首页|中医药治疗男性免疫性不育meta分析

中医药治疗男性免疫性不育meta分析

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目的:运用meta分析方法系统评价中医药治疗男性免疫性不育的有效性和安全性.方法:检索万方数据库、中国生物医学文献数据库、Cochrane Library、维普数据库、PubMed数据库、CNKI(China National Knowl-edge Infrastructure)数据库,搜集中医药治疗男性免疫性不育的随机对照试验(RCT),并进行方法学质量评价,采用RevMan5.4 软件进行统计分析与发表偏倚评估.结果:有25 篇RCT文献纳入本项研究,总共纳入病例2 563例,其中试验组1 407 例,对照组1 155 例.meta分析显示中医药治疗男性免疫性不育总有效率(OR=6.35,95%CI:4.96~8.13,P<0.000 01)、精浆抗精子抗体转阴率(OR=4.52,95%CI:2.72~7.51,P<0.000 01)、血清抗精子抗体转阴率(OR=2.98,95%CI:2.23~3.96,P<0.000 01)、精液浓度(MD=15.56,95%CI:11.32~19.79,P<0.000 01)、a级精子百分率(MD=3.85,95%CI:1.91~5.79,P=0.000 01)、a+b级精子百分率(MD=13.77,95%CI:7.06~20.48,P<0.000 1)、精子存活率(MD=10.32,95%CI:6.78~13.86,P<0.000 01)、妊娠率(OR=3.53,95%CI:2.68~4.63,P<0.000 01)、不良反应(OR=0.06,95%CI:0.01~0.23,P<0.000 01)均显著优于单纯西药治疗.中医药治疗男性免疫性不育的精子畸形率与单纯使用西药组疗效差异不明显(MD=-7.53,95%CI:-15.50~0.44,P=0.06).结论:中医药治疗男性免疫性不育疗效确切、安全性高,是治疗男性免疫性不育的有效方法.
Treatment of male immune infertility by traditional Chinese medicine:A meta-analysis
Objective:To evaluate the efficacy and safety of traditional Chinese medicine(TCM)in the treatment of male im-mune infertility(MII)by meta-analysis.Methods:We retrieved randomized controlled trial(RCT)on the treatment of male im-mune infertility with traditional Chinese medicine from the databases of WanFang,Chinese Biomedical Literature,Cochrane Library,Weipu,PubMed and CNKI,and performed methodological quality assessment of the RCTs identified and statistical analysis and evalua-tion of the publication bias using the RevMan5.4 software.Results:Totally,25 RCTs(2 563 cases)were included in this study.Compared with Western medicine alone in the treatment of MII,TCM achieved a significantly higher total effectiveness rate(OR=6.35,95% CI:4.96-8.13,P<0.000 01),negative conversion rate of seminal plasma anti-sperm antibodies(OR=4.52,95% CI:2.72-7.51,P<0.000 01),negative rate of serum anti-sperm antibodies(OR=2.98,95% CI:2.23-3.96,P<0.000 01),sperm concentration(MD=15.56,95% CI:11.32-19.79,P<0.000 01),grade a sperm motility(MD=3.85,95% CI:1.91-5.79,P=0.000 01),grade a+b sperm motility(MD=13.77,95% CI:7.06-20.48,P<0.000 1),sperm viability(MD=10.32,95% CI:6.78-13.86,P<0.000 01)and pregnancy rate(OR=3.53,95% CI:2.68-4.63,P<0.000 01),but a lower rate of adverse reactions(OR=0.06,95% CI:0.01-0.23,P<0.000 01).There was no statistically significant difference in the percentage of morphologically abnormal sperm between TCM and Western medicine alone in the treatment of MII(MD=-7.53,95% CI:-15.50-0.44,P=0.06).Conclusion:TCM has a definite effectiveness and high safe in the treatment of male immune infertility.

traditional Chinese medicinemale immune infertilitymeta-analysisefficacysafety

范春美、马斯棋、丁克凡、杨毅坚、文鑫邦、赵梓钦、陈淑慧、秦国政

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云南中医药大学第一临床医学院,云南 昆明 650021

云南省中医医院男科/生殖医学科,云南 昆明 650021

中医药 男性免疫性不育 Meta分析 有效性 安全性

国家自然科学基金地区科学基金国家中医药循证能力提升项目(2023)

81860853

2024

中华男科学杂志
南京军区南京总医院

中华男科学杂志

CSTPCD
影响因子:1.052
ISSN:1009-3591
年,卷(期):2024.30(6)
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