【摘要】 目的 运用meta分析方法系统评价补肾方剂治疗男性不育症患者精子DNA损伤(SDF)的有效性和安全性。方法 从中国知网、维普、万方、PubMed、Cochrane Library、Embase、Web of Science数据库中检索补肾方剂改善SDF的随机对照试验(RCT)研究，对文献进行方法学质量评价，运用RevMan5.3.5软件进行meta分析，并对结局指标进行GRADE质量分级。结果 共纳入17项RCT研究，涉及2 164例男性患者。与西医常规治疗相比，补肾方剂能够显著改善男性不育症患者DNA碎片指数(DFI)(MD=-6.50,95%CI:-7.88～-5.11,P<0.01),提高配偶妊娠率(RR=2.11,95%CI:1.12～4.00,P=0.87)、精子总活率(MD=5.56, 95%CI:4.39～6.74,P<0.01)、前向运动精子百分率(MD=6.82, 95%CI:5.62～8.03,P<0.01)、精子浓度(MD=6.51, 95%CI:3.81～9.21,P<0.01)和正常形态精子百分率(MD=1.26, 95%CI:0.45～2.06,P<0.01),且补肾方剂不会增加不良反应的发生。结论 低到中等质量证据表明，与西医常规治疗相比，补肾方剂在改善男性不育症患者DFI、精液参数、配偶妊娠率等方面具有一定优势，且安全性较好。更多还原

【Abstract】 Objective To systematically evaluate the effectiveness and safety of kidney-tonifying prescriptions for the treatment of male infertility with sperm DNA fragmentation(SDF). Methods Randomized controlled trials(RCTs) on the improvement of SDF through kidney-tonifying prescriptions were retrieved from CNKI, VIP, Wanfang, PubMed, Cochrane Library, Embase, and Web of Science databases. The methodological quality of the retrieved literature was evaluated, and meta-analysis was conducted using RevMan 5.3.5 software. The outcome indicators were graded for quality using the GRADE system. Results A total of 17 RCT involving 2 164 male patients were included. Compared with conventional western medicine treatment, the prescription method significantly improved DNA fragmentation index(DFI) in male infertility patients(MD =-6.50, 95% CI:-7.88,-5.11, P<0.01), increased the spouse pregnancy rate(RR = 2.11, 95% CI:1.12, 4.00, P=0.87), total sperm motility(MD = 5.56, 95% CI:4.39,6.74,P<0.01), progressive motile sperm(MD = 6.82, 95% CI:5.62, 8.03, P<0.01), sperm concentration(MD = 6.51, 95% CI:3.81, 9.21,P<0.01), and percentage of normal morphology sperm(MD = 1.26, 95% CI:0.45, 2.06, P<0.01). Additionally, kidney-tonifying prescriptions did not increase the likelihood of adverse reactions. Conclusion Low to moderate-quality evidence suggested that compared with conventional western medicine treatment, kidney-tonifying prescriptions have certain advantages in improving DFI, semen parameters, and spouse pregnancy rates in male infertility patients, with good safety.更多还原