中国临床保健杂志
中國臨床保健雜誌
중국림상보건잡지
CHINESE JOURNAL OF CLINICAL HEALTHCARE
2013年
6期
572-577
,共6页
梁金玉%艾星子·艾里%王迪%季菲%何婷婷
樑金玉%艾星子·艾裏%王迪%季菲%何婷婷
량금옥%애성자·애리%왕적%계비%하정정
子宫内膜异位症%雌激素类%促性腺素释放激素%激素替代疗法%Meta 分析
子宮內膜異位癥%雌激素類%促性腺素釋放激素%激素替代療法%Meta 分析
자궁내막이위증%자격소류%촉성선소석방격소%격소체대요법%Meta 분석
Endometriosis%Estrogens%Gonadorelin%Hormone replacement therapy%Meta-analysis
目的:评价促性腺激素释放激素激动剂(GnRHa)联合反向添加疗法用于我国中重度子宫内膜异位症患者术后疗效。方法检索 cochrane central Register of Controlled Trials(CENTRAL)、the cochrane Li-brary、PubMed、Medline、EMBASE、SCI、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库、维普数据库、万方数据资源,检索时间截止2013年3月,国家限制为中国,并辅以手工检索,根据入选标准选出 RCT 文献7篇,对其进行文献质量评价。采用 RevMan5.1软件进行 meta 分析。结果①反加疗法组较 GnRHa 组增加雌激素(E2)水平,P <0.01,降低卵泡刺激素(FSH)水平,P =0.006,两组差异均有统计学意义。反加组与 GnRHa 组间 CA125水平、黄体生成素(LH)水平差异无统计学意义。②在缓解疼痛 VAS 评分上反加疗法组与 GnRHa 组差异无统计学意义。③在药物不良反应中绝经症状严重程度(Kupperman 评分)上反加疗法组缓解了使用 GnRHa 造成的绝经症状,两组差异有统计学意义,P =0.001,在骨密度、骨钙素水平上,两组差异无统计学意义。结论保守手术后中重度子宫内膜异位症患者应用反加疗法,可以减少由GnRHa引起的低雌激素水平,但是未能对于骨密度水平和疼痛症状有显著地改善。
目的:評價促性腺激素釋放激素激動劑(GnRHa)聯閤反嚮添加療法用于我國中重度子宮內膜異位癥患者術後療效。方法檢索 cochrane central Register of Controlled Trials(CENTRAL)、the cochrane Li-brary、PubMed、Medline、EMBASE、SCI、中國期刊全文數據庫、中國生物醫學文獻數據庫、中文科技期刊全文數據庫、維普數據庫、萬方數據資源,檢索時間截止2013年3月,國傢限製為中國,併輔以手工檢索,根據入選標準選齣 RCT 文獻7篇,對其進行文獻質量評價。採用 RevMan5.1軟件進行 meta 分析。結果①反加療法組較 GnRHa 組增加雌激素(E2)水平,P <0.01,降低卵泡刺激素(FSH)水平,P =0.006,兩組差異均有統計學意義。反加組與 GnRHa 組間 CA125水平、黃體生成素(LH)水平差異無統計學意義。②在緩解疼痛 VAS 評分上反加療法組與 GnRHa 組差異無統計學意義。③在藥物不良反應中絕經癥狀嚴重程度(Kupperman 評分)上反加療法組緩解瞭使用 GnRHa 造成的絕經癥狀,兩組差異有統計學意義,P =0.001,在骨密度、骨鈣素水平上,兩組差異無統計學意義。結論保守手術後中重度子宮內膜異位癥患者應用反加療法,可以減少由GnRHa引起的低雌激素水平,但是未能對于骨密度水平和疼痛癥狀有顯著地改善。
목적:평개촉성선격소석방격소격동제(GnRHa)연합반향첨가요법용우아국중중도자궁내막이위증환자술후료효。방법검색 cochrane central Register of Controlled Trials(CENTRAL)、the cochrane Li-brary、PubMed、Medline、EMBASE、SCI、중국기간전문수거고、중국생물의학문헌수거고、중문과기기간전문수거고、유보수거고、만방수거자원,검색시간절지2013년3월,국가한제위중국,병보이수공검색,근거입선표준선출 RCT 문헌7편,대기진행문헌질량평개。채용 RevMan5.1연건진행 meta 분석。결과①반가요법조교 GnRHa 조증가자격소(E2)수평,P <0.01,강저란포자격소(FSH)수평,P =0.006,량조차이균유통계학의의。반가조여 GnRHa 조간 CA125수평、황체생성소(LH)수평차이무통계학의의。②재완해동통 VAS 평분상반가요법조여 GnRHa 조차이무통계학의의。③재약물불량반응중절경증상엄중정도(Kupperman 평분)상반가요법조완해료사용 GnRHa 조성적절경증상,량조차이유통계학의의,P =0.001,재골밀도、골개소수평상,량조차이무통계학의의。결론보수수술후중중도자궁내막이위증환자응용반가요법,가이감소유GnRHa인기적저자격소수평,단시미능대우골밀도수평화동통증상유현저지개선。
Objective To evaluate the effect of gonadotropin-releasing hormone agonist (Gonadotrophin re-leasing hormone agonist,GnRHa)combined with add back therapy for moderate /severe endometriosis after conserva-tive surgery in China.Methods In addition to manually searching,Cochrane CentralRegister of Controlled Trials (CENTRAL),the Cochrane Library,PubMed,Medline,EMBASE,SCI,Chinese journal full-text database,Chinese bi-omedical literature database,Chinese sci-tech periodical full-text database,VIP Chinese Periodical Database and Wan-fang Chinese Periodical Database were electronically searched from the establsihment of the database till March 2013, and state was limit as China.A total of seven RCTs meet the criteria.The data was extracted and analyzed by two re-viewers independently using the RevMan5.1 software.Results ①The increase in serum estrogen (E2 )levels,P <0.01,decrease in levels of serum follicle-stimulating hormone (FSH)was observed in the add-back therapy group,P=0.006,there was no statistic difference in the levels of serum CA125 and LH between the add-back therapy group and the GnRHa group,P >0.05.②There was no significant difference in the VAS score between the add-back thera-py group and the GnRHa group,P =0.12.③The menopause symptom(Kupperman score)caused by GnRHa was re-lieved in the add-back therapy group,P =0.001,There was no statistic difference in the levels of serum BMD and BPG levels,P >0.05.Conclusions GnRHa combined with add-back therapy post operation for moderate /severe en-dometriosis can effectively reduce the the menopause symptoms caused by GnRHa,with no evidence of changes in bone density,pain symptoms and CA125 levels.