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1.北京中医药大学 东直门医院,北京 100700
2.北京中医药大学 第三附属医院,北京 100029
3.北京市第一中西医结合医院,北京 100026
Received:17 April 2025,
Revised:2025-06-20,
Accepted:02 July 2025,
Online First:28 April 2026,
移动端阅览
SUN Xiaohui, TANG Ling, YU Mingyue, et al. Clinical Evidence Map Analysis of Traditional Chinese Medicine Treatment of Menopausal Syndrome[J/OL]. Chinese Journal of Experimental Traditional Medical Formulae, 2026, 1-11.
SUN Xiaohui, TANG Ling, YU Mingyue, et al. Clinical Evidence Map Analysis of Traditional Chinese Medicine Treatment of Menopausal Syndrome[J/OL]. Chinese Journal of Experimental Traditional Medical Formulae, 2026, 1-11. DOI: 10.13422/j.cnki.syfjx.20251526.
目的
2
绝经综合征(MPS)是女性绝经前后因性激素波动引发的常见健康问题,中医药因其多靶点调节及副作用小的优势逐渐成为除绝经激素治疗(MHT)外的另一重要选择,故该研究通过证据图对中医药治疗MPS临床证据的系统整合与评估。
方法
2
该研究通过证据图,系统梳理2015~2024年中、英文数据库的917篇文献(含干预性研究870篇、观察性研究18篇、Meta分析24篇及指南5篇),全面分析中医药治疗MPS的临床证据分布特征。
结果
2
①中医药治疗MPS研究热度在2021年达到峰值,近两年有所下降,研究样本量集中在60~100例、观察周期以3个月为主;②热点干预措施集中于中西医联合疗法(51.9%),高频干预措施为坤泰胶囊(53.6%)及二仙汤(12.1%),核心证型以肝肾阴虚(24.6%)、肝郁肾虚(18.2%)为主;③结局指标偏重临床疗效与激素水平,而中医证候积分、心理健康、睡眠障碍及远期症状(如认知功能、骨质疏松)等方面关注不足;④方法学质量亟待提升,随机对照试验(RCTs)随机序列产生、分配方案隐藏及盲法实施等方面存在问题,偏倚风险较高,Meta分析/系统评价主要在研究方案注册、文献排除清单、发表偏倚及异质性解释讨论方面存在问题。
结论
2
研究表明,中医药治疗MPS虽具有疗效优势,但存在研究设计规范性不足、证据碎片化问题,未来需推动多中心大样本研究。其次,干预性研究方面结局指标评价维度较单一,未来应依据“生物-心理-社会”评价框架从多维度评价药物疗效,同时建立并优化中医药治疗MPS的核心结局指标集(COS),提高研究质量,为中医药治疗MPS提供强有力支撑。
Objective
2
Menopausal syndrome (MPS) is a common health issue that occurs before and after menopause due to fluctuations in sex hormones. Traditional Chinese medicine (TCM), with its multi-target regulation and minimal side effects, has gradually become an important alternative to menopausal hormone therapy (MHT). Therefore, this study systematically integrates and evaluates the clinical evidence of TCM treatment of MPS through an evidence map.
Methods
2
This study used an evidence map to systematically review 917 articles (including 870 interventional studies, 18 observational studies, 24 meta-analyses, and 5 guidelines) from Chinese and English databases that were published between 2015 and 2024, comprehensively analyzing the distribution characteristics of clinical evidence for TCM treatment of MPS.
Results
2
① The research intensity of TCM treatment of MPS reached its peak in 2021 and declined slightly in the past two years. The sample size of studies was concentrated between 60 and 100 cases, with an observation period primarily of 3 months. ② Hot intervention measures were concentrated on integrated traditional and Western medicine therapy (51.9%), with high-frequency intervention measures being Kuntai Capsules (53.6%) and Erxian Decoction (12.1%). The core syndromes primarily involved liver-kidney Yin deficiency (24.6%) and liver depression and kidney deficiency (18.2%). ③ Outcome indicators prioritized clinical efficacy and hormone levels, while insufficient attention was paid to TCM symptom scores, mental health, sleep disorders, and long-term symptoms (such as cognitive function and osteoporosis). ④ Methodological quality urgently needs improvement, as randomized controlled trials (RCTs) had issues in random sequence generation, allocation concealment, and blinding implementation, which resulted in a high risk of bias. Meta-analyses/systematic reviews primarily faced challenges in study protocol registration, exclusion criteria, publication bias, and heterogeneity interpretation.
Conclusion
2
TCM treatment of MPS has therapeutic advantages, while there are issues with research design standardization and fragmented evidence. Future efforts should focus on promoting large-scale, multi-center studies. Secondly, in interventional studies, the evaluation dimensions of outcome indicators are relatively limited. In the future, drug efficacy should be evaluated from multiple dimensions based on the “bio-psycho-social” evaluation framework. Additionally, a core outcome set (COS) for TCM treatment of MPS should be established and optimized to improve research quality and provide strong support for TCM treatment of MPS.
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