本文選題：曼月樂 + 孕三烯酮��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:采用循證醫(yī)學方法系統(tǒng)評價曼月樂與孕三烯酮治療子宮腺肌病的有效性及安全性。方法:計算機檢索中國知網(wǎng)、萬方、維普期刊數(shù)據(jù)庫、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)及Pubmed、Ovid、EMBase、Medline、The Cochrane Library等外文數(shù)據(jù)庫,同時運用手工檢索婦產(chǎn)科相關(guān)期刊雜志,并根據(jù)已檢索到的相關(guān)文獻的參考文獻再次檢索。檢索時間從建庫至2017年2月,語種、地域不限,全面搜集國內(nèi)外曼月樂治療子宮腺肌病的有關(guān)臨床試驗研究。要求所納入文獻的試驗設(shè)計類型必須為臨床病例對照研究,由兩名評議員根據(jù)納入標準及排除標準對所有文獻進行篩選、質(zhì)量評價等,選擇最終納入文獻。將文獻相關(guān)數(shù)據(jù)提取并歸納,運用RevMan5.3軟件進行Meta分析。結(jié)果:共納入符合標準的文獻9篇,其中6個RCT,3個CCT,共包括706例子宮腺肌病患者,實驗組為曼月樂(n=359),對照組為孕三烯酮(n=347)。觀察指標包括痛經(jīng)評分(VAS)、月經(jīng)量、子宮內(nèi)膜厚度、子宮體積和不良反應(yīng)。Meta分析結(jié)果示:(1)痛經(jīng)評分(VAS):曼月樂組痛經(jīng)評分低于孕三烯酮組(MD=-1.43,95%CI=[-1.65,-1.21]),P0.00001),差異有統(tǒng)計學意義。(2)月經(jīng)量:曼月樂組經(jīng)量較孕三烯酮組減少(MD=-60.00,95%CI=[-102.52,-17.47],P=0.006),差異有統(tǒng)計學意義。(3)子宮內(nèi)膜厚度:曼月樂組較孕三烯酮組子宮內(nèi)膜厚度明顯變薄(MD=-1.08,95%CI=[-1.49,-0.66],P0.0001),差異有統(tǒng)計學意義。(4)子宮體積:曼月樂組子宮體積較孕三烯酮組明顯變小(MD=-18.05,95%CI=[-26.95,-9.15],P0.0001),差異有統(tǒng)計學意義。(5)不良反應(yīng)發(fā)生率:曼月樂組比孕三烯酮組不良反應(yīng)發(fā)生率低(OR=0.45,95%CI=[0.29,0.69],P=0.0003),差異有統(tǒng)計學意義。結(jié)論:現(xiàn)有數(shù)據(jù)表明曼月樂和孕三烯酮對子宮腺肌病患者均可緩解相關(guān)臨床癥狀,在痛經(jīng)評分、月經(jīng)量、內(nèi)膜厚度及子宮體積方面曼月樂可能較孕三烯酮療效更為明顯,在不良反應(yīng)發(fā)生率上,曼月樂比孕三烯酮可能更低。鑒于納入本次的文獻質(zhì)量和數(shù)量的限制,后續(xù)還需進一步臨床試驗證實。
[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.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R711.71

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