目的 本研究旨在综合评估中药方剂（traditional chinese medicine,TCM）和针灸对女性性功能障碍（female sexual dysfunction,FSD）的治疗效果,以及开展临床对照试验评价两种方法联合应用的疗效。方法 通过检索Cochrance、Embase、CNKI、CBM和PubMed数据库中药、针灸治疗FSD患者的临床文献,提取符合要求的文献进行Meta分析,检索时间为从建库开始至2024年5月31日。同时,在长沙市妇幼保健院选取2023年1月至2024年12月期间就诊的32例FSD患者,将其随机分配到TCM治疗对照组与TCM+针灸联合治疗组,一个月后对比治疗前后女性性功能指数（female sexual function index,FSFI）评分变化情况。结果 文献检索纳入8项有效研究文献,其中TCM治疗相关文献4篇,针灸治疗相关文献4篇。Meta分析结果显示,针灸治疗可提高FSFI评分（SMD=0.75,95% CI：0.44~1.07）,在改善性欲（SMD=0.90,95% CI：0.58~1.21）和性唤起（SMD=0.71,95% CI：0.4~1.02）方面具有显著效果,但对阴道润滑、性高潮、性交满意度及性交痛的改善无显著作用;TCM治疗同样能提高FSFI评分（SMD=0.91,95% CI：0.58~1.24）,且可提升FSD患者体内雌二醇水平（SMD=1.76,95% CI：0.60~2.92）,但对黄体酮、卵泡刺激素、促黄体生成素、泌乳素和睾丸素无明显影响。在临床研究中,将患者随机分为TCM治疗对照组与中药、针灸联合治疗组,治疗后一个月的对比分析发现,两组患者FSFI各项指标评分均较治疗前提高,且联合治疗组评分在阴道润滑度 、性高潮、性交满意度、性交痛以及FSFI 总分这几项指标中提升更为显著。结论 中药和针灸都能一定程度上治疗FSD,其可改善性欲、性唤起以及提高雌二醇水平,但在其他性功能指标方面改善不显著。临床治疗中,中药针灸联合治疗相较于单独中药治疗对FSD具有更佳的疗效,有助于提升患者性生活质量。
Abstract
Objective This study aims to comprehensively evaluate the therapeutic effects of traditional chinese medicine (TCM) formulas and acupuncture on female sexual dysfunction (FSD), as well as the clinical efficacy of their combined application. Methods We conducted a systematic review and Meta-analysis of clinical studies on TCM and acupuncture for FSD by searching Cochrane, Embase, CNKI, CBM, and PubMed databases from their inception to May 2024. Additionally, we enrolled 32 patients with FSD who visited the Changsha Maternal and Child Health Hospital from January 2023 to December 2024. These patients were randomly assigned to either a TCM control group or a combined TCM and acupuncture group. The Female Sexual Function Index (FSFI) scores were compared before and after one month of treatment. Results A total of 8 eligible studies were included in the Meta-analysis, with 4 studies focusing on TCM treatment and 4 on acupuncture treatment. The Meta-analysis revealed that acupuncture significantly improved FSFI scores (SMD=0.75, 95% CI: 0.44-1.07), particularly in enhancing sexual desire (SMD=0.90, 95% CI: 0.58-1.21) and sexual arousal (SMD=0.71, 95% CI: 0.4-1.02), but it had no significant effect on vaginal lubrication, orgasm, sexual satisfaction, or sexual pain. TCM treatment also increased FSFI scores (SMD=0.91, 95% CI: 0.58-1.24) and elevated serum estradiol levels in FSD patients (SMD=1.76, 95% CI: 0.60-2.92), while showing no significant impact on progesterone, follicle-stimulating hormone, luteinizing hormone, prolactin, or testosterone. In the clinical study, patients were randomly assigned to a TCM treatment control group and a combined treatment group receiving both Chinese herbal medicine and acupuncture. A comparative analysis conducted one month after treatment revealed that both groups showed improvements in all FSFI indicator scores compared to before treatment. Moreover, the combined treatment group demonstrated more significant improvements in vaginal lubrication, orgasm, satisfaction with intercourse, pain during intercourse, and the total FSFI score. Conclusion Both TCM and acupuncture can effectively treat FSD by improving enhancing sexual desire and arousal, and increasing estradiol levels. However, their effects on other indicators were not significant. The combined application of TCM and acupuncture demonstrated superior efficacy compared to TCM alone in treating FSD, thereby improving patients' sexual quality.
关键词
中药 /
针灸 /
女性性功能障碍 /
Meta分析
Key words
traditional Chinese medicine /
acupuncture /
female sexual dysfunction /
meta analysis
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基金
长沙市卫健委重点项目“构建氧化苦参碱—小檗碱纳米递药系统内外共治HPV及相关宫颈炎大鼠的作用研究”（KJ-A2023017）; 湖南省卫生健康委科研计划项目“一种新型聚乳酸/石墨烯薄膜联合huMSCs对宫腔粘连性子宫内膜损伤的作用及机制研究”（B202305036567）; 中国医药教育协会基金项目“T7 肽修饰的红细胞膜仿生纳米粒负载蒲公英甾醇用于乳腺癌靶向治疗研究”（2025-PJZXKT-05）
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