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目的:系统评价米非司酮治疗中国女性围绝经期异常子宫出血的有效性,为临床提供循证参考。方法:计算机检索中国期刊全文数据库(CJFD)、中国生物医学文献服务系统数据库(SinoMed)、中文科技期刊数据库和万方数据库,收集米非司酮治疗中国女性围绝经期异常子宫出血的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并按照Cochrane 系统评价员手册5.1.0评价纳入研究质量后,采用Stata 8.0统计软件进行Meta分析。结果:共纳入49项RCT,合计5 082例患者。Meta分析结果显示,米非司酮高剂量组(12.5 mg/d)患者有效率显著高于低剂量组(≤6.5 mg/d)[OR=2.13,95%CI(1.53,2.97),P<0.001],米非司酮组患者有效率显著高于孕酮类药物组[OR=6.05,95%CI(3.92,9.34),P<0.001];米非司酮组患者有效率与雌激素类药物组比较,差异无统计学意义[OR=1.52,95%CI(0.45,5.16),P=0.499]。结论:米非司酮治疗中国女性围绝经期异常子宫出血的疗效优于孕酮类药物,与雌激素类药物相当;并且高剂量米非司酮治疗效果优于低剂量。
OBJECTIVE: To evaluate the effectiveness of mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period, and to provide evidence-based reference in clinic. METHODS: Retrieved from CJFD, SinoMed, VIP, Wanfang database, randomized controlled trials (RCTs) about mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period were collected, data extraction was conducted for clinical studies meeting inclusion criteria. Meta-analysis was conducted by using Stata 8.0 statistical software after quality evaluation with Cochrane manual 5.1.0. RESULTS: A total of 49 RCTs were included, involving 5 082 patients. Meta-analysis showed that the response rate of mifepristone high-dose group (12.5 mg/d)was significantly higher than that of mifepristone low-dose group (≤6.5 mg/d)[OR=2.13,95%CI(1.53,2.97),P<0.001], and response rate of mifepristone group was significantly higher than that of progesterone drug group [OR=6.05,95%CI(3.92,9.34),P<0.001]. There was no statistical significance in response rate between mifepristone group and estrogen drug group [OR=1.52,95%CI(0.45,5.16),P=0.499]. CONCLUSIONS: Mifepristone is better than progesterone drug and similar to hormone drug in the treatment of abnormal uterine bleeding during perimenopause period. High-dose of mifepristone is better than low-dose of mifepristone in the treatment of abnormal uterine bleeding during perimenopause period.
米非司酮围绝经期异常子宫出血中国女性Meta分析疗效
MifepristonePerimenopause periodAbnormal uterine bleedingChinese womenMeta-analysisTherapeutic efficacy
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