目的:系统评价宫腹腔镜术结合中医疗法对输卵管阻塞性不孕症的临床疗效.方法:计算机检索中国生物医学文献数据库、中国知网、维普数据库、万方数据库、PubMed、Embase、Web of Science、Cochrane Library等中英文数据库及中国临床试验注册中心和Clinical Trials.经过文献筛选临床随机对照试验(Randomized Controlled Trial,RCT)并进行治疗评价后提取有效数据,基于RevMan 5.3软件进行Meta分析.结果:29篇文献被纳入,共计2 588例患者.Meta分析结果表明,宫腹腔镜术结合中医疗法组与宫腹腔镜术组的宫内妊娠率的比较,差异有统计学意义[相对危险度(RR)95%置信区间(CI)=1.77(1.63,1.92),P＜0.001];两组输卵管通畅率比较,差异有统计学意义[RR(95%CI)=1.38(1.20,1.58),P＜0.001];两组总有效率相比,差异显著[RR(95%CI)=1.25(1.18,1.33),P＜0.001];两组异位妊娠率相比,亦具有显著性差异[RR(95%CI)=0.51(0.35,0.75),P＜0.001].在中医外治亚组、中医内治亚组、中医内外疗法治疗亚组,两组输卵管通畅率的比较,在统计学上均表现有显著性差异:[RR=1.62(1.16,2.27),P＜0.01],[RR=1.24(1.06,1.44),P＜0.01],[RR=1.59(1.13,2.23),P＜0.01].所有纳入文献中仅有1篇对患者医治过程的不良反应进行了描述.结论:与宫腹腔镜术治疗相比,宫腹腔镜术结合中医疗法可以提高输卵管阻塞性不孕症患者在治疗后的宫内妊娠率、输卵管通畅率及总有效率,降低异位妊娠率,不良反应较少,有效性和安全性较高.
A Meta-analysis of the curative effect of hysteroscopy and laparoscopic surgery with traditional Chinese medicine on tubal obstructive infertility
Objective:To systematically evaluate the clinical efficacy of hysteroscopy and laparoscopic surgery combined with tradi-tional Chinese medicine therapy on tubal obstructive infertility.Methods:Retrieved from CBM,CNKI,VIP,Wanfang,PubMed,Em-base,Web of Science,Cochrane Library,other Chinese and English databases,Chinese Clinical Trial Registry,and Clinical Trials,all literatures on hysteroscopy and laparoscopic surgery combined with TCM therapy in the treatment of tubal obstructive infertility were searched.After literature screening and quality evaluation,valid data were extracted for Meta-analysis using RevMan5.3 software.Results:Twenty-nine articles were included,with a total of 2 588 patients.Meta-analysis showed the following results,the hysteroscopy and laparoscopic surgery combined with TCM therapy group and the hysteroscopy and laparoscopic surgery group were significantly different in the rate of intrauterine pregnancy[RR(95%CI)=1.77(1.63,1.92),P<0.001].There was significant difference in the rate of tubal patency between laparoscopy combined with traditional Chinese medicine and laparoscopy[RR(95%CI)=1.38(1.20,1.58),P<0.001].There was a significant difference in the total effective rate between the two groups[RR(95%CI)=1.25(1.18,1.33),P<0.001].There was also a significant difference in the ectopic preg-nancy rate between the two groups[RR(95%CI)=0.51(0.35,0.75),P<0.001].In the Chinese medicine external treatment subgroup,Chi-nese medicine internal treatment subgroup,Chinese medicine internal and external therapy treatment subgroup,there were statistically signif-icant differences in the rate of tubal patency between the two groups:[RR=1.62(1.16,2.27),P<0.01],[RR=1.24(1.06,1.44),P<0.01],[RR=1.59(1.13,2.23),P<0.01].There was only 1 piece of literature in which the adverse reactions during treatment were recorded.Conclusion:Compared with the hysteroscopy and laparoscopic surgery,the hysteroscopy and laparoscopic surgery combined with TCM therapy could increase the rate of intrauterine pregnancy,the patency rate of people's fallopian tube and the total effective rate,and decrease the rate of ectopic pregnancy rate of patients with tubal obstructive infertility after treatment.There are fewer adverse reactions,high effectiveness and safety in the hysteroscopy and laparoscopic surgery combined with TCM therapy.
Fallopian tube obstructionSterilityThe hysteroscopy and laparoscopic surgeryTraditional Chinese medicine therapyMeta-analysis
万方数据
维普
