罗格列酮治疗多囊卵巢综合征的系统评价  

Systematic Evaluation of Rosiglitazone for Polycystic Ovary Syndrome

作　　者：郑俊[1] 韩亭亭[1] 胡耀敏[1] 刘伟[1] 

机构地区：[1]上海交通大学医学院附属仁济医院内分泌科,上海市200127

出　　处：《中国全科医学》2010年第11期1192-1194,共3页Chinese General Practice

基　　金：国家自然科学基金(30670988);浦东新区社会发展局卫生科技项目(PW2008D-1)

摘　　要：目的系统评价罗格列酮治疗多囊卵巢综合征(PCOS)的疗效及安全性。方法用计算机检索Med-line数据库、Cochrane图书馆临床对照试验资料库、中国生物医学文献光盘数据库,检索年限从建库-2009年5月。查找以罗格列酮为干预措施治疗PCOS的随机对照临床试验,按Cochrane系统评价方法,评价纳入研究的方法学质量并提取有效数据进行Meta分析,统计软件采用RevMan5.0。结果共纳入7个随机对照试验,包括342例PCOS患者,Meta分析结果显示,罗格列酮改善PCOS患者胰岛素抵抗的作用优于其他药物,差异有统计学意义〔P=0.02,SMD=-0.36,95%CI(-0.66,-0.06)〕。罗格列酮独立降低雄激素和促排卵作用并不优于其他药物〔P=0.15,WMD=-0.56,95%CI(-1.31,0.20);P=0.31,WMD=-0.96,95%CI(-2.82,0.91)〕。无一项研究报道了罗格列酮的不良反应。结论罗格列酮较二甲双胍、促排卵药物等更能改善PCOS患者胰岛素抵抗,但罗格列酮独立治疗高雄激素血症和促排卵作用并不优于其他药物治疗。故罗格列酮适用于有胰岛素抵抗的PCOS,但目前收集到的文献质量较低,样本量少,若有高质量、大样本、长期随访的研究进一步证实其有效性和安全性,该结论将更可信。Objective To evaluate the efficacy and safety of rosiglitazone on polycystic ovary syndrome. Methods Rosiglitazone treating PCOS randomized controlled clinical trials were searched for in Medline database, Cochrane Library Clinical Controlled Trial Database, the Chinese Biomedical Literature Database CD - ROM, from the beginning of database to May 2009. According to Cochrane systematic methodology, a Meta - analysis was conducted on the metholdological quality and the extracted valid data, using RevMan5. 0. Results A total of 7 randomized controlled trials were enrolled, including 342 PCOS patients. Meta analysis showed that the effect of rosiglitazone was superior to the other drugs in improve insulin resistance in PCOS patients, the difference was significant [P =0. 02, SMD = -0.36, 95% CI （ -0. 66, -0.06） ）, but not superior in independent reduction of androgen and ovarian stimulation [P=0.15, WMD= -0.56, 95%CI （ -1.31, 0.20）; P=0.31, WMD = - 0.96, 95% CI （ - 2. 82, 0. 91 ） ]. No adverse reactions of rosiglitazone were reported. Conclusion Rosiglitazone improves insulin resistance better than metformin and clomiphene, but not superior to other drugs in independent treatment of hyperandrogenism and ovarian stimulation. So, rosiglitazone is suitable to treatment of PCOS with insulin resistance. But the evidence is not strong enough to support it because of lower quality of collected literatures and smaller samples. Its effectiveness and safety can be further confirmed if high quality studies with larger samples and long - term follow - up are found.

关 键 词：罗格列酮 多囊卵巢综合征 META分析 

分 类 号：R711.75[医药卫生—妇产科学]