本文選題：雌激素替代治療 + GSM　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:通過Meta分析方法評估雌激素替代治療不同給藥方式對絕經(jīng)泌尿生殖道綜合征的療效,從而為臨床工作中對于此類疾病治療提供思路。方法:全面搜索Pubmed,Embase,Cochrane Library,Web of science,中國知網(wǎng),中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM),萬方中文數(shù)據(jù)庫等,并結(jié)合手工檢索圖書館等方法,搜集自1985年1月至2017年1月期間發(fā)表的相關(guān)中英文文獻(xiàn)。根據(jù)之前所設(shè)計的納入與排除標(biāo)準(zhǔn),對符合標(biāo)準(zhǔn)的文獻(xiàn)進(jìn)行質(zhì)量評價及數(shù)據(jù)提取,應(yīng)用Rev Man5.3軟件對數(shù)據(jù)進(jìn)行Meta分析。結(jié)果:本次共納入16項研究,全部為英文發(fā)表的隨機(jī)對照研究(RCT)。根據(jù)雌激素替代治療的不同給藥方式進(jìn)行分組,分別分析其與安慰劑對比治療效果。經(jīng)陰道給予雌激素替代治療與安慰劑進(jìn)行對比中,陰道VMI指數(shù)增加納入3項研究分析,Meta分析結(jié)果顯示:MD=15.82,95%CI(2.22,29.41),Z=2.28,P=0.020.05,提示兩組差異有統(tǒng)計學(xué)意義。陰道PH值降低方面納入3項研究,分析結(jié)果提示:MD=1.26,95%CI(1.10,1.43),Z=14.82,P0.00001。提示兩組差異有統(tǒng)計學(xué)意義。陰道干澀情況改善方面納入5項研究,分析結(jié)果提示:RR=2.74,95%CI(1.59,4.74),Z=3.61,P=0.0003,P0.05,考慮兩組差異有統(tǒng)計學(xué)意義。壓力性尿失禁方面納入3項研究,分析結(jié)果提示:RR:3.93,95%CI(2.94,5.26),Z=9.20,P0.00001,兩組差異有統(tǒng)計學(xué)差異。性交困難改善方面納入5項研究,分析結(jié)果:RR:2.68,95%CI(1.67,4.29),Z=4.10,P0.0001。兩組差異有統(tǒng)計學(xué)意義。經(jīng)口服給予雌激素替代治療與安慰劑進(jìn)行對比中,陰道VMI指數(shù)增加納入2項研究,結(jié)果顯示:MD:16.84,95%CI(15.22,18.47),Z=20.33,P0.00001。兩組差異有統(tǒng)計學(xué)意義。陰道PH降低方面納入3項研究,結(jié)果顯示:MD:0.33,95%CI(0.05,0.62),Z=2.27,P=0.02,兩組差異有統(tǒng)計學(xué)意義。在泌尿系統(tǒng)癥狀的研究中,分析結(jié)果提示兩組差異均無統(tǒng)計學(xué)意義。經(jīng)皮給予雌激素替代治療與安慰劑對比中,陰道PH降低方面,納入3項研究,分析結(jié)果顯示:MD=0.77,95%CI(0.49,1.04),Z=5.41,P0.00001,兩組差異有統(tǒng)計學(xué)意義。結(jié)論:經(jīng)陰道給予雌激素替代治療GSM,與安慰劑對比,療效顯著�？诜o予雌激素替代治療在陰道VMI指數(shù)增加及陰道PH降低方面效果明顯,經(jīng)皮給予雌激素替代治療在陰道PH降低方面效果明顯。由于本研究納入文獻(xiàn)相對較少,未來仍需更多高質(zhì)量,大樣本的研究進(jìn)一步分析,為臨床工作提供證據(jù)支持。
[Abstract]:Objective: to evaluate the efficacy of estrogen replacement therapy in menopausal urogenital syndrome by meta-analysis. Methods: a comprehensive search was conducted for Pubmedus Embase Cochrane Library of Science, China knowledge Network, Chinese Biomedical Literature Database (CBMN), Wanfang Chinese Database, and other methods. The relevant Chinese and English literatures published from January 1985 to January 2017 were collected with the help of manual retrieval of libraries. According to the inclusion and exclusion criteria designed before, the quality evaluation and data extraction were carried out on the documents that met the criteria, and Meta-analysis of the data was carried out by using the software Rev Man5.3. Results: a total of 16 studies were included in this study, all of which were randomized controlled trials published in English. Estrogen replacement therapy was divided into groups and compared with placebo. In the comparison between vaginal estrogen replacement therapy and placebo, the increase of VMI index in vagina was included in three studies. Meta-analysis showed that the two groups had a significant difference between the two groups. The results of meta-analysis showed that the VMI index of the two groups was 2.222.28 and 29.41%, indicating that there was a significant difference between the two groups. Three studies were carried out on the reduction of vaginal PH value. The results showed that 1. 1. 26% CIQ of 1. 1010 1. 43% of the vagina PH value was 14. 82% (P 0. 0001). The results suggest that the difference between the two groups is statistically significant. In the aspect of improving the dry and astringent condition of vagina, five studies were included, and the results showed that the two groups had significant difference. The results showed that the ratio of the two groups was 2.74-95% (CI 1.59) and 4.74% (P < 0.05), and the difference between the two groups was statistically significant considering the difference between the two groups. Stress urinary incontinence was included in three studies. The results showed that the two groups had significant differences. The results showed that the two groups had a significant difference between the two groups. The improvement of sexual intercourse difficulty was included in five studies, and the results of the analysis were as follows: 1: RR: 2.68 / 95: CI1.67 / 4.29 / P 0.0001. The difference between the two groups was statistically significant. After oral estrogen replacement therapy compared with placebo, the vaginal VMI index was increased in two studies, and the results showed that: MD16.84% 95 CI15.22 18.47% 20. 33% P0.00001.The results showed that the VMI index of the vagina was increased after oral estrogen replacement therapy compared with the placebo, and the results showed that the VMI index of the vagina was increased in two studies. The difference between the two groups was statistically significant. Three studies were carried out on the reduction of vaginal PH. The results showed that there was a significant difference between the two groups. In the study of urinary system symptoms, the results showed that there was no significant difference between the two groups. Three studies were carried out on the reduction of vaginal PH in the comparison between percutaneous estrogen replacement therapy and placebo. The results of analysis showed that there was a significant difference between the two groups. Conclusion: transvaginal estrogen replacement therapy with GSM is more effective than placebo. Oral estrogen replacement therapy was effective in increasing VMI index and decreasing vaginal PH. Due to the relatively few literatures included in this study, more high quality is needed in the future. Large samples of research are further analyzed to provide evidence for clinical work.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.75

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃繼良,施錦仁,趙瑞芝;雌激素替代治療絕經(jīng)后婦女腦梗死研究進(jìn)展[J];醫(yī)學(xué)綜述;2001年09期

2 尹士男;;雌激素替代治療:利和弊[J];國外醫(yī)學(xué)(內(nèi)科學(xué)分冊);1992年11期

3 王琳;絕經(jīng)后婦女的雌激素替代治療——藥物劑量是否過大[J];國外醫(yī)學(xué).婦產(chǎn)科學(xué)分冊;1995年02期

4 袁志敏;;絕經(jīng)后女性雌激素替代治療的即刻血流動力學(xué)效應(yīng)[J];國外醫(yī)學(xué)(老年醫(yī)學(xué)分冊);1998年05期

5 ;雌激素替代治療在女性乳腺增生疾病中的作用[J];基礎(chǔ)醫(yī)學(xué)與臨床;1999年04期

6 焦魯霞;;不排斥也不濫用——雌激素替代治療(二)[J];中老年保健;2006年05期

7 焦魯霞;;激素替代療法的常用藥物——雌激素替代治療(三)[J];中老年保健;2006年06期

8 常青;絕經(jīng)及雌激素替代治療[J];人民軍醫(yī);2001年11期

9 黃繼良 ,張欣然 ,王東華;雌激素替代治療絕經(jīng)后婦女糖尿病研究進(jìn)展[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2002年10期

10 范雪梅,鄧新桃;雌激素替代治療對絕經(jīng)后婦女血脂的影響[J];江蘇大學(xué)學(xué)報(醫(yī)學(xué)版);2002年04期

相關(guān)會議論文 前5條

1 吳雪清;李曉峰;葉碧綠;Louis Breen;Kevin O'Byrne;;潮熱發(fā)生機(jī)理及雌激素替代治療的機(jī)制研究[A];中華醫(yī)學(xué)會第三次全國絕經(jīng)學(xué)術(shù)會議暨絕經(jīng)相關(guān)問題學(xué)習(xí)班論文匯編[C];2011年

2 陳琳;黃品同;李艷萍;管玉濤;;應(yīng)用新版e-tracking技術(shù)對圍絕經(jīng)期婦女雌激素替代治療后頸動脈壁彈性的初步研究[A];2008年浙江省超聲醫(yī)學(xué)學(xué)術(shù)年會論文匯編[C];2008年

3 羅艷敏;何琦;呂福林;肖倩;仇玄;張蕾;陳林;晁鳳蕾;高原;修蕓;黃春霞;唐勇;;雌激素替代治療對中老年大腦白質(zhì)作用的研究[A];第十三屆中國體視學(xué)與圖像分析學(xué)術(shù)會議論文集[C];2013年

4 夏賢;張紹芬;許琳娜;龔莉莉;鄒世恩;龍琦琦;;口服和經(jīng)皮雌激素替代治療對手術(shù)絕經(jīng)婦女圍絕經(jīng)癥狀、血脂和凝血功能的影響[A];中華醫(yī)學(xué)會第十次全國婦產(chǎn)科學(xué)術(shù)會議婦科內(nèi)分泌會場（婦科內(nèi)分泌學(xué)組、絕經(jīng)學(xué)組、計劃生育學(xué)組）論文匯編[C];2012年

5 吳雪清;李曉峰;葉碧綠;;潮熱發(fā)生機(jī)理及雌激素替代治療的機(jī)制研究[A];2011年浙江省婦產(chǎn)科學(xué)學(xué)術(shù)年會暨“婦產(chǎn)科常見疾病的臨床研究新進(jìn)展”學(xué)習(xí)班論文匯編[C];2011年

相關(guān)重要報紙文章 前4條

1 湖南 教授 劉少華;雌激素替代治療應(yīng)遵循哪些原則[N];家庭醫(yī)生報;2004年

2 劉少華;應(yīng)用雌激素替代療法要注意哪些問題？[N];大眾衛(wèi)生報;2004年

3 錢祖稀;絕經(jīng)后骨質(zhì)疏松癥防治指南[N];醫(yī)藥經(jīng)濟(jì)報;2003年

4 楊艷紅教授;采用雌激素替代治療 提高老年婦女生活質(zhì)量[N];醫(yī)藥經(jīng)濟(jì)報;2001年

相關(guān)碩士學(xué)位論文 前4條

1 趙順榮;雌激素替代治療與絕經(jīng)后女性冠心病相關(guān)性的Meta分析[D];重慶醫(yī)科大學(xué);2016年

2 沈歆e，

本文編號：1987535