目的 评价丹莪妇康煎膏治疗子宫内膜异位症的有效性和安全性.方法 计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、维普中文生物医学期刊、PubMed、Web of science、Embase、Cochrane Library、Medline数据库建库起至2022年8月31日发表的丹莪妇康煎膏联合西药治疗子宫内膜异位症的随机对照试验.由两名研究员独立筛选文献、提取资料,并通过Cochrane偏倚风险评估工具评估文献质量,针对复发率、临床综合疗效愈显率、疼痛视觉模拟量表(VAS评分)、血清糖类抗原125(CA125)、血清卵泡刺激素(FSH)、术后妊娠率、不良反应发生率进行Meta分析.结果 纳入14篇研究(1456例患者).Meta分析显示丹莪妇康煎膏联合西药治疗子宫内膜异位症在降低疾病复发率[RR=0.37,95％CI(0.26,0.53)]、提高临床综合疗效愈显率[RR=1.33,95％CI(1.20,1.48)],降低 VAS 评分[MD=1.80,95％CI(1.15,2.45)]、血清 CA125[MD=6.21,95％CI(4.29,8.13)]、FSH[MD=2.18,95％CI(1.44,2.92)],提高术后妊娠率[RR=2.50,95％CI(1.47,4.27)],降低不良反应发生率[RR=0.43,95％CI(0.31,0.59)]方面均优于单用西药(P＜0.05).结论 丹莪妇康煎膏联合西药治疗子宫内膜异位症可减少疾病复发,提高临床疗效,减轻盆腔疼痛,降低血清CA125、FSH水平,增加术后妊娠率,并且降低不良反应发生率.

目的 评价中药联合抗生素治疗女性生殖道衣原体感染的疗效和安全性.方法 计算机检索中国知网、PubMed等国内外数据库中建库至2022年09月30日发表的中药联合抗生素治疗女性生殖道衣原体感染的随机对照试验(RCT)研究文献.两名研究员独立筛选文献、提取资料并评价文献偏倚风险后,采用RevMan5.4软件进行Meta分析.结果 共纳入11篇RCT(1308例患者).Meta分析显示中药联合抗生素治疗女性生殖道衣原体感染在提高衣原体转阴率[RR=1.35,95％CI(1.24,1.47)]、临床治愈率[RR=1.53,95％CI(1.37,1.71)],改善中医证候评分[SMD=-1.70,95％CI(-3.24,-0.16)]及降低复发率[RR=0.43,95％CI(0.24,0.76)]等方面均优于单用抗生素(P＜0.05),两组不良反应发生率相当[RR=1.26,95％CI(0.63,2.55)](P＞0.05).结论 中药联合抗生素治疗女性生殖道衣原体感染可提高衣原体转阴率及临床疗效,改善临床症状,降低复发率,且不增加不良反应.

目的 通过网络药理学分析扶正利湿化瘀方治疗盆腔炎性疾病后遗症的机制.方法 利用文献和TCMSP平台查找扶正利湿化瘀方的活性成分;借助Swiss Target Prediction 数据库预测扶正利湿化瘀方的对应靶点;利用GeneCards数据库得到疾病相关靶点;导入Venny在线网站获取交集靶点.使用Cytoscape软件构建"药物-有效成分-靶点"网络;采用STRING 数据库制作PPI网络;并根据Metascape平台进行GO和KEGG通路富集分析;最后利用AutoDockTools和Pymol进行分子对接.结果 分析结果显示"药物-有效成分-靶点"网络中包含金合欢素、5,7,4'-三羟基-8-甲氧基黄酮、丹参酚B、麝香黄酮、诺沃格宁等162个有效成分,涉及PIK3R1、MAPK1、PIK3CA、STAT3、SRC等212个靶点,主要富集在AGE-RAGE、PI3K-Akt、Ras、Toll样受体等信号通路上发挥作用.分子对接结果显示,扶正利湿化瘀方的主要有效成分和核心靶点有较好的结合性.结论 扶正利湿化瘀方治疗盆腔炎性疾病后遗症的作用机制可能是通过多成分、多靶点、多通路控制炎症,提高免疫功能、抑制子宫组织黏连及纤维化、调节细胞自噬等.

ObjectiveThe objective of this study was to compare the efficacy differences between Chinese patent medicines combined with hormone replacement therapy (HRT) in the treatment of premature ovarian failure (POF) by the Bayesian network meta-analysis (NMA) method.MethodsRandomized controlled trials (RCTs) reporting Chinese patent medicine combined with HRT for POF included Medline (via PubMed), Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), Wanfang Database (Wanfang), VIP Database (VIP), and China Biology Medicine Database (CBM) from the inception of the databases to July 2022. Two researchers independently screened the articles, extracted data, and evaluated the quality. The literature that met the inclusion criteria was screened out, the quality and risk of bias of the included studies were assessed according to the Cochrane 5.1 manual and RevMan 5.4, and NMA was performed using Stata 15.0 and R software.ResultsSixty-four RCTs involving 5,675 individuals containing 12 oral Chinese patent medicines combined with HRT were enrolled into the current NMA. The results showed that when compared with patients using only HRT, the total clinical response rate is greater in patients using HRT combined with one of these 12 oral Chinese patent medicines. Among them, Zuogui pills + HRT [odds ratio (OR) = 3.92; 95% credible interval (CrI) = 0.86, 23.84; SUCRA = 73.76%] is most likely to be the best intervention, and the suboptimal intervention is Guishen pills + HRT (OR = 3.22, 95% CrI = 1.16, 9.44, SUCRA = 70.60%).ConclusionChinese patent medicines combined with HRT were more effective than HRT alone in the treatment of POF. Zuogui pills are good at decreasing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and more effective in the improvement of total clinical response rate; Xuefu Zhuyu capsule is also good at decreasing FSH. Ziheche capsule is an expert in improving estradiol level; Kuntai capsule shows the lowest incidence of adverse reactions. However, the quality of the literature included in this study is relatively low, so it may affect the results of the study. Therefore, higher quality and multi-center trial would be necessary for supporting these results.Systematic review registration[www.crd.york.ac.uk/prospero], identifier [CRD42022350587].

魏绍斌教授临证治疗绝经前后诸证时善用古方,巧施药对,常用方剂为归肾丸或黄连阿胶汤加减,常用药对为鳖甲配浮小麦(滋阴清热止汗)、莲子配百合(养心安神)、鸡血藤配丹参(养血行血调经)、黄柏配知母(滋阴清热)、杜仲配续断(补肝肾强筋骨)、佛手配香附(理气解郁)、石斛配葛根(补益肾精)、南沙参配黄芪(气血双补)、桔梗配冬瓜仁(调畅大便),形成了"乙癸同源,肝肾同治""重视气血,强调补养"等用药特点.