中医药防治子宫内膜息肉术后复发的临床证据图分析

Clinical evidence mapping on postoperative recurrence of endometrial polyps by traditional Chinese medicine

  • 摘要:
    目的 梳理中医药干预子宫内膜息肉(EPs)术后的文献证据分布特点,了解中医药在改善子宫内膜息肉患者术后状态及预防复发方面的应用现状,挖掘具有潜力的研究方向并总结不足。
    方法 检索中国知网(CNKI)、万方数据知识服务平台(WanFang)、维普中文期刊(VIP)、中国生物医学文献数据库(SinoMed)、中国临床试验注册中心(CHICTR)、PubMed、Cochrane Library、Web of Science、Embase数据库、美国临床试验注册中心(CT. gov)中有关中医药治疗EPs的临床研究,补充检索中华医学期刊全文数据库。检索日期为建库至2025年1月,并以图表形式展现其基本特征、结局指标及方法学质量评价。
    结果 共纳入150篇文献,其中系统评价/Meta分析4篇,临床研究146篇,专家共识或临床路径0篇。临床研究以双臂试验为主,样本量集中在60~120例。干预措施以口服中药汤剂为主,疗程多为3个月。结局指标主要包括临床疗效、复发率、月经情况等,评判标准不统一,忽视了患者的生活质量。随机对照试验研究在盲法实施、随机化过程及结果报告方面存在偏倚; 非随机对照试验存在组间人数不均衡的问题; 观察性研究在暴露因素测量中存在偏倚; 系统评价/Meta分析在方法学质量与报告质量方面存在不足。
    结论 中医药在改善子宫内膜息肉患者术后状态及预防复发方面具有优势。后续研究应提高研究设计和实施质量,选用客观的结局指标,统一中医证候疗效标准,提升循证医学研究的证据质量。

     

    Abstract:
    Objective To sort out the distribution characteristics of literature evidences on traditional Chinese medicine interventions for postoperative endometrial polyps (EPs), understand the current application status of traditional Chinese medicine in improving the postoperative status and preventing recurrence in patients with endometrial polyps, explore potential research directions, and summarize the deficiencies.
    Methods Clinical studies on traditional Chinese medicine treatment for EPs were searched in databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WanFang), VIP Chinese Journal Service Platform (VIP), Chinese Biomedical Literature Database (SinoMed), Chinese Clinical Trial Registry (CHICTR), PubMed, Cochrane Library, Web of Science, Embase, and Clinical Trials. gov (CT. gov). The Chinese Medical Journal Full-text Database was also supplemented for retrieval. The search period spanned from the establishment of each database to January 2025. The basic characteristics, outcome indicators, and methodological quality assessments of the included studies were presented in graphical form.
    Results A total of 150 articles were included, comprising 4 systematic reviews/Meta-analyses, 146 clinical studies, and 0 expert consensuses or clinical pathways. The clinical studies were predominantly two-arm trials with sample sizes concentrated between 60 and 120 cases. Oral administration of traditional Chinese medicine decoctions was the primary intervention, with treatment durations mostly lasting 3 months. Outcome indicators mainly included clinical efficacy, recurrence rate, and menstrual conditions, among others. However, the evaluation criteria were inconsistent, and patients' quality of life was neglected. Randomized controlled trials exhibited biases in blinding implementation, randomization processes, and outcome reporting. Non-randomized controlled trials faced issues with imbalanced sample sizes between groups. Observational studies demonstrated biases in measuring exposure factors. Systematic reviews/Meta-analyses showed deficiencies in methodological and reporting quality.
    Conclusion Traditional Chinese medicine demonstrates advantages in improving the postoperative status and preventing recurrence in patients with endometrial polyps. Subsequent research should enhance the quality of study design and implementation, adopt objective outcome indicators, standardize efficacy criteria for traditional Chinese medicine syndromes, and improve the evidence quality of evidence-based medicine research.

     

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