| 针刺治疗反复种植失败妊娠结局的系统评价和meta分析 |
| Efficacy of acupuncture in treating recurrent implantation failure: a systematic review and meta-analysis |
| DOI： |
| 中文关键词: 针刺疗法 体外受精-胚胎移植 反复种植失败 Meta分析 |
| 英文关键词: Acupuncture therapy In vitro fertilization-embryo transfer Recurrent implantation failure Meta-analysis |
| 基金项目:全国名老中医药专家传承工作室建设项目（国中医药人教函〔2022〕75号）；湖北省中医药管理局联合基金项目（ZY2025L191）； |
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| 中文摘要: |
| 【】目的:系统评价针刺治疗对体外受精-胚胎移植中反复种植失败(RIF)患者妊娠结局的影响,以期为临床提供循证依据。方法:研究遵循PRISMA 2020指南,并在PROSPERO注册。通过计算机检索PubMed、Embase、Cochrane Library、中国知网(CNKI)、万方学术期刊全文数据库(Wanfang)以及维普网(VIP)数据库中针刺治疗RIF的随机对照试验文献(RCT),检索时间为建库至2025年8月1日。采用Cochrane偏倚风险评估工具评价文献质量,通过RevMan 5.4软件行Meta分析,总结提出方法进行敏感性分析,绘制漏斗图评估发表偏倚。结果:共纳入17项RCT,涉及1500例RIF患者。Meta分析结果显示,与对照组相比,联合针刺治疗能显著改善RIF患者的临床妊娠率(RR=1.74, 95%CI [1.51, 2.00], P<0.00001)、活产率(RR=2.20, 95%CI [1.63, 2.98], P<0.00001)、胚胎种植率(RR=1.54, 95%CI [1.33, 1.79], P<0.00001)和生化妊娠率(RR=1.60, 95%CI [1.33, 1.92], P<0.00001),两组在不良反应发生率上无统计学差异(RR=0.58, 95%CI [0.24, 1.40], P=0.23)；敏感性分析则表明数据稳健,但可能存在发表偏倚。结论:针刺治疗能显著改善RIF患者的生殖结局,且安全性良好。但未来仍需开展大样本、多中心、高质量的RCT进一步验证。<br />【关键词】针刺疗法；体外受精-胚胎移植；反复种植失败；Meta分析 |
| 英文摘要: |
| Objective To systematically evaluate the efficacy and safety of acupuncture in treating pregnancy outcomes of patients with recurrent implantation failure (RIF) during in vitro fertilization-embryo transfer, providing evidence-based basis for clinical practice. Methods This review adhered to the PRISMA 2020 guidelines and was registered with PROSPERO. A computerized literature search was conducted on databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Chinese Journal Database (VIP) for randomized controlled trials (RCTs) on acupuncture for RIF, from database inception until August 1, 2025. The Cochrane Risk of Bias tool was used to assess the methodological quality of the included studies. Meta-analysis was performed using RevMan 5.4 software. Sensitivity analysis was conducted by sequentially excluding each study, and a funnel plot was generated to assess publication bias. Results Seventeen RCTs involving 1500 RIF patients were included. The meta-analysis results demonstrated that, compared to the control group, adjuvant acupuncture significantly improved the clinical pregnancy rate (RR=1.74, 95% CI [1.51, 2.00], P<0.00001), live birth rate (RR=2.20, 95% CI [1.63, 2.98], P<0.00001), embryo implantation rate (RR=1.54, 95% CI [1.33, 1.79], P<0.00001), and biochemical pregnancy rate (RR=1.60, 95% CI [1.33, 1.92], P<0.00001) in RIF patients. There was no statistically significant difference in the incidence of adverse reactions between the two groups (RR=0.58, 95% CI [0.24, 1.40], P=0.23). Sensitivity analysis indicated robust data, although potential publication bias was suggested. Conclusion Adjunctive acupuncture intervention, based on conventional treatment, can significantly improve reproductive outcomes in RIF patients with a favorable safety profile. However, future large-sample, multi-center, high-quality RCTs are warranted for further validation. |
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