Meta-analysis Of The Effect Of Liver And Kidney Treatment On Endocrine Level Of Ovarian Reserve Dysfunction

Objective: As the incidence of ovarian reserve function declining gradually increases,a series of reproductive and endocrine-related problems caused by ovarian reserve function are plagued by more and more women,resulting in many social and psychological problems,the quality of life of patients has seriously declined.Traditional Chinese medicine dialectics mostly start from the liver,spleen and kidney,while liver and kidney treatment is a commonly used clinical treatment method by many doctors.This article aims at meta-analysis.Methods To evaluate the effect of liver and kidney treatment on the endocrine level of ovarian reserve function decline.Methods: The Chinese databases such as CNKI,Wanfang Data Knowledge Service Platform,Weipu Chinese Periodicals Service Platform,Duxiu and Pub Med English databases were searched by computer,and the relevant literatures on the treatment of ovarian reserve decline in liver and kidney aspects of TCM were searched.The strategies of literature retrieval and the criteria of rejection were formulated.After screening,the included literatures were selected.The quality evaluation was carried out,and the relevant data were extracted.Finally,the meta-analysis was carried out by using Rev Man 5.3 software.Results: This study included 12 randomized controlled trials involving 891 patients.Serum FSH,serum LH,serum E2,serum FSH/LH,AFC and clinical efficacy were studied.Meta-analysis showed that the treatment group was better than the control group in reducing serum LH [SMD=-0.36,95%(-0.64,-0.09),Z=2.57,P=0.01(P < 0.05)].In terms of AFC [SMD = 0.61,95%(0.21,1.01),Z = 2.99,P = 0.003(P < 0.05)],the increase of AFC in the treatment group was better than that in the control group,with statistical significance.the treatment group was superior to the control group in terms of clinical efficiency(OR = 1.75,95%(1.20,2.57),Z = 2.88,P = 0.004(P < 0.05).In the aspect of serum FSH,there may be differences between the treatment group and the control group,and there is controversy about the efficacy comparison.There was no significant difference in serum E2(SMD = 0.08,95%(-0.70,0.85),Z = 0.19,P = 0.85(P > 0.05)between the treatment group and the control group.In serum FSH/LH [SMD = 0.12,95%(-0.10,0.34),Z = 1.07,P = 0.29(P > 0.05)],there was no significant difference between the treatment group and the control group.Conclusion: The treatment group was superior to the control group in three aspects: reducing serum LH level,increasing AFC and improving clinical total effective rate.In reducing serum FSH level,there was no clear conclusion between the treatment group and the control group.In regulating serum E2 and FSH/LH,there was no significant difference between the treatment group and the control group.In terms of adverse drug reactions,the treatment group is superior to the control group,and the drug safety is higher.Due to the limitations of the number and quality of the literature,the above conclusions still need tobe confirmed by more well-designed multi-center,large-sample randomized controlled trials.