给9日龄 SD 雌性大鼠注射丙酸睾丸酮造成雄激素致不孕大鼠(ASR),分别观察卵巢形态、血液及组织匀浆激素含量、糖耐量和血胰岛素水平以及卵泡膜和卵巢间质细胞在体外不同刺激状态下(空白、加胰岛素、加 hCG、加胰岛素+hCG)的 T 含量。结...给9日龄 SD 雌性大鼠注射丙酸睾丸酮造成雄激素致不孕大鼠(ASR),分别观察卵巢形态、血液及组织匀浆激素含量、糖耐量和血胰岛素水平以及卵泡膜和卵巢间质细胞在体外不同刺激状态下(空白、加胰岛素、加 hCG、加胰岛素+hCG)的 T 含量。结果发现:(1)卵巢体积缩小,呈多囊性改变,无黄体;(2)垂体 LH 含量比对照组降低(P<0.01),肾上腺及卵巢中 T、E_2 含量明显升高(分别为P<0.05及P<0.01);(3)糖耐量下降,胰岛素水平显著升高(分别为 P<0.01及 P<0.05);(4)卵泡膜和卵巢间质细胞体外培养 T 含量明显高于对照组(P<0.001),在 hCG 协同作用下胰岛素可使 ASR 及正常大鼠卵巢 T 含量明显增加(P<0.01)。提示雄激素致不孕大鼠可作为高胰岛素和高雄激素性无排卵的动物模型。展开更多
目的:基于Meta分析评价杞菊地黄汤加减联合西药治疗妊娠期高血压疾病的有效性及安全性,为中医药治疗妊娠期高血压疾病提供循证医学依据。方法:通过电子及手工检索建库至2025年1月31日在中国知网、万方数据库、维普数据库、PubMed、Embas...目的:基于Meta分析评价杞菊地黄汤加减联合西药治疗妊娠期高血压疾病的有效性及安全性,为中医药治疗妊娠期高血压疾病提供循证医学依据。方法:通过电子及手工检索建库至2025年1月31日在中国知网、万方数据库、维普数据库、PubMed、Embase、Cochrane library发表的杞菊地黄汤加减联合西药治疗妊娠期高血压疾病的随机对照试验研究,纳入的文献按Cochrane系统评价方法,采用Review Manager 5.4.1及Stata/MP 18软件进行Meta分析。结果:最终共纳入24篇文献,合计2553例样本量,其中观察组1276例,对照组1277例。Meta分析结果显示:观察组比对照组更能提高治疗总有效率[OR = 3.19,95% CI (2.47, 4.11),P < 0.00001];降低治疗后收缩压水平[MD = −13.91, 95% CI (−16.88, −10.95), P < 0.00001]、治疗后舒张压水平[MD = −10.59, 95% CI (−13.13, −8.04), P < 0.00001]、治疗后24小时尿蛋白水平[SMD = −1.07, 95% CI (−1.37, −0.77), P < 0.00001];减低胎盘早剥发生率[RR = 0.52, 95% CI (0.20, 1.32), P = 0.17]、剖宫产发生率[RR = 0.52, 95% CI (0.30, 0.93), P = 0.03]、产后出血发生率[RR = 0.28, 95% CI (0.12, 0.64), P = 0.002]、胎儿窘迫发生率[RR = 0.29, 95% CI (0.15, 0.58), P = 0.0005]、不良反应发生率[RD = −0.01, 95% CI (−0.04, 0.02), P = 0.53]。胎盘早剥、不良反应发生率的差异未见统计学意义。结论:杞菊地黄汤加减联合西药治疗妊娠期高血压疾病在提高治疗总有效率,降低血压水平、24 h尿蛋白水平,减低不良母婴结局方面优于单纯西医药治疗。但存在纳入文献的质量不高、部分结局指标具有较高的异质性、评价结果可能存在发表偏倚等因素,故证据可靠性仍需更多高质量、大样本的随机对照试验研究进一步验证。展开更多
目的:基于我们在《汉斯》2024,13(7)期刊发表“中西医联合用药对照单纯西药改善不孕症患者子宫内膜容受性疗效的系统评价及Meta分析”一文撰写本篇文章,进一步分析中药改善ER的用药规律及特点,形成姊妹篇,用以完善方法与结论。方法:手...目的:基于我们在《汉斯》2024,13(7)期刊发表“中西医联合用药对照单纯西药改善不孕症患者子宫内膜容受性疗效的系统评价及Meta分析”一文撰写本篇文章,进一步分析中药改善ER的用药规律及特点,形成姊妹篇,用以完善方法与结论。方法:手工检索姊篇所包含的15篇文献,统计所用中药方药,依据功效特点分为两组进行比较分析用药规律及特点:A组补肾填精益气养血类(有8项研究)、B组补肾活血化瘀类(有7项研究)。两组18篇文献,共纳入28个药方,归纳中药20种,单药用药次数共计217次,提取可对比分析的有效文献15篇,通过分类比较药物基本信息,将研究数据输入Excel,统计分析使用SPSS17.0。结果:文献共使用28种药方,高频用药有菟丝子(选用25次)、当归(选用18次),其中补肾中药占比为43.2%,益气中药占比27.2%,活血化瘀类药占比20.7%。A组补肾基础上偏重于健脾益气(益气21.4%,养血14.3%,化瘀8.3%),化瘀药局限(药量占比:5/76 = 6.6%);后者补肾基础上偏重于活血化瘀消症(化瘀26.4%,养血27.1%,益气16.3%),化瘀药种类繁多,频次高,剂量大,(药量占比:25/91 = 27.5%)近三成比重。结论:中药改善ER低下性不孕,从补肾健脾疏肝化瘀等多靶点调节体质,可减轻临床症状,降低西药不良反应,提高妊娠率。临床应用简便易行,副作用少,起到未孕助孕,已孕安胎之效,总之中药以补肾为主,活血化瘀为辅,补泻兼施各有法度,化瘀药运用约占用药比重1/5,颇具意义。Objective: Based on “A Systematic Review and Meta-Analysis of the Efficacy of Traditional Chinese Medicine Combined with Western Medicine against Western Medicine Alone in Improving Endometrium Receptivity in Infertility Patients” published in the journal Hans 2024, 13 (7), this paper was written to further analyze the medication rules and characteristics of Chinese medicine in improving ER, and form a companion paper to improve the methods and conclusions. Methods: The 15 literatures included in the first five articles were manually searched, and the traditional Chinese medicines used were statistically analyzed and divided into two groups according to their efficacy and characteristics: Group A (8 studies) and Group B (7 studies) for tonifying kidney and promoting blood stasis. A total of 28 prescriptions were included in 18 literatures of the two groups, 20 kinds of traditional Chinese medicine were summarized, and the number of single medicinal drugs was 217 times. 15 effective literatures that could be compared and analyzed were extracted. The basic information of drugs was classified and compared, and the research data was input into Excel, and SPSS17.0 was used for statistical analysis. Results: A total of 28 kinds of prescriptions were used in literature, and the high frequency drugs were dodder (25 times) and angelica (18 times), among which 43.2% of kidney tonifying Chinese medicines, 27.2% of qi tonifying Chinese medicines, and 20.7% of blood circulation and blood stasis tonifying drugs. Group A focused on strengthening spleen and supplementing qi (supplementing qi 21.4%, supplementing blood 14.3%, removing blood stasis 8.3%), and limited drugs for removing blood stasis (proportion: 5/76 = 6.6%). On the basis of tonifying kidney, the latter focuses on promoting blood circulation and eliminating blood stasis (eliminating blood stasis 26.4%, nourishing blood 27.1%, benefiting qi 16.3%), with a wide variety of drugs for removing blood stasis, high frequency and large dose (proportion of drug: 25/91 = 27.5%). Conclusion: Traditional Chinese medicine can improve ER hyposterility, regulate physique from multiple targets such as tonifying kidney, invigorating spleen, soothing liver and removing blood stasis, alleviate clinical symptoms, reduce adverse reactions of western medicine, and increase pregnancy rate. Clinical application is simple and easy, less side effects, to help pregnancy without pregnancy, pregnancy has the effect of pregnancy, in short, Chinese medicine to tonifying the kidney, blood circulation and blood stasis as a supplement, tonifying and reducing each method, the use of stasis drugs about 1/5 of the proportion of occupied drugs, quite meaningful.展开更多
文摘给9日龄 SD 雌性大鼠注射丙酸睾丸酮造成雄激素致不孕大鼠(ASR),分别观察卵巢形态、血液及组织匀浆激素含量、糖耐量和血胰岛素水平以及卵泡膜和卵巢间质细胞在体外不同刺激状态下(空白、加胰岛素、加 hCG、加胰岛素+hCG)的 T 含量。结果发现:(1)卵巢体积缩小,呈多囊性改变,无黄体;(2)垂体 LH 含量比对照组降低(P<0.01),肾上腺及卵巢中 T、E_2 含量明显升高(分别为P<0.05及P<0.01);(3)糖耐量下降,胰岛素水平显著升高(分别为 P<0.01及 P<0.05);(4)卵泡膜和卵巢间质细胞体外培养 T 含量明显高于对照组(P<0.001),在 hCG 协同作用下胰岛素可使 ASR 及正常大鼠卵巢 T 含量明显增加(P<0.01)。提示雄激素致不孕大鼠可作为高胰岛素和高雄激素性无排卵的动物模型。
文摘目的:基于Meta分析评价杞菊地黄汤加减联合西药治疗妊娠期高血压疾病的有效性及安全性,为中医药治疗妊娠期高血压疾病提供循证医学依据。方法:通过电子及手工检索建库至2025年1月31日在中国知网、万方数据库、维普数据库、PubMed、Embase、Cochrane library发表的杞菊地黄汤加减联合西药治疗妊娠期高血压疾病的随机对照试验研究,纳入的文献按Cochrane系统评价方法,采用Review Manager 5.4.1及Stata/MP 18软件进行Meta分析。结果:最终共纳入24篇文献,合计2553例样本量,其中观察组1276例,对照组1277例。Meta分析结果显示:观察组比对照组更能提高治疗总有效率[OR = 3.19,95% CI (2.47, 4.11),P < 0.00001];降低治疗后收缩压水平[MD = −13.91, 95% CI (−16.88, −10.95), P < 0.00001]、治疗后舒张压水平[MD = −10.59, 95% CI (−13.13, −8.04), P < 0.00001]、治疗后24小时尿蛋白水平[SMD = −1.07, 95% CI (−1.37, −0.77), P < 0.00001];减低胎盘早剥发生率[RR = 0.52, 95% CI (0.20, 1.32), P = 0.17]、剖宫产发生率[RR = 0.52, 95% CI (0.30, 0.93), P = 0.03]、产后出血发生率[RR = 0.28, 95% CI (0.12, 0.64), P = 0.002]、胎儿窘迫发生率[RR = 0.29, 95% CI (0.15, 0.58), P = 0.0005]、不良反应发生率[RD = −0.01, 95% CI (−0.04, 0.02), P = 0.53]。胎盘早剥、不良反应发生率的差异未见统计学意义。结论:杞菊地黄汤加减联合西药治疗妊娠期高血压疾病在提高治疗总有效率,降低血压水平、24 h尿蛋白水平,减低不良母婴结局方面优于单纯西医药治疗。但存在纳入文献的质量不高、部分结局指标具有较高的异质性、评价结果可能存在发表偏倚等因素,故证据可靠性仍需更多高质量、大样本的随机对照试验研究进一步验证。
文摘目的:基于我们在《汉斯》2024,13(7)期刊发表“中西医联合用药对照单纯西药改善不孕症患者子宫内膜容受性疗效的系统评价及Meta分析”一文撰写本篇文章,进一步分析中药改善ER的用药规律及特点,形成姊妹篇,用以完善方法与结论。方法:手工检索姊篇所包含的15篇文献,统计所用中药方药,依据功效特点分为两组进行比较分析用药规律及特点:A组补肾填精益气养血类(有8项研究)、B组补肾活血化瘀类(有7项研究)。两组18篇文献,共纳入28个药方,归纳中药20种,单药用药次数共计217次,提取可对比分析的有效文献15篇,通过分类比较药物基本信息,将研究数据输入Excel,统计分析使用SPSS17.0。结果:文献共使用28种药方,高频用药有菟丝子(选用25次)、当归(选用18次),其中补肾中药占比为43.2%,益气中药占比27.2%,活血化瘀类药占比20.7%。A组补肾基础上偏重于健脾益气(益气21.4%,养血14.3%,化瘀8.3%),化瘀药局限(药量占比:5/76 = 6.6%);后者补肾基础上偏重于活血化瘀消症(化瘀26.4%,养血27.1%,益气16.3%),化瘀药种类繁多,频次高,剂量大,(药量占比:25/91 = 27.5%)近三成比重。结论:中药改善ER低下性不孕,从补肾健脾疏肝化瘀等多靶点调节体质,可减轻临床症状,降低西药不良反应,提高妊娠率。临床应用简便易行,副作用少,起到未孕助孕,已孕安胎之效,总之中药以补肾为主,活血化瘀为辅,补泻兼施各有法度,化瘀药运用约占用药比重1/5,颇具意义。Objective: Based on “A Systematic Review and Meta-Analysis of the Efficacy of Traditional Chinese Medicine Combined with Western Medicine against Western Medicine Alone in Improving Endometrium Receptivity in Infertility Patients” published in the journal Hans 2024, 13 (7), this paper was written to further analyze the medication rules and characteristics of Chinese medicine in improving ER, and form a companion paper to improve the methods and conclusions. Methods: The 15 literatures included in the first five articles were manually searched, and the traditional Chinese medicines used were statistically analyzed and divided into two groups according to their efficacy and characteristics: Group A (8 studies) and Group B (7 studies) for tonifying kidney and promoting blood stasis. A total of 28 prescriptions were included in 18 literatures of the two groups, 20 kinds of traditional Chinese medicine were summarized, and the number of single medicinal drugs was 217 times. 15 effective literatures that could be compared and analyzed were extracted. The basic information of drugs was classified and compared, and the research data was input into Excel, and SPSS17.0 was used for statistical analysis. Results: A total of 28 kinds of prescriptions were used in literature, and the high frequency drugs were dodder (25 times) and angelica (18 times), among which 43.2% of kidney tonifying Chinese medicines, 27.2% of qi tonifying Chinese medicines, and 20.7% of blood circulation and blood stasis tonifying drugs. Group A focused on strengthening spleen and supplementing qi (supplementing qi 21.4%, supplementing blood 14.3%, removing blood stasis 8.3%), and limited drugs for removing blood stasis (proportion: 5/76 = 6.6%). On the basis of tonifying kidney, the latter focuses on promoting blood circulation and eliminating blood stasis (eliminating blood stasis 26.4%, nourishing blood 27.1%, benefiting qi 16.3%), with a wide variety of drugs for removing blood stasis, high frequency and large dose (proportion of drug: 25/91 = 27.5%). Conclusion: Traditional Chinese medicine can improve ER hyposterility, regulate physique from multiple targets such as tonifying kidney, invigorating spleen, soothing liver and removing blood stasis, alleviate clinical symptoms, reduce adverse reactions of western medicine, and increase pregnancy rate. Clinical application is simple and easy, less side effects, to help pregnancy without pregnancy, pregnancy has the effect of pregnancy, in short, Chinese medicine to tonifying the kidney, blood circulation and blood stasis as a supplement, tonifying and reducing each method, the use of stasis drugs about 1/5 of the proportion of occupied drugs, quite meaningful.
