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宫瘤清胶囊联合米非司酮治疗子宫肌瘤有效性的Meta分析
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| 篇名： | 宫瘤清胶囊联合米非司酮治疗子宫肌瘤有效性的Meta分析 |
| TITLE： | Meta-analysis of the Efficacy of Gongliuqing Capsules Combined with Mifepristone in the Treatment of Uterine Leiomyoma |
| 摘要： | 目的：系统评价宫瘤清胶囊联合米非司酮治疗子宫肌瘤的疗效，为临床用药提供循证参考。方法：计算机检索Cochrane图书馆、PubMed、Embase、中国期刊全文数据库、中文科技期刊数据库、中国生物医学文献数据库和万方数据库等，收集宫瘤清胶囊联合米非司酮（试验组）对比米非司酮（对照组）治疗子宫肌瘤的随机对照试验（RCT）。筛选文献、提取资料后，采用改良Jadad量表评价纳入文献的质量；采用Stata14.0软件进行Meta分析；采用TSA0.9软件进行试验序贯分析。结果：共纳入12项RCT，共计1210例患者。Meta分析结果显示，试验组患者总有效率[RR＝1.12，95％CI（1.00，1.26），P＜0.05]显著高于对照组，治疗后最大子宫肌瘤体积[SMD＝－1.08，95％CI（－1.21，－0.95），P＜0.05]、治疗后子宫体积[SMD＝－0.80，95％CI（－1.14，－0.45），P＜0.05]、卵泡刺激素水平[SMD＝－0.28，95％CI（－0.45，－0.19），P＜0.05]、促黄体生成素水平[SMD＝－0.44，95％CI（－0.52，－0.12），P＜0.05]、雌二醇水平[SMD＝－2.69，95％CI（－3.08，－1.49），P＜0.05]、孕酮水平[SMD＝－1.27，95％CI（－1.69，－0.71），P＜0.05]均显著小于或低于对照组。各亚组分析结果显示，除5、10mg米非司酮组的卵泡刺激素水平（P＞0.05）外，试验组患者治疗后最大子宫肌瘤体积、治疗后子宫体积、卵泡刺激素水平、促黄体生成素水平、雌二醇水平、孕酮水平均显著小于或低于对照组。试验序贯分析结果显示，宫瘤清胶囊联合米非司酮治疗子宫肌瘤的总有效率更优的证据确切。结论：宫瘤清胶囊联合米非司酮治疗子宫肌瘤的总有效率显著优于单用米非司酮，可有效缩小最大子宫肌瘤体积及子宫体积，降低血清雌激素水平。 |
| ABSTRACT： | OBJECTIVE：To systematically evaluate therapeutic efficacy of Gongliuqing capsules combined with mifepristone in the treatment of uterine leiomyoma ，in order to provide evidence-based reference for clinical medication. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CJFD，VIP，CBM and Wanfang database ，randomized controlled trials （RCTs）about Gongliuqing capsules combined with mifepristone （trial group ）versus mifepristone alone （control group ）in the treatment of uterine leiomyoma were collected. After literature screening and data extraction ，the quality of included literatures was evaluated with modified Jadad scale. Meta-analysis was conducted by using Stata 14.0 software，and trial sequential analysis （TSA）was performed by using TSA 0.9 software. RESULTS ：A total of 12 RCTs were included ，involving 1 210 patients. The results of Meta- analysis showed that the total response rate of trial group [RR ＝1.12，95％CI（1.00，1.26），P＜0.05] was significantly higher than that of control group ；maximum uterine leiomyoma volume after treatment [SMD ＝－1.08，95％CI（－1.21，－0.95），P＜0.05]，uterine volume after treatment [SMD ＝－0.80，95％CI（－1.14，－0.45）， P＜0.05]，follicle stimulating hormone （FSH）level [SMD ＝ － 0.28，95％ CI（－ 0.45，－ 0.19），P＜0.05]，luteinizing hormone（LH）level [SMD ＝－0.44，95％CI（－0.52，－0.12）， 020-38076311。E-mail：867203217@qq.com P＜0.05]，E2 level [SMD ＝－2.69，95％CI（－3.08，－1.49）， P＜0.05] and progesterone （P）level [SMD ＝－1.27，95％CI（－1.69，－0.71），P＜0.05] of trial group were significantly lower or better than those of control group. Results of subgroup analysis showed that except for the level of FSH in 5 and 10 mg mifepristone groups （P＞0.05），maximum uterine leiomyoma volume after treatment ，uterine volume after treatment ，the levels of FSH，LH，E2 and P in trial group were significantly lower than control group. The results of TSA showed that there were definite evidences for total response rate of Gongliuqing capsules combined with mifepristone being better in the treatment of hysteromyoma. CONCLUSIONS ：Total response rate of Gongliuqing capsules combined with mifepristone in the treatment of hysteromyoma is better than mifepristone alone ，which can effectively decrease the volume of maximum uterine leiomyoma volume and uterine vilume ，and reduce the level of serum hormone. |
| 期刊： | 2020年第31卷第02期 |
| 作者： | 钟毅征，黄嘉华，潘美均，江桦清，郑昊，李炜，陈思缄，曹英莹，黄帆，邓发森，孙伟鹏，郭凯敏 |
| AUTHORS： | ZHONG Yizheng，HUANG Jiahua，PAN Meijun，JIANG Huaqing， ZHENG Hao，LI Wei，CHEN Sijian，CAO Yingying，HUANG Fan，DENG Fasen，SUN Weipeng，GUO Kaimin |
| 关键字： | 子宫肌瘤；米非司酮；宫瘤清胶囊；疗效；Meta分析；试验序贯分析 |
| KEYWORDS： | Uterine leiomyoma ；Mifepristone；Gongliuqing capsules ；Therapeutic efficacy ；Meta-analysis；Trial sequential |
| 阅读数： | 393 次 |
| 本月下载数： | 11 次 |
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