• 1. 四川大學(xué)華西第二醫(yī)院,婦產(chǎn)科2. 四川大學(xué)華西醫(yī)院急診科,成都,610041;

目的 　評(píng)價(jià)中草藥治療輸卵管阻塞性不孕的療效與安全性.
方法 　通過檢索MEDLINE、EMBASE、CBM及Cochrane臨床試驗(yàn)數(shù)據(jù)庫及手工檢索所提取文獻(xiàn)的參考文獻(xiàn),比較中草藥(包括單劑和復(fù)合劑)與安慰劑、未治療、手術(shù)或常規(guī)西藥治療的隨機(jī)對(duì)照試驗(yàn),并用Cochrane協(xié)作網(wǎng)專用軟件Revman 4.2進(jìn)行Meta-分析.
結(jié)果　 有7篇隨機(jī)對(duì)照試驗(yàn)共治療1 042名病人(平均每篇148例)滿足納入標(biāo)準(zhǔn).與常規(guī)西藥抗炎、通水治療相比,活血化瘀之中草藥的輸卵管復(fù)通效果優(yōu)于西藥抗炎通水法[RR 1.49,95%CI(1.37,1.62),P＜0.000 01],妊娠率亦高于西藥抗炎通水法[RR 1.46,95%CI(1.09,1.96),P=0.01],且中草藥治療組未見不良反應(yīng).
結(jié)論 　現(xiàn)有臨床資料表明,中草藥治療輸卵管阻塞性不孕可能有效,但由于試驗(yàn)在嚴(yán)格隨機(jī)、雙盲、嚴(yán)格隨訪等方面還有欠缺,其療效目前尚無充分的證據(jù).在以后的研究中尚需要設(shè)計(jì)良好的隨機(jī)、雙盲、安慰劑對(duì)照試驗(yàn)對(duì)其潛在的療效加以證實(shí).

引用本文： 賀豪杰,李尚為,許良智,陳瑤. 中草藥治療輸卵管阻塞性不孕的系統(tǒng)評(píng)價(jià). 中國(guó)循證醫(yī)學(xué)雜志, 2004, 04(4): 244-248. doi: 復(fù)制

1. ［1］Gao DL, Chen XF. Investigation of primary pregnancy rate and subfertility rate about 60 000 newly married women [ J ].Chin J 0bstet Gyneco , 1989 ;24(4) :234-235.
2. 高道利,陳霞飛六萬新婚婦女初孕率和不孕率調(diào)查[J].中華婦產(chǎn)科雜志,1989;24(4):234～235.
3. ［2］Neville F. Hacker, J. George Moore. Essentials of obstetrics and gonaecology. See: David R. Meldrum: Infertility[M]. 3rd Ed.Philadelphia: W.B. Saunders Company,1998. 610-611.
4. ［3］Tang GL. Clinical analysis of tubal subfertility treated with Chinese traditional medicine[J]. Beijing J TCM, 2001 ;20(2) :36 ～37.
5. 唐桂蘭.中藥綜合治療輸卵管炎性不孕癥35例臨床觀察[J]北京中醫(yī),2001;20(2):36～37.
6. ［4］Wang TG, Feng DJ. Chinese traditional medicine for subfertility due to fallopian tube obstruction compared with western medicine (128cases) [J]. Hebei J TCM, 1995;17(4) :16-17.
7. 王廷國(guó),馮冬菊中醫(yī)辨證與西醫(yī)對(duì)照治療輸卵管阻塞性不孕128例小結(jié)[J]河北中醫(yī),1995;17(4):16～17.
8. ［5］Lin J, Li KX, Zhang Y. Clinical analysis of Subfertility (58cases) due to fallopian tube obstruction treated with TCM[J].New Journal of Traditional Chinese Medicine, 1999; 31 ( 3 ):42-43.
9. 林潔,李克湘,張燁中藥內(nèi)外合治輸卵管炎性不孕56例臨床分析[J]新中醫(yī),1999;31(3):42～43.
10. ［6］Wang BP. Subfertility (300 cases) due to fallopian tube obstruction treated with Tong-Xiao-San [ J ]. Shandong J TCM, 1999 ;21 (2) :74-75.
11. 王本鵬.通消散沖劑治療輸卵管阻塞性不孕癥300例[J].山東中醫(yī)雜志,2002;21(2):74～75.
12. ［7］Kang JL, Xia W. Clinical study of fallopian tube obstruction treated with integrated traditional and western medicine [J ].Chinese Journal of Integrated Traditional and Western medicine,2001 ;21(6): 416-418.
13. 康佳麗,夏葳中西醫(yī)結(jié)合治療輸卵管阻塞的臨床研究[J].中國(guó)中西醫(yī)結(jié)合雜志,2001;21(6):416～418.
14. ［8］Chen X. Sterility (68 cases) due to fallopian tube obstruction treated with TCM and Western medicine [J ]. Heilongjiang J TCM, 1997;20(4) :19.
15. 陳翔中西醫(yī)結(jié)合治療輸卵管阻塞性不孕68例[J]黑龍江中醫(yī)藥,1997;20(4):19.
16. ［9］Liu YY. Analysis of effect on 102 infertile cases of nonspecific inflammation and oviduct obstruction with integrated traditional Chinese and western medicine [ J ]. Modern Journal of Integrated Traditional and Western Medicine , 2001; 10 ( 9 ):796-797.
17. 劉貽玉.中西醫(yī)結(jié)合治療非特異性炎癥輸卵管阻塞性不孕102例療效分析[J]現(xiàn)代中西醫(yī)結(jié)合雜志,2001;10(9):796～797.
18. ［10］Sui P. Subfertility (47 cases) due to chronic pelvic inflammation treated with TCM and Western medicine[J]. Liaoning J of TCM, 2001 ;20(5) :300.
19. 隋蓬.中西醫(yī)結(jié)合治療慢性盆腔炎性不孕47例[J].遼寧中醫(yī)雜志,2001;20(5):300.
20. ［11］Peng SF, Li SF, Cai PJ. Blood-activating and Heat-clearing as a Main Therapy for Tubal Infertility[J]. Shanghai Journal of Traditional Chinese Medicine, 2000 ;34 ( 9 ) :23-25.
21. 彭少芳,李少芬,蔡佩君.活血清熱法為主治療輸卵管阻塞性不孕癥[J]上海中醫(yī)藥雜志,2000;34(9):23～25.
22. ［12］Liang Y. Medicine combined with acupuncture as the therapy for tubal subfertility[J]. Liaoning J of TCM, 2001 ;28(5) :294.
23. 梁燕針?biāo)幉⑴e治療輸卵管阻塞性不孕36例[J].遼寧中醫(yī)雜志,2001;28(5):294.
24. ［13］Li M, Wu T. Clinical analysis of integrated traditional and western medicine for tubal inflammatory subfertility [ J ]. Chinese Journal of Information and Traditional Medicine, 2001 ;8 (2):57-58.
25. 李梅,吳霆.中西藥內(nèi)外合治輸卵管炎性不孕臨床分析[J].中國(guó)中醫(yī)藥信息雜志,2001;8(2):57～58.
26. ［14］Tu GC, Zhou Y. Report of injection in acupuncture point for fallopian obstruction (130 cases)[J]. Journal of Guiyang College of Traditional Chinese Medicine, 1997; 19 ( 4 ): 37-38.
27. 屠國(guó)春,周艷.穴位注射治療輸卵管阻塞130例報(bào)告[J].貴陽中醫(yī)學(xué)院學(xué)報(bào),1997;19(4):37～38.
28. ［15］Chen WY, Qin Y. Integrated traditional and western medicine for tubal subfertility [J ]. Chinese Journal of Information and Traditional Medicine, 2001 ;8 ( 6 ) :55.
29. 陳文英,覃怡.中西醫(yī)結(jié)合治療輸卵管梗阻性不孕[J]中國(guó)中醫(yī)藥信息雜志,2001;8(6):55.
30. ［16］Yuan YM . Clinical observation of integrated traditional and western medicine for tubal subfertility[J]. Jiangxi J of TCM,2001 ;32(6) :53.
31. 袁悅明.中西醫(yī)結(jié)合治療輸卵管阻塞臨床觀察[J].江西中醫(yī)藥,2001;32(6):53.
32. ［17］Zhou DQ. Blood-activating and coagulation-clearing for tubal infertility (56 cases) [J]. Guangming Zhongyi, 1997; (2):32-33.
33. 周端求.活血化瘀法治療輸卵管阻塞不孕癥56例[J].光明中醫(yī),1997;(2):32～33.
34. ［18］Schulz KF, Chalmers l, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5):408-412.
35. ［19］Vickers A, Goyal N, Harland R, Rees R Do certain countries produce only posifve results? A systematic review of controlled trials[J]. Control Clin Trials, 1998;19(2) :159-166.
  1. 1. ［1］Gao DL, Chen XF. Investigation of primary pregnancy rate and subfertility rate about 60 000 newly married women [ J ].Chin J 0bstet Gyneco , 1989 ;24(4) :234-235.
  2. 2. 高道利,陳霞飛六萬新婚婦女初孕率和不孕率調(diào)查[J].中華婦產(chǎn)科雜志,1989;24(4):234～235.
  3. 3. ［2］Neville F. Hacker, J. George Moore. Essentials of obstetrics and gonaecology. See: David R. Meldrum: Infertility[M]. 3rd Ed.Philadelphia: W.B. Saunders Company,1998. 610-611.
  4. 4. ［3］Tang GL. Clinical analysis of tubal subfertility treated with Chinese traditional medicine[J]. Beijing J TCM, 2001 ;20(2) :36 ～37.
  5. 5. 唐桂蘭.中藥綜合治療輸卵管炎性不孕癥35例臨床觀察[J]北京中醫(yī),2001;20(2):36～37.
  6. 6. ［4］Wang TG, Feng DJ. Chinese traditional medicine for subfertility due to fallopian tube obstruction compared with western medicine (128cases) [J]. Hebei J TCM, 1995;17(4) :16-17.
  7. 7. 王廷國(guó),馮冬菊中醫(yī)辨證與西醫(yī)對(duì)照治療輸卵管阻塞性不孕128例小結(jié)[J]河北中醫(yī),1995;17(4):16～17.
  8. 8. ［5］Lin J, Li KX, Zhang Y. Clinical analysis of Subfertility (58cases) due to fallopian tube obstruction treated with TCM[J].New Journal of Traditional Chinese Medicine, 1999; 31 ( 3 ):42-43.
  9. 9. 林潔,李克湘,張燁中藥內(nèi)外合治輸卵管炎性不孕56例臨床分析[J]新中醫(yī),1999;31(3):42～43.
  10. 10. ［6］Wang BP. Subfertility (300 cases) due to fallopian tube obstruction treated with Tong-Xiao-San [ J ]. Shandong J TCM, 1999 ;21 (2) :74-75.
  11. 11. 王本鵬.通消散沖劑治療輸卵管阻塞性不孕癥300例[J].山東中醫(yī)雜志,2002;21(2):74～75.
  12. 12. ［7］Kang JL, Xia W. Clinical study of fallopian tube obstruction treated with integrated traditional and western medicine [J ].Chinese Journal of Integrated Traditional and Western medicine,2001 ;21(6): 416-418.
  13. 13. 康佳麗,夏葳中西醫(yī)結(jié)合治療輸卵管阻塞的臨床研究[J].中國(guó)中西醫(yī)結(jié)合雜志,2001;21(6):416～418.
  14. 14. ［8］Chen X. Sterility (68 cases) due to fallopian tube obstruction treated with TCM and Western medicine [J ]. Heilongjiang J TCM, 1997;20(4) :19.
  15. 15. 陳翔中西醫(yī)結(jié)合治療輸卵管阻塞性不孕68例[J]黑龍江中醫(yī)藥,1997;20(4):19.
  16. 16. ［9］Liu YY. Analysis of effect on 102 infertile cases of nonspecific inflammation and oviduct obstruction with integrated traditional Chinese and western medicine [ J ]. Modern Journal of Integrated Traditional and Western Medicine , 2001; 10 ( 9 ):796-797.
  17. 17. 劉貽玉.中西醫(yī)結(jié)合治療非特異性炎癥輸卵管阻塞性不孕102例療效分析[J]現(xiàn)代中西醫(yī)結(jié)合雜志,2001;10(9):796～797.
  18. 18. ［10］Sui P. Subfertility (47 cases) due to chronic pelvic inflammation treated with TCM and Western medicine[J]. Liaoning J of TCM, 2001 ;20(5) :300.
  19. 19. 隋蓬.中西醫(yī)結(jié)合治療慢性盆腔炎性不孕47例[J].遼寧中醫(yī)雜志,2001;20(5):300.
  20. 20. ［11］Peng SF, Li SF, Cai PJ. Blood-activating and Heat-clearing as a Main Therapy for Tubal Infertility[J]. Shanghai Journal of Traditional Chinese Medicine, 2000 ;34 ( 9 ) :23-25.
  21. 21. 彭少芳,李少芬,蔡佩君.活血清熱法為主治療輸卵管阻塞性不孕癥[J]上海中醫(yī)藥雜志,2000;34(9):23～25.
  22. 22. ［12］Liang Y. Medicine combined with acupuncture as the therapy for tubal subfertility[J]. Liaoning J of TCM, 2001 ;28(5) :294.
  23. 23. 梁燕針?biāo)幉⑴e治療輸卵管阻塞性不孕36例[J].遼寧中醫(yī)雜志,2001;28(5):294.
  24. 24. ［13］Li M, Wu T. Clinical analysis of integrated traditional and western medicine for tubal inflammatory subfertility [ J ]. Chinese Journal of Information and Traditional Medicine, 2001 ;8 (2):57-58.
  25. 25. 李梅,吳霆.中西藥內(nèi)外合治輸卵管炎性不孕臨床分析[J].中國(guó)中醫(yī)藥信息雜志,2001;8(2):57～58.
  26. 26. ［14］Tu GC, Zhou Y. Report of injection in acupuncture point for fallopian obstruction (130 cases)[J]. Journal of Guiyang College of Traditional Chinese Medicine, 1997; 19 ( 4 ): 37-38.
  27. 27. 屠國(guó)春,周艷.穴位注射治療輸卵管阻塞130例報(bào)告[J].貴陽中醫(yī)學(xué)院學(xué)報(bào),1997;19(4):37～38.
  28. 28. ［15］Chen WY, Qin Y. Integrated traditional and western medicine for tubal subfertility [J ]. Chinese Journal of Information and Traditional Medicine, 2001 ;8 ( 6 ) :55.
  29. 29. 陳文英,覃怡.中西醫(yī)結(jié)合治療輸卵管梗阻性不孕[J]中國(guó)中醫(yī)藥信息雜志,2001;8(6):55.
  30. 30. ［16］Yuan YM . Clinical observation of integrated traditional and western medicine for tubal subfertility[J]. Jiangxi J of TCM,2001 ;32(6) :53.
  31. 31. 袁悅明.中西醫(yī)結(jié)合治療輸卵管阻塞臨床觀察[J].江西中醫(yī)藥,2001;32(6):53.
  32. 32. ［17］Zhou DQ. Blood-activating and coagulation-clearing for tubal infertility (56 cases) [J]. Guangming Zhongyi, 1997; (2):32-33.
  33. 33. 周端求.活血化瘀法治療輸卵管阻塞不孕癥56例[J].光明中醫(yī),1997;(2):32～33.
  34. 34. ［18］Schulz KF, Chalmers l, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5):408-412.
  35. 35. ［19］Vickers A, Goyal N, Harland R, Rees R Do certain countries produce only posifve results? A systematic review of controlled trials[J]. Control Clin Trials, 1998;19(2) :159-166.