1.
[Acupuncture artificial menstrual cycle method for abnormal uterine bleeding-ovulatory dysfunction (spleen deficiency syndrome)]
Zhang L, Li J, Pan S, Zhang X, Li Y, Hu S, Chen W
Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2019;39(5):489-94
Abstract
OBJECTIVE To compare the clinical efficacy between acupuncture artificial menstrual cycle method and medication artificial menstrual cycle method for abnormal uterine bleeding-ovulatory (AUB-O) dysfunction (spleen deficiency syndrome). METHODS Sixty patients were randomly assigned into an observation group and a control group, 30 cases in each one. 3 cases dropped out in the observation group and 27 cases were included into analysis; 2 cases dropped out in the control group and 28 cases were included into analysis. The patients in the observation group were treated with acupuncture artificial menstrual cycle method. The acupoints were selected according to different stages of menstrual cycle. The acupuncture was given for 30 min per treatment, once every other day; no treatment was given during menstrual period. Xuehai (SP 10), Sanyinjiao (SP 6), Taixi (KI 3), Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36) and Zhangmen (LR 13) were selected after menstrual period. Taichong (LR 3), Hegu (LI 4), Yaoyangguan (GV 3), Geshu (BL 17), Ganshu (BL 18), Sanyinjiao (SP 6), Pishu (BL 20) were selected in ovulaton periods. Baihui (GV 20), Shenshu (BL 23), Yaoyangguan (GV 3), Geshu (BL 17), Sanyinjiao (SP 6), Zusanli (ST 36), Gongsun (SP 4) were selected before menstrual period. The patients in the control group were treated with medication artificial menstrual cycle method. Femoston (estradiol tablets/estradiol dydrogesterone tablets) was taken orally. The white tablets were estradiol (1 mg), while the gray tablets were estradiol (1 mg) and dydrogesterone (10 mg). The Femoston was taken once a day, white tablets for the first 14 days, then gray tablets for the last 14 days. The 28-day treatment was taken as one session, and one cycle menstrual was taken as one treatment course, and totally 3 courses were given in the two groups. The clinical symptom score was observed before and after treatment as well as in follow-up visit (3 months after treatment). The clinical efficacy was evaluated based on the total effective rate, the marked effective rate of main symptoms (including menstrual cycle, menstrual period, menstrual volume) and basal body temperature (BBT). RESULTS 1 in circle Compared before treatment, the clinical symptom score in the two groups was decreased after treatment and in the follow-up visit (P<0.05). Compared with the control group, the clinical symptom score after treatment as well as the difference of that before and after treatment had no significant difference in the observation group (P>0.05). Compared with the control group, the clinical symptom score in the follow-up visit as well as the difference of that between pre-treatment and follow-up visit had significant difference in the observation group (P<0.05, P<0.01). 2 in circle The total effective rate was 81.5% (22/27) in the observation group and 85.7% (24/28) in the control group, without significant difference between the two groups (P>0.05). 3 in circle After treatment, the marked effective rate of menstrual cycle, menstrual period, menstrual volume had no significant difference between the two groups (P>0.05); during the follow-up visit, the marked effective rate of menstrual cycle in the observation group was superior to that in the control group (P<0.05), but that of menstrual period and menstrual volume had no significant difference between the two groups (P>0.05). 4 in circle After treatment, the diphasic curve rate of BBT had no significant difference between the two groups (P>0.05); during the follow-up visit, the diphasic curve rate of BBT in the observation group was higher than that in the control group (P<0.05). CONCLUSION Acupuncture artificial menstrual cycle method has superior efficacy for AUB-O dysfunction (spleen deficiency syndrome), which has similar efficacy with medication artificial menstrual cycle method. Moreover, acupuncture has advantages in regulating menstrual cycle and improving ovulation, and has a longer curative effect.
2.
Uterine artery embolization versus hysterectomy in the treatment of refractory postpartum hemorrhage: a systematic review and meta-analysis
Liu Z, Wang Y, Yan J, Li J, Liu X, Zhang L, Cheng L
The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2018;:1-13.
Abstract
INTRODUCTION We carried out a systematic review and meta-analysis to assess the safety and effectiveness of uterine artery embolization (UAE) compared with conventional hysterectomy on refractory postpartum hemorrhage (PPH). METHODS We searched PubMed, Embase, Chinese National Knowledge Infrastructure database (CNKI), Cochrane Library, and Wanfang database through October 2017 for randomized controlled trials (RCTs) and observational studies assessing the safety and effectiveness of UAE compared with hysterectomy on refractory PPH. The main outcome measures included the blood loss, operating time, hemostatic effective rate, and length of stay. RESULTS Six RCTs and nine observational studies were included in the meta-analysis, which involved 1142 women with refractory PPH. The results demonstrated that UAE was more beneficial on refractory PPH compared with hysterectomy using four scales: blood loss (WMD 893.39 mL; 95% CI: -1205.65, -581.13; p < .001); operating time (WMD -37.19 minutes; 95% CI: -44.42, -29.96; p < .001); length of stay (WMD -5.36 days; 95% CI: -5.76, -4.97; p < .001), hemostatic effective rate (OR 1.58, 95% CI: 0.80, 3.12, p = .184) . CONCLUSIONS In the present meta-analysis, the positive findings suggest UAE has beneficial effects on refractory PPH. UAE significantly reduced blood loss, shortened the operating time, and length of stay compared with hysterectomy. And there is no difference between the UAE group and hysterectomy group in hemostatic effective rate. However, those findings should be treated with caution because of heterogeneity and potential biases.
3.
Intravenous iron sucrose versus oral iron in the treatment of pregnancy with iron deficiency anaemia: a systematic review
Shi Q, Leng W, Wazir R, Li J, Yao Q, Mi C, Yang J, Xing A
Gynecologic & Obstetric Investigation. 2015;80((3)):170-8.
Abstract
BACKGROUND Intravenous iron sucrose and oral iron therapy are the main therapies for iron deficiency anaemia (IDA), but there is still a debate regarding their efficacy and especially as to which one is the best choice during pregnancy. METHODS A meta-analysis of randomised controlled trials comparing patients treated with intravenous iron sucrose (intravenous group) with those treated with oral iron (oral group) for IDA during pregnancy was performed. The primary outcomes of interest were mean maternal haemoglobin and serum ferritin levels at the end of treatment. Secondary outcomes were treatment-related adverse events and foetal birth weight. RESULTS Six randomised controlled trials, involving a total of 576 women, were included in the present review. Significant increases in haemoglobin [mean difference (MD), 0.85; 95% confidence interval (CI), 0.31-1.39; p = 0.002] and ferritin levels (MD, 63.32; 95% CI, 39.46-87.18; p < 0.00001) were observed in the intravenous group. Compared with the oral group, there were fewer adverse events in the intravenous group (risk ratio, 0.50; 95% CI, 0.34-0.73; p = 0.0003). There was no significant difference in birth weight between the two groups. CONCLUSION For pregnant women who could not tolerate the side effects of oral treatment or required a rapid replacement of iron stores, intravenous iron sucrose was associated with fewer adverse events and was more effective than regular oral iron therapy.Copyright © 2015 S. Karger AG, Basel.
4.
Intravenous immunoglobulin treatment for repeated IVF/ICSI failure and unexplained infertility: a systematic review and a meta-analysis
Li J, Chen Y, Liu C, Hu Y, Li L
American Journal of Reproductive Immunology. 2013;70((6):):434-47.
Abstract
Intravenous immunoglobulin (IVIG) has been introduced empirically into IVF/ICSI programs with the hopes of improving in vitro fertilization (IVF) success. However, the effects of IVIG have been inconsistent. We investigated the effects of IVIG on hard outcomes, including implantation rate, clinical pregnancy rate, live birth rate, miscarriage rate, and live birth rate per embryo transferred. The PubMed, EMBASE, and CNKI databases were searched up to June of 2013 and 10 studies were included. Case-controlled studies comparing IVIG with placebo in IVF/ICSI women and/or unexplained infertility were included. Using fixed and random effects models, the pooled risk ratios (RR) with 95% confidence intervals (CIs) were calculated. The use of IVIG was significantly associated with a higher implantation rate and RR was 2.708 (95%CI: 1.302-5.629) compared with the placebo. The clinical pregnancy rate and the live birth rate were significantly increased in patients randomized to IVIG; RR was 1.475 (95%CI: 1.191-1.825) for the clinical pregnancy rate and RR was 1.616 (95%CI: 1.243-2.101) for the live birth rate. Moreover, the miscarriage rate was significantly less in patients randomized to IVIG (0.352, 95%CI: 0.168-0.738), but the live birthrate per embryo transferred was not (2.893; 95%CI: 0.810-10.331) less. Our results strongly support that IVIG is a useful treatment option for women undergoing repeated IVF failure. 2013 John Wiley & Sons Ltd.