盛楠 曹梦娣 赵薇

【摘 要】 目的：系统评价补肾活血中药联合来曲唑治疗多囊卵巢综合征不孕症的疗效。方法：检索CNKI、Wan Fang Data、VIP 、PubMed和CBM数据库，查找补肾活血中药联合来曲唑治疗多囊卵巢综合征不孕症临床疗效观察的随机对照试验。采用Rev Man5.3软件进行Meta分析。结果：最终纳入文献9篇，共810例患者，其中补肾活血中药联合来曲唑治疗组450例，单用来曲唑对照组360例;在改善总有效率、妊娠率、子宫内膜厚度、LH（促黄体生成激素）、FSH（促卵泡生成激素）水平方面，补肾活血中药联合来曲唑组优于单用来曲唑组（P<0.05）;治疗组不良反应发生率低于对照组，安全性更高（P<0.05）。结论：与单纯来曲唑治疗相比，补肾活血中药联合来曲唑可有效改善多囊卵巢综合征不孕症患者的临床症状，提高治疗总有效率、妊娠率，增加子宫内膜厚度，改善LH、FSH水平，且安全性较高。

【关键词】 补肾活血;来曲唑;多囊卵巢综合征;不孕症;Meta分析

【中图分类号】R259   【文献标志码】 A    【文章编号】1007-8517（2021）10-0053-06

Meta Analysis of the Treatment of Infertility in Polycystic Ovary with Chinese Herbal Medicines for Tonifying Kidney and Activating Blood Combined with Letrozole

SHENG Nan1 CAO Mengdi1 ZHAO Wei2*

1.Nanjing University of Chinese Medicine ，Nanjing 210023，China;

2.Nanjing Hospital of Chinese Medicine，Nanjing 210001，China

Abstract：Objective To evaluate the efficacy of kidney-tonifying and blood-activating herbs combined with letrozole in treating PCOS （Polycystic ovary syndrome）infertility. Methods To collect the randomized controlled trials about the clinical effect of treatment of PCOS infertility with kidney-tonifying and blood-activating herbs combined with letrozole by retrieval of CNKI， Wan Fang， VIP， PubMed and CBM databases. Meta analysis was carried out by Rev Man 5.3 software. Results A total of 9 articles were included. Totally 810 cases were included，including 450 in the treatment group and 360 in the control group;In terms of improving the total effective rate， pregnancy rate， endometrial thickness， LH levels， FSH levels， the treatment group is better than the control group（P<0.05）;The adverse reactions of treatment groups was lower than that of control group（P<0.05）. Conclusion Compared with letrozole treatment alone， the kidney-tonifying and blood-activating herbs combined with letrozole can effectively improve the clinical symptoms of patients with PCOS infertility， improve the total effective rate， pregnancy rate， increase the thickness of the endometrium， and regulate the levels of LH and FSH ，and have a high safety.

Keywords：Kidney-Tonifying and Blood-Activating Herbs; Letrozole; Polycystic Ovary Syndrome; Infertility; Meta Analysis

多囊卵巢綜合征（Polycystic ovary syndrome，PCOS）近年发病率逐年升高，临床常表现为月经失调、不孕、肥胖、多毛和痤疮，远期可增加2型糖尿病及心脑血管疾病的患病风险，严重危害女性健康。排卵障碍为其主要临床特征，PCOS导致70%左右的育龄期妇女出现排卵问题，是导致不孕的重要因素[1]。西医主要通过调节内分泌水平、促排卵途径治疗本病，但妊娠率不高[2]。来曲唑作为临床常用促排卵药物，通过降低雌激素负反馈作用，促进促性腺按激素释放激素的分泌，诱导卵泡发育及排卵，但其临床整体疗效有限。中医认为肾为封藏之本，内藏先天之精，是生殖的根本。肾阳肾阴的虚衰皆可导致瘀血的形成，从而阻塞胞脉，影响排卵。本研究通过检索国内外数据库，纳入补肾活血中药联合来曲唑治疗PCOS不孕症的临床研究进行系统评价，明确补肾活血中药联合来曲唑对PCOS 不孕症的临床疗效及安全性，为临床治疗提供循证医学证据。……