| Objective:To evaluate the clinical efficacy and adverse reactions of Chinese medicine combined with Western medicine in the treatment of perimenopausal abnormal uterine bleeding by statistical method of meta-analysis,in order to provide reliable theoretical basis for clinical treatment of perimenopausal abnormal uterine bleeding.Methods:Literature retrieval was carried out by computer and manual methods.Chinese databases: CNKI,Wanfang Database,VIP Database,China Biomedical literature database.English databases: Pubmed,Cochrane Library.The scope is from the establishment of the data platform to March 2022.All the subjects are the domestic and foreign literatures related to the randomized clinical study on the treatment of perimenopausal abnormal uterine bleeding by combining traditional Chinese and Western medicine with western medicine.According to the customized criteria of included and excluded literatures,the literature quality assessment and relevant data extraction were carried out for the finally included literatures.The results of the experimental data were meta-analyzed by the Cochrane system management software Revman5.4.The prescriptions related to this study were entered into Excel to summarize the frequency of drug use.Results:1.A total of 1725 literatures were retrieved in this study,and 29 literatures were finally included.The literatures were distributed between2011 and 2021.A total of 2636 subjects were enrolled,including 1339 in the study group and 1297 in the control group.There were 9 outcome indicators in this study,including 3 main indicators,including total clinical response rate,hemoglobin and recurrence rate.Five secondary indexes were complete hemostasis time and bleeding control time,endometrium,estradiol and progesterone,respectively.Safety index 1 was adverse reaction.2.Meta-analysis results showed that: compared with western medicine,(1)integrated Chinese and Western medicine in improving the total clinical effective rate of perimenopausal abnormal uterine bleeding,effect size was:OR=2.50,95%CI=[1.88,3.34],Z=6.25,P<0.00001 difference was statistically significant.(2)In terms of the index of improving hemoglobin content,the effect size was MD=11.25,95%CI = [8.37,14.13],Z=7.66,P< 0.00001 the difference was statistically significant.(3)In terms of reducing bleeding control time,the effect size was MD=-10.92,95%CI=[-12.58,-8.20],Z=9.29,P<0.00001 the difference was statistically significant.(4)In terms of reducing the time to complete hemostasis,the effect size was: MD=-19.20,95%CI=[-24.68,13.72],Z=6.86,P<0.00001 the difference was statistically significant.(5)In terms of reducing endometrial thickness,the effect size was SMD=-1.10,95%CI=[-1.83,0.02],Z=2.99,P=0.003 the difference was statistically significant.(6)In terms of progesterone index,the effect size was: SMD=-0.82,95%CI=[-1.86,0.22],P=0.12 there was no statistical significance.(7)In terms of down-regulation of estradiol level,the effect size was:SMD=-1.68,95%CI=[-2.60,-0.77],Z=3.61,P<0.5the difference was statistically significant.(8)In terms of adverse reaction indicators,the effect size was: OR=0.53,95CI%=[0.38,0.74],Z=3.70,P=0.0002 The difference was statistically significant.(9)In terms of recurrence rate,the effect size was:OR=0.22,95CI%=[0.11,0.45],Z=4.18,P<0.0001 the difference was statistically significant.3.Drug frequency analysis results: In this study,the frequency of tonic drugs was 164 times,accounting for 54.49%,followed by the frequency of hemostatic drugs was 38 times,accounting for 12.6%.Conclusion:1.Integrated traditional Chinese and Western medicine can significantly improve the clinical efficacy of perimenopausal abnormal uterine bleeding.It is superior to western medicine therapy in improving hemoglobin content,reducing estradiol level,accelerating hemostasis and reducing endometrial thickness.However,there was no obvious advantage in regulating progesterone levels.2.The combined therapy of Traditional Chinese and Western medicine can effectively improve the adverse reactions caused by the treatment of perimenopausal abnormal uterine bleeding by western medicine alone,and reduce the recurrence rate,which is worthy of clinical application.3.The main drug efficacy categories of integrated Traditional Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding include tonifying drugs,hemostatic drugs and astringent drugs.Cooperate with western medicine can enhance the body coagulation function,alleviate anemia,promote anti-inflammatory prevention of infection,and assist western medicine to regulate the secretion of sex hormones. |
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