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地诺孕素治疗子宫内膜异位症有效性和安全性的Meta分析

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目的 系统评价地诺孕素治疗子宫内膜异位症的有效性和安全性.方法 计算机检索PubMed、Embase、Cochrane Library、CBM、WanFang Data和CNKI数据库,搜集地诺孕素治疗子宫内膜异位症的随机对照试验(randomized controlled trials,RCT),检索时限均从建库至2024年2月.由 2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析.结果 共纳入20个RCT,包括2 826例患者.Meta分析结果显示,地诺孕素与促性腺激素释放激素激动剂类药物疗效相似,差异无统计学意义;与安慰剂相比,地诺孕素可减少患者疼痛;与口服避孕药相比,地诺孕素可缓解患者疼痛、改善复发率和妊娠率;与其他药物相比(如非甾体抗炎药、孕激素类药等),地诺孕素可减少患者疼痛.安全性方面,地诺孕素与对照组相比可减少药物相关的骨密度损害及潮热发生.结论 当前证据显示,地诺孕素治疗子宫内膜异位症的效果良好且安全耐受.受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证.
Efficacy and safety of dienogest in the treatment of endometriosis:a meta-analysis
Objective To systematically review the efficacy and safety of dienogest in the treatment of endometriosis.Methods The PubMed,Embase,Cochrane Library,CBM,WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials(RCTs)of dienogest for the treatment of endometriosis from inception to February 2024.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.4 software.Results A total of 20 RCTs,involving 2 826 patients were included.Meta-analysis showed that compared with gonadotropin-releasing hormone agonist(GnRH-a),dienogest had similar efficacy.Compared with placebo,dienogest was more effective in reducing endometriosis-related pelvic pain.Compared with oral contraceptives,dienogest performed better in relieving endometriosis-related pelvic pain and improving recurrence and pregnancy rates.Compared with other drugs(such as non-steroidal anti-inflammatory drugs,dydrogesterone,etc.),dienogest could gradually reduce the pain.In terms of safety,dienogest could reduce bone density damage and hot flashes in patients with endometriosis compared with those in the control group.Conclusion Current evidence shows that dienogest is effective and safely tolerated in the treatment of endometriosis.Due to the limited quantity and quality of the included studies,the above conclusion needs to be verified by more high-quality studies.

DienogestEndometriosisMeta-analysisSystematic reviewRandomized controlled trial

李睿、刘璇、李晓燕、肖非易、王耀羚、张誉铮、赵琨、郭武栋、李雪

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国家卫生健康委卫生发展研究中心(北京 100044)

沈阳药科大学工商管理学院(沈阳 110016)

中国医学科学院北京协和医学院北京协和医院妇产科,国家妇产疾病临床研究中心(北京 100730)

地诺孕素 子宫内膜异位症 Meta分析 系统评价 随机对照试验

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(12)