目的:多囊卵巢综合征(PCOS)是一种影响许多育龄妇女的内分泌妇科疾病。克罗米芬是PCOS患者的一线治疗药物,但是大多数人可能会对它产生抵抗力。本研究旨在评估地塞米松和氯米芬治疗PCOS患者的疗效。为临床医师研究和治疗PCOS提供理论依据。
方法:中文和英文数据库,包括PubMed,Embase,科克伦图书馆,中国国家知识基础设施(CNKI),万方医学网,和VIP信息中文期刊服务平台(VIP)从成立至2023年1月进行搜索。使用ReviewManager和Stata软件进行Meta分析。使用Cochrane的偏倚风险工具评估符合条件的研究的偏倚风险。通过漏斗图评估出版偏倚,Begg\和Egger\的测试。
结果:最终收录了12篇文献,共有1270名PCOS患者。与对照组相比,地塞米松联合克罗米芬能显著改善妊娠(RR=1.71,P<0.00001),排卵(RR=1.30,P<0.00001),黄体生成素水平(SMD=-0.94,P<0.00001),雌二醇水平(SMD=0.99,P=0.05),孕酮程度(SMD=5.08,P=0.002)和睾酮程度(SMD=-1.59,P<0.00001)。然而,对促排卵激素水平无显著影响(SMD=0.15,P=0.37),不良反应(RR=1.30,P=0.30),头晕(RR=1.50,P=0.45),呕吐(RR=1.67,P=0.48)。
结论:地塞米松联合克罗米芬治疗有助于提高PCOS患者的排卵率和妊娠率。改善患者的激素水平。
OBJECTIVE: Polycystic ovary syndrome (PCOS) is an endocrine gynecological disease affecting many women of reproductive age.
Clomiphene is the first-line treatment for PCOS patients, but most individuals may be resistant to it. This study aims to assess the efficacy of dexamethasone and
clomiphene in the treatment of PCOS patients, and to provide a theoretical basis for clinicians to study and treat PCOS.
METHODS: Chinese and English databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Medical Network, and VIP Information Chinese Journal Service Platform (VIP) were searched from the inception to January 2023. Review Manager and Stata software were used for meta- analysis. The risk of bias of eligible studies were assessed using Cochrane\'s risk of bias tool. Publication bias was assessed by funnel plots, Begg\'s and Egger\'s tests.
RESULTS: A total of 12 literatures were finally included, with a total of 1270 PCOS patients. Compared with the control group, dexamethasone combined with
clomiphene could significantly improve pregnancy (RR = 1.71, P < 0.00001), ovulation (RR = 1.30, P < 0.00001), luteinizing hormone level (SMD = -0.94, P < 0.00001), estradiol level (SMD = 0.99, P = 0.05), progesterone level (SMD = 5.08, P = 0.002) and testosterone level (SMD = -1.59, P < 0.00001). However, there were no significant effects on ovulation-stimulating hormone level (SMD = 0.15, P = 0.37), adverse reactions (RR = 1.30, P = 0.30), dizziness (RR = 1.50, P = 0.45), and vomiting (RR = 1.67, P = 0.48).
CONCLUSIONS: The treatment of dexamethasone combined with
clomiphene is helpful to improve the ovulation and pregnancy rate in patients with PCOS, and improve the hormone levels of patients.