成晓玲　周仲瑜　黄伟　吴桂玲　陈霞　郑易炜

摘要：目的 比较电针与激素替代疗法（HRT）治疗围绝经期综合征（PMS）的临床疗效及安全性。方法 计算机检索中国知识资源总库（CNKI）、中国学术期刊数据库（万方数据）、中国生物医学文献数据库（CBM）、中文科技期刊数据库（重庆维普）、PubMed、Cochrane Library中电针与HRT比较治疗PMS临床随机对照试验文献，检索范围均从建库至2017年1月28日。2名研究者独立筛选文献、提取资料，并按照Cochrane评价员手册5.1.0对纳入文献进行质量评价，采用RevMan 5.3软件进行Meta分析。结果 共纳入6篇文献，共计受试者457例。Meta分析结果显示：在治疗期及治疗后6个月随访时，电针与HRT在改善PMS患者血清雌二醇、KI方面均无显著差异。随着治疗时间延长，电针在降低促卵泡生成激素水平方面优于HRT[MD=-5.93，95%CI（-9.90，-1.96），P=0.003]，差异有统计学意义。治疗期间电针组发生不良反应更少。结论 电针能有效治疗PMS，与HRT疗效相当，且安全性较好，可为临床提供参考。但本研究纳入研究质量普遍偏低，尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证。

关键词：电针；激素替代疗法；围绝经期综合征；随机对照试验；系统评价

DOI：10.3969/j.issn.1005-5304.2018.03.024

中图分类号：R2-05；R245.3 文献标识码：A 文章编号：1005-5304（2018）03-0107-05

Abstract： Objective To compare the clinical efficacy and safety of electroacupuncture and hormone replacement therapy （HRT） on the treatment of perimenopausal syndrome （PMS）. Methods Clinical randomized controlled trial literature about electroacupuncture and HRT for the treatment of PMS in CNKI， Wanfang database， CBM， Chongqing Weipu， PubMed and Cochrane Library from establishment of the databases to 28th of January 2017 was retrieved by computers. Two researchers screened out data and extracted materials quality. Qualities of the literature were assessed by relevant standards in the Cochrane Handbook 5.1.0. Meta-analysis was conducted with RevMan5.3 software. Results 6 articles with 457 participants met the inclusion criteria and were included in this study. Meta-analysis showed that during the treatment or the follow-up period of 6 months， there was no significant difference in the improvement of serum E2 and Kupperman scores between the electroacupuncture and HRT. With the prolongation of treatment time， electroacupuncture showed superiority over HRT in depressing the level of serum FSH [MD=-5.93， 95%CI （-9.90， -1.96）， P=0.003]， with statistical significance. During the treatment period， the electroacupuncture group had fewer adverse reactions. Conclusion Electroacupuncture can effectively treat PMS， with similar efficacy as HRT， and with good safety， which can provide references for clinic. However， the quality of included studies is generally low， yet more large sample， multicenter， high-quality clinical RCTs are needed for further validation.

Keywords： electroacupuncture； hormone replacement therapy； perimenopausal syndrome； randomized controlled trial； systematic review

圍绝经期综合征（perimenopausal syndrome，PMS）是指妇女由于卵巢功能衰退而导致性激素减少引起的以自主神经功能紊乱症状为主的一组症候群。临床表现为潮热、盗汗、失眠、泌尿生殖综合征、疲劳、关节痛、头痛等，严重影响患者的生活质量[1]。目前国际上常用激素替代疗法（hormone replacement therapy，HRT）治疗本病，有一定疗效，但存在一定的局限性。……