Meta-analysis and Grading of Recommendations Assessment,Development and Evaluation quality evaluation of tonify kidney prescription to improve natural pregnancy outcome in women of advanced age
Objective To systematically evaluate the clinical efficacy and safety of tonify kidney prescription(TKP)in improving natural pregnancy outcomes in women of advanced age.Methods Literature of randomized controlled trial(RCT)about TKP in improving natural pregnancy outcomes in women of advanced age in CNKI,Wanfang,VIP,SinoMed PubMed,Web of Science,Cochrane Library,Embase from the establishment to June 2022 were searched.The quality was assessed by using the Risk of Bias tool and Meta-analysis was performed using RevMan software.Results A total of 14 RCTs were included in this study.Meta-analysis results showed that TKP combined with western treatment was better than western medicine treatment group in increasing pregnancy rate[RR=1.71,95％CI(1.45,2.01),P＜0.000,01],reducing follicle-stimulating hormone(FSH)level[SMD=-1.63,95％CI(-2.84,-0.43),P=0.008],increasing estradiol(E2)level[SMD=3.97,95％CI(1.76,6.17),P=0.000,4]and increasing endometrial thickness during ovulation[SMD=2.12,95％CI(1.07,3.18),P＜0.000,1].In addition,TKP alone has significant efficacy in terms of increasing pregnancy rate[RR=1.94,95％CI(1.31,2.88),P=0.001]and reducing FSH[SMD=-0.48,95％CI(-0.74,-0.22),P=0.000,3].Conclusions TKP can significantly improve natural pregnancy outcomes in women of advanced age with fewer adverse effects,when compared with western medicine treatment.However,more high-quality,large-sample,and multicenter RCTs are still needed for validation.
Tonify kidney prescriptionWomen of advanced ageNatural pregnancy outcomeMeta-analysisGrading of Recommendations Assessment,Development and Evaluation quality evaluation
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