【摘要】 目的　评价中草药治疗女性免疫性不孕的疗效与安全性。方法　计算机检索MEDLINE( 196 6～ 2 0 0 2 2 )、EMBASE( 1984～ 2 0 0 2 2 )、CBM ( 1978～ 2 0 0 2 2 )及Cochrane临床对照试验数据库 ( 2 0 0 2年第 1期 ) ,手工检索纳入试验的所有参考文献 ,比较中草药 (包括单剂和复合剂 )与安慰剂、未治疗、或常规西药治疗的随机对照试验。对纳入研究的质量进行方法学评价 ,并用RevMan 4 2软件进行Meta分析。结果　最终纳入 6个RCT ,但其方法学质量均不高 ,且采用不同的中药或对照 ,故进行单独描述。结果发现 :在妊娠率方面 ,抗免一号片比强的松 +避孕套的治疗效果好 [RR 3 75 ,95 %CI ( 1 6 1,8 75 ) ,P =0 0 0 2 ];加味滋肾生肝饮加减比强的松 +避孕套的治疗效果好 [RR 2 4 8,95 %CI ( 1 4 0 ,4 39) ,P =0 0 0 2 ];补肾泻浊汤比抗炎药的治疗效果好 [RR 2 97,95 %CI ( 1 6 0 ,5 5 0 ) ,P =0 0 0 0 6 ];贞芪转阴汤单用与宫腔内人工授精 (IUI)比较 ,其治疗效果无显著性差异 [RR 1 80 ,95 %CI ( 0 5 8,5 6 0 ) ,P =0 31],但贞芪转阴汤 +IUI比IUI治疗效果好 [RR 3 6 0 ,95 %CI ( 1 32 ,9 85 ) ,P =0 0 1]。在抗精子抗体 (antispermantibody ,AsAb)转阴率方面 ,抗免一号片比强的松 +避孕套的治疗?更多还原

【Abstract】 Objective To assess the effectiveness and safety of Chinese medicinal herbs for female immune-caused subfertility. Methods .Databases included: MEDLINE(1966-2002.2), EMBASE(1984-2002.2), CBM(1978-2002.2) and Cochrane Controlled Trial Register, CCTR (Issue 1, 2002). Reference lists of trials were handsearched. Published randomized controlled trials (RCTs) whether blind or unblind, any languages and length of follow up were included. Treatments included Chinese medicinal herbs (single or compound). Controls were placebo and western medicine, or no intervention. Data were extracted independently by two reviewers and analyzed with Revman 4.2.Results Six RCTs were included, all of which were poor in methodological quality. Because of different therapies in the treatment and control groups, we did not perform meta-analysis. The No.1 anti-immune tablet was more effective than corticosteroid plus condom during intercourse both in the pregnancy rate (RR 3.75, 95%CI 1.61 to 8.75, 3=0.002 ) and AsAb negative rate (RR 1.66, 95%CI 1.23 to 2.22, 3=0.000 8). Bushen Xiezhuo Soup was more effective than antibiotic in the pregnancy rate (RR 2.97, 95%CI 1.60 to 5.50, XP3=0.000 6) and antisperm antibody (AsAb) negative rate (RR 2.33, 95%CI 1.54 to 3.54, XPB3<0.000 1)?Zhenqi Zhuanyin Soup was as effective as IUI in pregnancy rate (RR 1.80, 95%CI 0.58 to 5.60, XP3=JP10.31) but more effective than IUI in AsAb negative conversion rate (RR 9.61, 95%CI 3.22 to 28.67, XP3<0.000 1), Zhenqi ZhuanyinSoup combined with IUI was more effective than IUI in pregnancy rate (RR 3.60, 95%CI 1.32 to 9.85, XP3=0.01) and AsAb negative rate (RR 8.92, 95%CI 2.98 to 26.75, XP3<0.000 1).Conclusions Some Chinese medicinal herbs may work well in subfertility treatment. However, the evidence is too weak to draw a conclusion for there are deficiencies in strict randomization, blinding and follow-up.More strictly designed, randomized, double-blind, placebo-controlled trials are required.更多还原