摘要
目的:评价二甲双胍联合克罗米芬治疗多囊卵巢综合征的有效性。方法:采用计算机检索PUBMED、ScienceDirect、Cochrane图书馆、万方数据库等文献资料库。纳入二甲双胍联合克罗米芬治疗多囊卵巢综合征的有效性的随机对照试验(RCTs),同时按照纳入与排除标准对文献质量进行严格评价和资料提取。对符合质量标准的RCTs用Review manager 5.0软件进行。结果:共纳入9个符合要求的RCT研究,共542例患者;其中二甲双胍及克罗米芬联合用药组(试验组)279例,克罗米芬组(对照组)258例,5例试验组患者因在采用促排卵药物之前已妊娠退出治疗。所纳入的研究根据随机方法、分配隐藏、盲法、失访、意向性分析和基线情况的描述对纳入研究进行质量评价,结果质量均为B级。Meta分析结果显示:二甲双胍及克罗米芬联合用药组(试验组)的妊娠率[OR=2.17,95%CI(1.18,4.02),P=0.01]高于克罗米芬组(对照组),而试验组与对照组的多周期排卵率[OR=1.26,95%CI(0.35,4.46),P=0.008]及一个周期排卵率[OR=2.71,95%CI(0.09,8.12),P=0.008]无明显的统计学差异。结论:二甲双胍联合克罗米芬治疗多囊卵巢综合征是一种有效的方法,但临床随机对照试验的方法学质量中等,仍需要高质量的多中心随机双盲对照试验加以证实。
Objective： To evaluate the effectiveness of the polycystic ovary syndrome （PCOS） by combination therapy of metformin plus clomiphene citratc. Methods： According to the Cochrane handbook for systematic reviews of interventions, we searched the clinical trials from PUBMED, ScienceDirect, Chinese database CNKI and Wanfang. Randomized controlled trials （RCTs） about clomiphene citratc alone versus combined metformin and clomiphene citratc for the efficacy of PCOS were included. Results. Nine RCTs studies meeting the requirement were included and they are in total of 542 cases of patients. Evaluating quality of trails which are brought into the study based on stochastic methods, allocation concealment, blind, lost, intentionality analysis and description of the baseline. The results are in B grade totally. Meta analysis showed significant difference between the two groups in the pregnancy rates of the PCOS （OR=2.17, 95% CI [1.18, 4.02], P =0. 01）. No significant difference was found in ovulation rates of medication combination team （OR=1. 26, 95% CI[0.35, 4.46], P=0. 008）. Conclusion. Treatment of P- COS with metformin plus clomiphene citratc is better than clomiphene citratc alone.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2013年第1期99-104,共6页
Medical Journal of Wuhan University
基金
国家重点基础研究发展计划项目(编号:2011CB944400)
