Background: Polycystic ovary syndrome (PCOS) patients are prone to early pregnancy loss. Studies have found that the blood fibrinolytic activity of PCOS patients is closely related to the high abortion rate. At present, it is considered that the combination of traditional Chinese and Western medicine in the treatment of PCOS with threatened abortion has a good effect on fetal protection. Therefore, the clinical efficacy of the combination of traditional Chinese and Western medicine in the treatment of PCOS with threatened abortion was systematically evaluated, and the effect of traditional Chinese medicine on the blood fibrinolytic status of patients was also evaluated.
Methods: The clinical randomized controlled trials (RCTs) of integrated traditional Chinese and Western medicine in the treatment of PCOS with threatened abortion were reviewed from four Chinese databases (CNKI, WANFANG, VIP, and SINOMED) and two English databases (PubMed, EMBASE) from their time of establishment to May 2021. According to the inclusive and exclusive criteria, tests were selected, data were extracted and evaluated, the systematic review was carried out by description analysis, and the meta-analysis was conducted using RevMan 5.3 software from Cochrane Collaboration. Begg's and Egger's tests were performed for assessing symmetries of funnel plot by the software Stata 16.0.
Results: 6 RCTs involving 361 participants were included. Meta-analysis results showed that integrated traditional Chinese and Western medicine can increase the total efficacy compared with the control groups [RR=1.22, 95% CI (1.10, 1.35), P=0.0002]. Meanwhile, the improvement of TCM syndrome integral [MD=-2.11, 95% CI (-2.56, -1.66), P<0.00001], D-II [MD=-0.29, 95% CI (-0.49, -0.09), P=0.004], Hcy [MD=-3.02, 95% CI (-3.64, -2.39, P=0.00001], PAI-I [SMD=-2.38, 95% CI (-2.82, -1.73), P<0.00001] were better than a single Western medicine treatment. And it can increase the level of β-HCG [SMD=3.44, 95% CI (1.87, 5.01), P<0.0001], P [MD=7.70, 95% CI (7.10, 8.31), P<0.00001], E2 [MD=205.36, 95% CI (140.93, 269.80), P<0.00001]. The funnel plot, Egger's test (P=0.210), and Begge's test (P=0.573) suggested that there was no evidence of substantial publication bias.
Conclusions: The effect of integrated traditional Chinese and Western medicine is better than that of Western medicine alone in the treatment of PCOS with threatened abortion, and it has certain advantages in improving the fibrinolytic status of patients. However, due to the limitation of the quality and quantity of the included literature, more rigorous and larger sample studies are needed to confirm these conclusions in the future.
Keywords: Polycystic ovarian syndrome; coagulation and fibrinolysis system; integrated traditional Chinese and Western medicine meta-analysis; threatened abortion.
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