五子衍宗方联合左卡尼汀治疗男性不育症的meta分析

Meta-analysis of Wuziyanzong Prescription Combined with Levocarnitine in the Treatment of Male Infertility

关键词:  五子衍宗方  左卡尼汀  男性不育症  少弱精子症  meta分析

Key words:  Wuziyanzong prescription  levocarnitine  male infertility  oligospermia and asthenospermia  meta analysis

摘要:

目的 系统评价五子衍宗方联合左卡尼汀治疗男性不育症的临床疗效。方法 通过检索PubMed数据库、Embase数据库、The Cochrane Library、EBSCO数据库、中国知网（CNKI）、维普数据库（VIP）、万方数据库（Wanfang）、中国生物医学数据库（CBM），收集五子衍宗方联合左卡尼汀治疗男性不育症的临床随机对照研究（randomized controlled trails，RCTs）。根据Cochrane 5.1手册要求，分别选择研究、提取数据并评价纳入RCTs的质量，使用Rev Man 5.3软件进行meta分析。结果 纳入5项研究，共441例患者。Meta分析显示，五子衍宗方联合左卡尼汀在有效率（P=0.000 4）、D精子密度（P<0.000 01）、D精子活率（P=0.005）、Da级精子率（P=0.002）、Da+b级精子率（P=0.003）均明显优于左卡尼汀，但D精液量（P=0.40）两者相当。结论 五子衍宗方联合左卡尼汀方治疗男性不育症的疗效较为确定，但鉴于纳入研究有一定的局限性，仍需采用设计良好的大规模临床随机对照研究来验证。

Abstract:

OBJECTIVE To systematically evaluate the efficacy of Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility. METHODS Searched PubMed, Embase, The Cochrane Library, EBSCO, CNKI, VIP, Wanfang and CBM databases to collect randomized controlled clinical trials(RCTs) on the treatment of male infertility with Wuziyanzong prescription and levocarnitine. The data were extracted and the quality of the included RCTs literature were evaluated according to Cochrane 5.1 handbook, and meta-analysis was conducted using the Rev Man 5.3 software. RESULTS Five trials involving 441 patients were included. The results of meta-analysis showed that effectiveness rate(P=0.000 4), Dsperm density(P<0.000 01), Dsperm motility(P=0.005), Dgrade a sperm rate(P=0.002) and Dgrade a+b sperm rate(P=0.003) of Wuziyanzong prescription combined with levocarnitine were better than levocarnitine, but Dsemen volume(P=0.40)was not inferior to levocarnitine. CONCLUSION Wuziyanzong prescription combined with levocarnitine in the treatment of male infertility is effective. However, due to the limitations of the included study, a well-designed large-scale clinical randomized controlled study is still needed to verify the efficacy.