本文選題：子宮內(nèi)膜增生 + 左炔諾孕酮宮內(nèi)緩釋系統(tǒng)�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：【目的】:通過meta分析來評估左炔諾孕酮宮內(nèi)緩釋系統(tǒng)(LNG-IUS或者曼月樂)與口服孕激素治療子宮內(nèi)膜增生的有效性及安全性,為臨床上需要保守治療的子宮內(nèi)膜增生患者提供治療證據(jù)�！痉椒ā�:確定檢索詞及檢索策略后檢索以下數(shù)據(jù)庫:萬方數(shù)據(jù)庫,中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM),維普數(shù)據(jù)庫,中國知網(wǎng)數(shù)據(jù)庫,Pubmed,Medline,Cochrane,Web of science,Embase等數(shù)據(jù)庫,檢索時間2000年1月-2016年12月1日,語言種類限定為中文和英文,按照納入和排除標(biāo)準(zhǔn)納入關(guān)于左炔諾孕酮宮內(nèi)緩釋系統(tǒng)與口服孕激素治療子宮內(nèi)膜增生的隨機(jī)對照研究或非隨機(jī)對照研究。對所納入文獻(xiàn)行質(zhì)量評價后提取所需數(shù)據(jù),采用Stata 12.1軟件進(jìn)行meta分析�！窘Y(jié)果】:共納入符合標(biāo)準(zhǔn)文獻(xiàn)12篇,其中外文8篇,中文4篇。在12篇文獻(xiàn)中,隨機(jī)對照研究8篇,非隨機(jī)對照研究4篇,共1068例患者,左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組504例,口服孕激素組564例。其中有7篇文獻(xiàn)研究的對象為無不典型子宮內(nèi)膜增生患者,給予左炔諾孕酮宮內(nèi)緩釋系統(tǒng)和口服孕激素治療隨訪3個月、6個月、12個月、24個月后對其有效性行meta分析,結(jié)果表明:治療3個月后左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.20,95%CI:1.07~1.34,z=3.13,P=0.002);治療6個月后左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.34,95%CI:1.20~1.50,z=5.20,P=0.000);治療12個月后左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.36,95%CI:1.20~1.54,z=4.80,P=0.000);治療24個月后左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.50,95%CI:1.23~1.83,z=4.05,P=0.000)。有3篇文獻(xiàn)的研究對象為無不典型子宮內(nèi)膜增生和子宮內(nèi)膜不典型增生混合的患者,給予左炔諾孕酮宮內(nèi)緩釋系統(tǒng)和口服孕激素治療末次隨訪的有效性行meta分析,結(jié)果表明:左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.45,95%CI:1.25~1.68,z=4.94,P=0.000)。有4篇文獻(xiàn)的研究對象為子宮內(nèi)膜不典型增生的患者,給予左炔諾孕酮宮內(nèi)緩釋系統(tǒng)和口服孕激素治療末次隨訪的有效性行meta分析,結(jié)果表明:左炔諾孕酮宮內(nèi)緩釋系統(tǒng)組較口服孕激素組有效(RR=1.33,95%CI:1.18~1.50,z=4.76,P=0.000)�！窘Y(jié)論】:左炔諾孕酮宮內(nèi)緩釋系統(tǒng)在治療子宮內(nèi)膜增生的效果優(yōu)于口服孕激素,有可能是子宮內(nèi)膜增生患者保守治療安全而有效的首選治療方法。
[Abstract]:Objective: to evaluate the efficacy and safety of levonorgestrel intrauterine sustained release system (LNG-IUS or Manyue) and oral progesterone in the treatment of endometrial hyperplasia by meta analysis. To provide evidence for the treatment of endometrial hyperplasia patients who need conservative treatment in clinic. [methods] after determining the key words and searching strategies, the following databases were searched: Wanfang database, Chinese biomedical literature database (CBMN), Weip database, Chinese knowledge Network Database Pubmedan Medline, Cochraneof Web of Science Embase, etc., is available from January 2000 to December 1, 2016. The languages are limited to Chinese and English. According to the inclusion and exclusion criteria, randomized controlled or non-randomized controlled studies on the treatment of endometrial hyperplasia with levonorgestrel intrauterine release system and oral progesterone were included. The required data were extracted after the quality evaluation of the included literature, and meta analysis was carried out with Stata12.1 software. [results]: 12 articles were included, including 8 in foreign language and 4 in Chinese. Of the 12 articles, 8 were randomized controlled studies, 4 were non-randomized controlled trials, 504 patients were treated with levonorgestrel intrauterine sustained-release system, and 564 patients were treated with oral progesterone. Seven of them were treated with levonorgestrel intrauterine sustained release system and oral progesterone therapy for 3 months, 6 months, 12 months and 24 months after meta analysis. The results showed that the intrauterine sustained-release system of levonorgestrel was more effective than that of the oral progesterone group after 3 months of treatment, and that of the levonorgestrel intrauterine sustained-release system group was more effective than that of the oral progesterone group after 6 months, and that of the levonorgestrel intrauterine sustained-release system group was more effective than that of the oral progesterone group, and that of the levonorgestrel intrauterine sustained release system group was more effective than that of the oral progesterone group, and that of the levonorgestrel intrauterine sustained-release system group was more effective than that of the oral progesterone group; The intrauterine sustained-release system of progesterone was more effective than that of the oral progesterone group, and the RRN 1.5095% was more effective than that of the oral progesterone group (CI: 1.201.154) and the levonorgestrel intrauterine sustained-release system was 0.000g / kg after 24 months of treatment compared with the oral progesterone group (CI: 1.231.83z1 / 4.05). Three articles of study were conducted to study the efficacy of levonorgestrel intrauterine slow release system and oral progesterone therapy in the last follow-up of patients with nonatypical endometrial hyperplasia and endometrial atypical hyperplasia. The results showed that levonorgestrel intrauterine sustained-release system was more effective than that of oral progesterone group in RQ1.45 ~ (95) CI: 1.25 ~ (1.68) ~ 1.68 ~ (th) ~ (4.94) P ~ (+) 0.000 ~ (th). Patients with atypical endometrial hyperplasia received levonorgestrel intrauterine sustained-release system and oral progesterone for the last follow-up were analyzed by meta. The results showed that levonorgestrel intrauterine sustained-release system was more effective than oral progesterone group in the treatment of endometrial hyperplasia. [conclusion] the effect of levonorgestrel intrauterine sustained-release system on endometrial hyperplasia was better than that of oral progesterone. It may be a safe and effective first choice for the conservative treatment of endometrial hyperplasia.
【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】：R711.74

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