비만을 동반한 다낭성 난소 증후군 난임 환자에 대한 한약 및 침구 치료의 효과 : 체계적 문헌 고찰 및 메타 분석 = Effect of Herbal Medicine, Acupuncture and Moxibustion for Obese Polycystic Ovary Syndrome Patients with Infertility : A Systematic Review and Meta-analysis

다국어 초록 (Multilingual Abstract)

Objective:
The purpose of this study is to evaluate the efficacy and safety of herbal medicine, acupuncture and moxibustion treatment for obese polycystic ovary syndrome patients with infertility by systematic review and meta-analysis.
Methods:
Studies were retrieved from PubMed, CENTRAL, EMBASE, CNKI, OASIS and KISS. RCTs evaluating herbal medicine, acupuncture and moxibustion therapy for obese PCOS patients with infertility were included in the systematic review and meta-analysis. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and Review Manager software version 5.4 were used to assess the risk of bias and to perform the meta-analysis.
Results:
A total of 12 studies were included, all of which were conducted in China and published between 2015 and 2025. The total number of participants was 1,015. All studies included an intervention group receiving herbal medicine, acupuncture or moxibustion in combination with standard therapy. Regarding pregnancy methods, two studies involved natural conception attempts, seven studies involved ovulation induction, and three studies involved in vitro fertilization. The most common treatment duration was 3 months or three menstrual cycles. Among the treatment group, seven studies used only herbal medicine, one study used only acupuncture, and four studies used both herbal medicine and acupuncture. In the meta-analysis, the combination of herbal medicine, acupuncture or moxibustion with standard therapy demonstrated statistical significance over control group in BMI, HOMA-IR, testosterone, LH, ovulation rate, and pregnancy rate. However, in the miscarriage rate, there was no statistical difference between combined group and non-combined group. There was no significant difference in the incidence of mild adverse events or OHSS between the combined treatment and non-combined control groups. The incidence of LUFS was significantly lower in the combined group than the control group.
Conclusion:
This study investigated the efficacy and safety of herbal medicine, acupuncture and moxibustion in obese PCOS patients with infertility. The findings suggested that combined treatment with herbal medicine, acupuncture and moxibustion demonstrates a significant therapeutic benefit compared with non-combination therapy, without increasing the incidence of adverse events. However, the heterogeneity of the included studies and the limited number of available trials impose restrictions on the generalizability of the findings.

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅳ
• 그림목차 ⅴ
• Ⅰ. 서 론 01
• Ⅱ. 연구 방법 03
• 1. 연구 대상 선정 및 배제 기준 03
• 1) 연구 대상 03
• 2) 중재 방식 03
• 3) 비교 중재 03
• 4) 중재 결과 03
• 5) 연구 설계 04
• 2. 문헌 검색 04
• 3. 자료 선별 09
• 4. 자료 추출 09
• 5. 비뚤림 위험 평가 09
• 6. 통계적 분석 및 결과 합성 10
• Ⅲ. 연구 결과 11
• 1. 문헌 선정 11
• 2. 포함된 연구의 특성 13
• 1) 출판 경향 13
• 2) 연구 대상자의 특성 13
• 3) 치료군 중재 분석 16
• 4) 대조군 중재 분석 18
• 5) 평가 지표 분석 18
• 6) 치료 효과 분석 18
• 7) 이상 반응 및 탈락자 보고 분석 27
• 3. 비뚤림 위험 평가 29
• 1) 무작위 배정 과정에서 발생하는 비뚤림 29
• 2) 의도한 중재에서 이탈로 인한 비뚤림 29
• 3) 중재 결과 자료의 결측으로 인한 비뚤림 29
• 4) 중재 결과 측정의 비뚤림 30
• 5) 보고된 연구 결과 선택의 비뚤림 30
• 6) 전반적인 비뚤림 평가 30
• 4. 메타 분석 32
• 1) 한약 및 침구 치료 병행군 vs 한약 및 침구 치료 비병행군 32
• (1) BMI 32
• (2) HOMA-IR 34
• (3) Testosterone 34
• (4) LH 35
• (5) 배란율 36
• (6) 임신율 37
• (7) 유산율 39
• (8) 이상 반응 40
• Ⅳ. 고찰 42
• Ⅴ. 결 론 49
• 참 고 문 헌 51
• 영 문 초 록 56