曼月乐与孕三烯酮治疗子宫腺肌病疗效比较的meta分析

发布时间：2018-05-11 05:11

本文选题：曼月乐 + 孕三烯酮　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:采用循证医学方法系统评价曼月乐与孕三烯酮治疗子宫腺肌病的有效性及安全性。方法:计算机检索中国知网、万方、维普期刊数据库、中国生物医学文献数据库(CBM)及Pubmed、Ovid、EMBase、Medline、The Cochrane Library等外文数据库,同时运用手工检索妇产科相关期刊杂志,并根据已检索到的相关文献的参考文献再次检索。检索时间从建库至2017年2月,语种、地域不限,全面搜集国内外曼月乐治疗子宫腺肌病的有关临床试验研究。要求所纳入文献的试验设计类型必须为临床病例对照研究,由两名评议员根据纳入标准及排除标准对所有文献进行筛选、质量评价等,选择最终纳入文献。将文献相关数据提取并归纳,运用RevMan5.3软件进行Meta分析。结果:共纳入符合标准的文献9篇,其中6个RCT,3个CCT,共包括706例子宫腺肌病患者,实验组为曼月乐(n=359),对照组为孕三烯酮(n=347)。观察指标包括痛经评分(VAS)、月经量、子宫内膜厚度、子宫体积和不良反应。Meta分析结果示:(1)痛经评分(VAS):曼月乐组痛经评分低于孕三烯酮组(MD=-1.43,95%CI=[-1.65,-1.21]),P0.00001),差异有统计学意义。(2)月经量:曼月乐组经量较孕三烯酮组减少(MD=-60.00,95%CI=[-102.52,-17.47],P=0.006),差异有统计学意义。(3)子宫内膜厚度:曼月乐组较孕三烯酮组子宫内膜厚度明显变薄(MD=-1.08,95%CI=[-1.49,-0.66],P0.0001),差异有统计学意义。(4)子宫体积:曼月乐组子宫体积较孕三烯酮组明显变小(MD=-18.05,95%CI=[-26.95,-9.15],P0.0001),差异有统计学意义。(5)不良反应发生率:曼月乐组比孕三烯酮组不良反应发生率低(OR=0.45,95%CI=[0.29,0.69],P=0.0003),差异有统计学意义。结论:现有数据表明曼月乐和孕三烯酮对子宫腺肌病患者均可缓解相关临床症状,在痛经评分、月经量、内膜厚度及子宫体积方面曼月乐可能较孕三烯酮疗效更为明显,在不良反应发生率上,曼月乐比孕三烯酮可能更低。鉴于纳入本次的文献质量和数量的限制,后续还需进一步临床试验证实。
[Abstract]:Objective: to evaluate the efficacy and safety of manyue and pregnenone in the treatment of adenomyosis. Methods: the foreign language databases, such as China Zhiwang, Wanfang, Weipu Journal Database, Chinese Biomedical Literature Database (CBM), Pubmedmeda Ovidae EMBaseMedline and the Cochrane Library, were searched by computer, and the journals related to gynecology and obstetrics were searched by hand. And according to the references of the relevant documents that have been retrieved, they are retrieved again. The retrieval time was from the establishment of the library to February 2017, in which there was no restriction on the language and region. The clinical trial studies on the treatment of adenomyosis of uterus by Manyue at home and abroad were collected. The type of experimental design required to be included in the literature must be a clinical case-control study. According to the inclusion criteria and exclusion criteria, two assessors should screen all the documents, evaluate the quality of the documents, and select the final inclusion of the literature. The related data are extracted and summarized, and Meta analysis is carried out by using RevMan5.3 software. Results: a total of 9 articles were included, including 6 RCTs and 3 CCTs, including 706 patients with adenomyosis. The observed parameters included dysmenorrhea score, menstrual volume, endometrial thickness, and dysmenorrhea score. Uterine volume and adverse effects. Meta-analysis results showed that the menstrual volume in the Manyue group was lower than that in the gestational trienone group, and the menstrual score was lower than that in the gestational trienone group. The difference was statistically significant (P = 0.00001). The menstrual volume was significantly lower in the Manyue group than in the gestational trienone group, and the difference was statistically significant (P = 0.006, P = -102.52 ~ -17.47). The thickness of endometrium in Manyue group was significantly thinner than that in gestational trienone group (P = 0.0001). The uterine volume in Manyue group was significantly smaller than that in pregnant trienone group (P 0.0001), and the difference was statistically significant (P 0.0001). The difference was statistically significant (P 0.0001). The incidence of adverse reactions in Manyue group was lower than that in pregnancy trienone group (CI = 0.290.69), and the difference was statistically significant. Conclusion: the available data indicate that manyue and pregnenone can relieve the related clinical symptoms in patients with adenomyosis, and may be more effective than pregnancy trienone in terms of dysmenorrhea score, menstrual volume, endometrial thickness and uterine volume. In the incidence of adverse reactions, Manyue may be lower than pregnancy trienone. In view of the limited quality and quantity of this literature, further clinical trials are needed.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.71

【参考文献】