中西医结合治疗高催乳素血症临床效果meta分析

摘要

目的：评价中西医结合治疗高催乳素血症（ hyperprolactinemia，HPRL）的临床效果。方法检索1991年1月-2013年12月 PubMed、EMbase、Medline 和循证医学数据库（ EBMR）、中国期刊全文数据库（ CNKI）、中国科技期刊全文数据库（ VIP）、万方数据库中有关中西医结合治疗 HPRL 的文献。运用系统评价和 meta 分析法对采用中西医结合治疗（治疗组）和单纯西医治疗（对照组）的 HPRL患者的临床效果、治疗后血清催乳素（ PRL）水平及不良反应情况进行分析比较。结果本研究共纳入9篇文献，包括HPRL 816例，治疗组423例，对照组393例。meta分析结果显示，治疗组总体有效率显著高于对照组，差异有统计学意义（RR＝1.06，95%CI 1.01~1.11，Z ＝2.32，P ＝0.02）；停药时及停药后6个月血清 PRL水平显著低于对照组，差异均有统计学意义（SMD-1.82，95%CI -3.49~-0.16，Z ＝2.14，P＝0.03；SMD-14.06，95%CI-19.24~-8.88，Z＝5.32，P﹤0.00001）；不良反应发生率明显低于对照组，差异亦具有统计学意义（RR＝0.20，95%CI 0.10~0.42，Z ＝4.30，P ﹤0.0001）。结论中西医结合治疗 HPRL 效果显著优于单纯西医治疗，且不良反应发生率低。%Objective To evaluate the effect of combined treatment of traditional Chinese medicine and western medi-cine in treatment of hyperprolactinemia( HPRL). Methods Relevant literature of combined treatment of traditional Chinese medicine and western medicine in treatment of HPRL published during January 1991 and December 2013 was retrieved in Pubmed,EMbase,Medline,EMBR,CNKI,VIP and Wanfang database. The efficacy,post-treatment level of serum prolactin ( PRL)and adverse reaction were comparatively analyzed with system evaluation and meta-analysis between combined treat-ment of traditional Chinese medicine and western medicine group( treatment group ) and western medicine group( control group). Results A total of 9 papers were recruited in this study,including 816 hyperprolactinemia patients,and 423 patients were in treatment group and 393 patients in control group. The meta-analysis showed that the total effective rate in treatment group was significantly higher than that in control group(RR =1. 06,95% CI:1. 01 -1. 11,Z =2. 32,P =0. 02);serum PRL level on the time of drug withdrawal and 6 months after drug withdrawal in treatment group was significantly lower than those in control group(SMD-1. 82,95%CI:-3. 49-0. 16,Z=2. 14,P=0. 03;SMD-14. 06,95%CI:-19. 24--8. 88, Z=5. 32,P﹤0. 00001);the incidence rate of adverse reaction in treatment group was significantly lower than that in control group(RR=0. 20,95% CI:0. 10 -0. 42,P ﹤0. 0001). Conclusion Combined treatment of traditional Chinese medicine and western medicine in treatment of HPRL is more effective with a lower incidence rate of adverse reaction compared with that of western medicine therapy.