Meta-Analysis Of Combined Treatment Of Chinese And Western Medicine For PCOS Infertility

Objective:Objectively evaluate the clinical efficacy combined Chinese and Western medicine in the treatment of PCOS infertility by means of Meta-analysis.To provide evidence-based basis for the clinical promotion of the combined application of Chinese and Western medicine in the treatment of PCOS infertility.Methods:The randomized controlled trials of combined Chinese and Western medicine versus Western medicine alone in the treatment of PCOS infertility was searched from literature database,which were published from January 2012 to December 2021.The retrieved literatures were imported into Note Express V3.3 software to eliminate the duplicates,and further screened according to the inclusion criteria.The data of the final included literature was extracted by Excel,and the quality of the literature was evaluated according to the method of Cochrane Manual.At the same time,Meta analysis of the data is carried out by using Rev Man5.4.1 software.A total of 9 outcome indicators were included in the study,including total clinical effective rate,ovulation rate,pregnancy rate,LH,FSH,LH/FSH,T,endometrial thickness and spontaneous abortion rate.Results:A total of 1080 articles were retrieved in this study,and 18 were finally included after screening,with a total sample size of 1605 cases,including 804 cases in the combined treatment group of Chinese and Western medicine,and 801 cases in the pure Western medicine treatment group.The results of Meta analysis showed that:(1)the total clinical effective rate:OR=3.28,95% CI [2.34,4.59],Z=6.94(P<0.00001),The difference is statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in improving the total clinical effective rate.(2)Ovulation rate:OR=3.07,95% CI [2.22,4.25],Z=6.77(P<0.00001),The difference is statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in improving ovulation rate.(3)pregnancy rate: OR=3.15,95% CI[2.51,3.97],Z=9.80(P<0.00001),The difference was statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in improving pregnancy rate.(4)LH: SMD =-0.96,95% CI [-1.44,-0.47],Z=3.87(P=0.0001<0.05),The difference was statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in reducing the level of LH.(5)FSH: SMD =-0.32,95%CI[-0.60,0.04],Z=2.21(P=0.03<0.05),The difference was statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in raising the level of FSH.(6)LH/FSH: SMD =-2.19,95%CI[-3.70,-0.68],Z=2.84(P=0.004<0.05),The difference was statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in reducing LH/FSH.(7)T: SMD =-1.09,95%CI[-1.71,-0.48],Z=3.49(P=0.0005 < 0.05),The difference was statistically significant.(8)endometial thickness: MD =1.27,95%CI[0.44,2.09],Z=3.01(P=0.003<0.05),The difference was statistically significant,It shows that the combination of traditional Chinese and western medicine is superior to western medicine in promoting endometrial thickening.(9)Spontaneous abortion rate: OR=0.82,95%CI[0.28,2.39],Z=0.37(P=0.71>0.05),The difference was not statistically significant,It shows that the effect of combination of traditional Chinese and western medicine is similar to that of western medicine alone in reducing the rate of spontaneous abortion.Conclusion:1.The combination of traditional Chinese and western medicine in the treatment of PCOS infertility is superior to western medicine in improving the total clinical effective rate.2.The combination of Chinese and Western medicine in the treatment of PCOS infertility is superior to western medicine in improving ovulation rate.3.The combination of traditional Chinese and western medicine in the treatment of PCOS infertility is superior to western medicine in improving the pregnancy rate.4.Compared with western medicine alone,the combination of traditional Chinese and western medicine is more effective in regulating the level of sex hormones,including increasing the level of FSH,reducing the level of serum LH,T and the ratio of LH to FSH.5.The combination of Chinese and Western medicine in the treatment of PCOS infertility is more effective in promoting endometrial thickening than western medicine alone.