中国药房2012，Vol.23Issue(38)：3613-3618,6.DOI:10.6039/j.issn.1001-0408.2012.38.21
地屈孕酮治疗先兆流产的系统评价
Dydrogesterone for Threatened Miscarriage:A Systematic Review
梁毅 1张伶俐 2王晨露 1曾力楠 2王丽1
作者信息
- 1. 四川大学华西第二医院药剂科,成都610041
- 2. 四川大学华西药学院,成都610041
- 折叠
摘要
Abstract
OBJECTIVE: To evaluate the efficacy and safety of dydrogesterone in the treatment of threatened miscarriage. METHODS: Randomized controlled trials (RCT) involving dydrogesterone in the treatment of threatened miscarriage were identified from PubMed, Embase, Cochrane Central, CBM, CNKI, VIP, ClinicalTrials.gov and WHO ICTRP. Published and unpublished RCTs were obtained on dydrogesterone in the treatment of threatened miscarriage. Included literatures were extracted and bias risks were evaluated independently by two reviewers. RevMan 5.0 software was used for Meta-analysis. RESULTS: A total of 8 RCT involving 1185 participants were included. Dydrogesterone vs. Conservative treatment: 4 RCT were included, the results of Meta-analysis showed that participants treated with dydrogesterone had a lower risk of miscarriage, compared with conservative treatment [RR=0.46,95%CI(0.32,0.65) ,P<0.0001]; no statistical significance was found in the incidence of premature birth (P= 0.77), antepartum haemorrhage (P=0.57) and congenital malformation (P= 0.71).Dydrogesterone vs. Progesterone: 2 RCT were included. We did not conduct Meta-analysis as included studies were in high risk of bias. No statistical significance was reported between two groups in the incidence of miscarriage (P= 1.000 and P= 0.630). Dydrogesterone vs. HCG: 1 RCT was included. No statistical significance was reported between two groups regarding to the incidence of miscarriage (P=0.711), premature birth (P= 0.727) and congenital malformation (P=0.461). Dydrogesterone combined with TCM treatment: 2 RCT were included, the incidences of miscarriage in dydrogesterone combined with Zishen yutai pills group and dydrogesterone alone group were 8% and 13% , there was no statistical significance (P=0.655) ; miscarriage occurred in 7.5% of women treated with dydrogesterone combined with Bushen huoxue antai prescription, and in 15% of that treated with progesterone, without statistical significance, neither (P=0.390). CONCLUSION: Dydrogesterone group has a lower incidence of miscarriage than conservative treatment only, but further studies with good methodological design are still needed to investigate its efficacy. There is no sufficient evidence to show any negative outcomes occurred in mothers or children related to dydrogesterone. Current studies with poor methodological quality show
no difference in the efficacy between dydrogesterone and progesterone or HCG. There is insufficient evidence to show the benefit of dydrogesterone combined with TCM.关键词
地屈孕酮/先兆流产/系统评价Key words
Dydrogesterone/ Threatened miscarriage/ Systematic review分类
医药卫生引用本文复制引用
梁毅,张伶俐,王晨露,曾力楠,王丽..地屈孕酮治疗先兆流产的系统评价[J].中国药房,2012,23(38):3613-3618,6.
