曼月乐和口服药物治疗月经过多的有效性的meta分析  

Effectiveness of Mirena and oral drug for menorrhagia: a metaanalysis of randomized controlled trials

作　　者：肉孜汗.吾斯曼 艾星子.艾里 王迪[1] 何艳[1] 童晓文 

机构地区：[1]新疆医科大学第一附属医院妇科,乌鲁木齐830054 [2]上海东方医院妇科,上海200120

出　　处：《中南药学》2013年第11期807-811,共5页Central South Pharmacy

基　　金：国家自然科学基金(编号:81160077);自治区高校科研计划科学研究重点项目(编号:XJEDU2011132)

摘　　要：目的评价左炔诺孕酮宫内释放系统[levonorgestrel-releasing intrauterine system,LNG-IUS,商品名:曼月乐(Mirena)]和口服药物在月经过多治疗中的有效性。方法检索Cochrane Library、MEDLINE、EMBASE、ISI Web、BMJ、CBM、中国生物医学文献数据库、万方医学数据库、CNKI等数据库。纳入曼月乐和口服药物对比治疗月经过多的随机对照试验,对其方法学质量进行评价。用RevMan 5.0软件进行统计分析。结果①共纳入7篇符合要求的RCT文献,共计1 154例患者。②根据随机方法、分配隐藏、盲法、失访、基线比较和等级描述等对所纳入的研究行质量评估,结果其中7篇文献为高质量文献,1篇文献为低质量文献。Meta分析结果:曼月乐的有效率高于口服药物(12个月OR=3.51,95%CI=[1.95,6.3],P=0.000 1);曼月乐组的PBAC减小量百分比低于口服药物组(6个月RR=31.83,95%CI=[1.07,62.59],P=0.04;12个月RR=58.39,95%CI=[10.10,107.28],P=0.02);曼月乐组的MBL减小量百分比低于口服药物组(12个月时RR=66.91,95%CI=[42.61,91.20],P=0.000 01);曼月乐组的血红蛋白增高比口服药物明显(治疗12个月RR=1.37,95%CI=[1.04,1.70],P=0.000 01)。结论曼月乐对月经过多的治疗安全有效,是一种较好的保守性治疗手段。Objective To evaluate the effectiveness of levonorgestrel-releasing intrauterine system [LNG-IUS, commodity name： Mirena] and oral drug for menorrhagia. Methods We retrived the Cochrane Library, MEDLINE, EMBASE, ISI Web, BMJ, CBM, Chinese Biomedical Literature Database, Wanfang Medicine Database, and CNKI. Randomized controlled trials with Mirena treatment for menorrhagia were included. The data were analyzed with RevMan 5.0 software. Results Seven trials involving 1 154 patients were included. The quality of the included studies was evaluated based on the randomization method, allocation concealment, blindness, loss of follow-up, compare with the baseline and grade description. Six articles were considered high quality literature, and 1 article low quality literature. Meta analysis found that Mirena was more effective than oral medications（12 months, OR = 3.51, 95%CI = [1.95,6.3], P = 0.0001 0.05）; PBAC reduction percentage in the Mirena group was lower than that in the oral drug group（6 months RR = 31.83, 95%CI = [1.07, 62.59], P = 0.04; 12 months RR = 58.39, 95%CI = [10.10, 107.28], P = 0.02）; MBL reduction percentage in Mirena group was lower than that in the oral drug group（12 months of RR = 66.91, 95%CI = [42.61, 91.20], P = 0.000 01）. The level of hemoglobin in the Mirena group increased more significantly than that in the oral drug group（12 months, RR = 1.37, 95%CI = [1.04, 1.70], P = 0.000 01）. Conclusion Mirena is safe and effective for menorrhagia.

关 键 词：左炔诺孕酮宫内释放系统 曼月乐 月经过多 复方口服避孕药 炔诺酮 醋酸甲羟孕酮 META分析 

分 类 号：R969.3[医药卫生—药理学]