[1] MOU Jing - Zhan, ZHANG Wen-li, Wang Teng, et al. Network Meta Analysis on The Efficacy of TCM Syndrome Differentiation in The Treatment of Dysfunctional Uterine Bleeding [J]. Journal of Shaanxi University of Traditional Chinese Medicine, 2021, 44(01): 107-121. [doi: 10.13424/j.cnki.jsctcm.2021.01.019]
Network Meta Analysis on The Efficacy of TCM Syndrome Differentiation in The Treatment of Dysfunctional Uterine Bleeding
- Article number:
- 2096-1340(2021)01-0107-15
- Keywords:
- Dysfunctional uterine bleeding; TCM syndrome differentiation treatment; Network Meta analysis; Randomized controlled trial
- ZTFLH:
- R271.12
- Code:
- A
- Abstract:
- Objective: To explore and compare the therapeutic effects of 8 different TCM differentiated interventions on dysfunctional uterine bleeding . Methods: PubMed, CBM, CNKI, Wanfang Data, VIP, the Cochrane Library and EMBASE databases were searched for randomized controlled trials on TCM syndrome differentiation and treatment of dysfunctional uterine bleeding. The retrieval period was from the establishment of the database to February 3, 2020. According to Cochrane 5. 1 manual standard, the included studies were evaluated for literature quality and bias risk, and R soft- ware was used for network meta - analysis and probability ranking. Results: A total of 43 studies involving 4606 patients with dysfunctional uterine bleeding were included. The results of network meta - analysis showed that the curative effect of each TCM intervention group was better than that of Western medicine intervention group, among which the liver and kidney nourishing Group [OR = 6. 9,95% CI (3. 5,14. 0)] was the best, followed by the heat clearing and blood cooling group [OR = 6. 1,95% CI (3. 1,14. 0)], The group of nourishing blood and Qi [ OR = 5. 5, 95% CI (2. 6, 13. 0)], Jianpi group [OR = 3. 7, 95% CI (1. 7, 9. 0)], Buqi group[ OR = 2. 9, 95% CI (1. 3, 6. 8)], kidney tonifying group [OR = 2. 7, 95% CI (1. 7, 4. 4)], blood activating and blood stasis resolving group [OR = 2. 6, 95% CI (1. 5, 4. 7)] , and nourishing spleen and kidney Group [OR = 2. 4, 95% CI (1. 5, 3. 8)]. Conclusion: The therapeutic effects of different TCM syndrome differentiation intervention measures on dysfunctional uterine bleeding is better than that of Western medicine intervention measures, and Yanggan Bushen method has the best effect. Due to the limitation of the quantity and quality of the included literature, more large sample and high - level randomized controlled trials are needed to verify the above conclusions.
References:
[1]杜惠兰,冯晓玲,王玮,等.排卵障碍性异常子宫出血中西医结合诊疗指南[J/OL].中国中西医结合杂志:1-10[2020-04-22].http://kns.cnki.net/kcms/detail/11.2787.R.20200310.0937.004.html.
[2]马宝璋,齐聪.中医妇产科学[M].北京:中国中医药出版社,2012:83-88.
[3]邹晴燕,谢小馨,曾榕,等.崩漏的中医诊疗进展[J].实用妇科内分泌电子杂志,2019,6(11):36-38.
[4]张荣华,鲁影.黄体酮联合坤泰胶囊对围绝经期功能失调性子宫出血患者的有效性及子宫平滑肌功能的影响[J/OL].辽宁中医药大学学报:1-8[2020-04-22].http://kns.cnki.net/kcms/detail/21.1543.R.20200324.1152.018.html.
[5]高玉娟.崩漏的病因机制及中医治疗进展[J].医学理论与实践,2019,32(4):505-507.
[6]LumleyT.Networkmeta-analysisforindirecttreatmentcomparisons[J].StatMed,2002,21(16):2313-2324.
[7]谢幸,孔北华,段涛.妇产科学.[M].北京:人民卫生出版社,2018.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:27-28.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:人民卫生出版社,2002.
[10]孙传兴.临床疾病诊断依据治愈好转标准[M].北京:人民军医出版社,2002.
[11]Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions (Version 5.1.0). Available at: http://handbook.cochrance.org.
[12]朱洁云,王霄玲,钟枝梅,等.体质量指数与慢性心力衰竭死亡率相关性的Meta分析[J].中国循证医学杂志,2020,20(2):144-151.
[13]刘宁,陈锋,吴晓飞,等.不同手术方式治疗腰椎间盘突出症疗效的网状Meta分析[J].广西医学,2019,41(24):3173-3180.
[14]Brooks SP, Gelman A. General methods for monitoring convergence of iterative simulations. J Comput Graph Stat, 1997,7(4): 434 - 455. 12.
[15]钟远鸣,万通,何炳坤,等.活血化瘀类中药注射剂辅助治疗腰椎间盘突出症的网状meta分析[J/OL].中华中医药学刊:1-16[2020-05-04].http://kns.cnki.net/kcms/detail/21.1546.R.20200407.0921.002.html.
[16] Salanti G, Ades AE, Ioannidis JP. Graphical methods and numerical summaries for presenting results from multiple - treatment meta - analysis: an overview and tutorial. J ClinEpidemiol, 2011, 64(2): 163 - 171.
[17]蒋玲洁,岳伟岗,王盛均,等.非药物干预比较改善ICU患者睡眠质量效果的网状Meta分析[J].中国循证医学杂志,2020,20(4):403-411.
[18]姚荔香.补肾疏肝法治疗肾虚肝郁型崩漏的临床疗效分析[J].中医临床研究,2020,12(4):124-126.
[19]叶天士.临证指南医案.[M].上海:上海人民出版社,1976-07.
[20]曹丽君,王瑞,刘永惠.刘永惠教授补肾论治崩漏[J].河北中医药学报,2017,32(5):45-47.
[21]刘丽.从肝肾论治崩漏的临床体会[J].河北中医,2015,37(12):1862-1864.
[22]哈荔田.哈荔田妇科医案医论选[M].北京:中国医药科技出版社,2014:31-43.
[23]展文国.丹栀逍遥散止崩漏体会[N].中国中医药报,2015-09-07(005).[24]陈瑶,曾雪扬,杨丰文,等.基于CiteSpace的中医药领域网状Meta分析的研究热点可视化分析[J/OL].中国中药杂志:1-11[2020-04-24].https://doi.org/10.19540/j.cnki.cjcmm.20200324.501.
Memo
通讯作者:徐慧军,主任医师,硕士研究生导师。 E-mail:xuhuijun08@163.Com