR = 1.45, 95% CI: 1.33-1.59), fertilization rate (RR = 1.12, 95% CI: 1.08-1.15) (RR = 1.36, 95% CI: 1.17-1.58), high quality embryos (RR = 1.16, 95% CI: 1.06-1.26) and increased endometrial thickness (MD = 0.77, 95% CI: 0.18-1.37) (OR = 0.30, 95% CI: 0.13-0.69) and OHSS (OR = 0.30, 95% CI: 0.13-0.62) in the incidence of complications, (OR = 0.35, 95% CI: 0.17-0.73). Conclusion: The intervention of Chinese herbal compound in IVF-ET can improve clinical pregnancy rate, egg quality, embryo quality and uterine environment quality, and can reduce the use of Gn and abortion rate, the incidence of OHSS. Therefore, based on the current evidence, it can be proved that intervention of traditional Chinese medicine compound IVF-ET has good effect and safety.