目的 系统评价桂枝茯苓胶囊（丸）联合促性腺激素释放激素激动剂（GnRH-a）防治子宫内膜异位症术后复发的疗效及安全性。方法 计算机检索中英文数据库，英文库包括PubMed、Embase、Web of Science及The Cochrane Library，中文库包括中国学术期刊全文数据库（CNKI）、维普生物医学数据库（VIP）、SinoMed、万方数据库（Wanfang Data）。检索时间从建库起至2026年1月16日，内容为桂枝茯苓胶囊（丸）联合GnRH-a防治子宫内膜异位症术后的随机对照试验研究（RCT）。由2名研究员独立筛选文献、提取资料，并通过Cochrane偏倚风险评估工具评估文献质量，针对疾病复发率、血清糖类抗原125(CA125)、疼痛视觉模拟量表（VAS评分）、术后妊娠率、不良反应发生率进行Meta分析。结果 纳入15项RCT研究，共1 480例患者。Meta分析结果显示，桂枝茯苓胶囊（丸）联合GnRH-a类药物与单用GnRH-a类药物相比，能更有效降低术后疾病复发率（P<0.000 01），降低术后CA125水平（P<0.000 01）、VAS评分（P=0.000 2），提高术后妊娠率（P<0.000 01），同时不增加不良反应发生率（P=0.81）。结论 桂枝茯苓胶囊（丸）联合GnRH-a治疗子宫内膜异位症术后可减少术后疾病复发率，降低CA125水平，减轻盆腔疼痛，提高术后妊娠率，且安全性良好。

Objective To evaluate the efficacy and safety of Guizhi Fuling Capsules(Pills) combined with GnRH-a in preventing postoperative recurrence of endometriosis. Methods Randomized controlled trials on Guizhi Fuling Capsules(Pills) combined with GnRH-a for preventing postoperative recurrence of endometriosis were retrieved from Chinese and English databases, including PubMed, Embase, Web of Science, The Cochrane Library, CNKI, VIP, SinoMed, and Wanfang Database, from the establishment of each database until January 16 th, 2026. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies using the Cochrane Risk of Bias Tool. Meta-analysis was performed on disease recurrence rate, serum carbohydrate antigen 125(CA125) level, visual analog scale(VAS) score for pain, postoperative pregnancy rate, and incidence of adverse reactions. Results Fifteen studies involving 1 480 patients were included. The Meta-analysis results showed that, compared with GnRH-a alone, Guizhi Fuling Capsules(Pills) combined with GnRH-a significantly reduced the postoperative disease recurrence rate(P < 0.000 01), lowered postoperative CA125 levels(P < 0.000 01), decreased VAS scores(P = 0.000 2), increased postoperative pregnancy rates(P < 0.000 01), and did not increase the incidence of adverse reactions(P = 0.81). Conclusion Guizhi Fuling Capsules(Pills) combined with GnRH-a can effectively reduce postoperative recurrence of endometriosis, lower CA125 levels, alleviate pelvic pain, improve postoperative pregnancy rates, and demonstrates favorable safety.

R984

国家中医药管理局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); 四川省中医药管理局第四届四川省十大名中医工作室建设项目(川中医药函[2024]56号)