PDF(Pubmed)
Abstract：
BACKGROUND: Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA).
METHODS: In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0.
RESULTS: This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate.
CONCLUSIONS: The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.
METHODS: In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0.
RESULTS: This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate.
CONCLUSIONS: The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.
摘要：
背景：多囊卵巢综合征（PCOS）不孕由于其发病率高，引起了研究者的极大关注。大量研究表明,中医药治疗本病有效,但是有各种各样的中医疗法，而临床上对各种中医综合疗法的疗效缺乏比较评价,这需要进一步深入的探索。本研究旨在使用网络荟萃分析（NMA）评估中药（TCM）联合疗法治疗PCOS不孕症的疗效。
方法：在PubMed中，科学网,科克伦图书馆,Embase,中国知网,万方数据,VIP数据库,中国生物医学文献数据库(SinoMed)数据库,对中医综合疗法治疗PCOS不孕症的随机对照试验(RCTs)进行了研究。使用Cochrane5.3偏差风险评估工具进行质量评估，和NMA使用Stata16.0。
结果：本研究共包括28个RCTs，使用8种中医综合疗法。NMA的结果表明，艾灸+草药，火针+草药，针灸+草药,电针+草药，穴位贴敷+中药提高临床妊娠率优于针灸，草药,西药单药治疗(P<0.05)。此外,耳点压力+草药灌肠+草药，针灸+草药,火针+草药，针灸+中药比针灸更好地提高排卵率，草药,西药单药治疗(P<0.05)。艾灸+草药,火针+草药，针灸+中药是提高临床妊娠率最有效的3种疗法。火针+草药,针灸+草药,耳穴贴压+中药灌肠+中药是提高排卵率最有效的3种疗法。
结论：中医综合疗法治疗PCOS不孕症的疗效优于针灸，草药,和西药单一疗法。然而,最佳治疗方案因结局指标而异.进一步的大样本，高品质，需要标准化的随机对照试验来验证这些发现.
方法：在PubMed中，科学网,科克伦图书馆,Embase,中国知网,万方数据,VIP数据库,中国生物医学文献数据库(SinoMed)数据库,对中医综合疗法治疗PCOS不孕症的随机对照试验(RCTs)进行了研究。使用Cochrane5.3偏差风险评估工具进行质量评估，和NMA使用Stata16.0。
结果：本研究共包括28个RCTs，使用8种中医综合疗法。NMA的结果表明，艾灸+草药，火针+草药，针灸+草药,电针+草药，穴位贴敷+中药提高临床妊娠率优于针灸，草药,西药单药治疗(P<0.05)。此外,耳点压力+草药灌肠+草药，针灸+草药,火针+草药，针灸+中药比针灸更好地提高排卵率，草药,西药单药治疗(P<0.05)。艾灸+草药,火针+草药，针灸+中药是提高临床妊娠率最有效的3种疗法。火针+草药,针灸+草药,耳穴贴压+中药灌肠+中药是提高排卵率最有效的3种疗法。
结论：中医综合疗法治疗PCOS不孕症的疗效优于针灸，草药,和西药单一疗法。然而,最佳治疗方案因结局指标而异.进一步的大样本，高品质，需要标准化的随机对照试验来验证这些发现.
