广西医学Issue(5)：618-623,630,7.DOI:10.11675/j.issn.0253-4304.2014.05.22
促性腺激素释放激素激动剂联合激素反向添加治疗子宫内膜异位症的 Meta 分析
Gonadotrophin-Releasing Hormone Agonist Combined with Hormone Applied to‘Add-Back’ Therapy for Endometriosis:A Meta-Analysis
林丽娜 1徐红 1韦仕洋1
作者信息
- 1. 广西医科大学第一附属医院妇科，南宁市 530021
- 折叠
摘要
Abstract
Objective To evaluate the effect and safety of ‘add-back ’ therapy with gonadotropin-releasing hormone agonist ( GnRH-a) plus hormone for endometriosis ( EMT) according to evidence-based medicine .Methods We searched the Cochrane Library , MEDLINE, EMBase, CBM, CNKI, VIP and Wanfang Database to collect the domestic and overseas RCTs of ‘add-back’ therapy with GnRH-a combined with hormone for endometriosis .The useful data were collected from the selected RCTs , and their methodological quality was assessed according to Jadad scale .A Meta-analysis was performed by using RevMan 5.1 software.Results Eleven RCTs were included,they were studies on the comparison of GnRH-a combined with ‘add-back’ therapy versus GnRH-a treatment alone.The results of the meta-analysis were as follows:①The patients in ‘add-back’ therapy group had a less lumbar spine bone loss compared with those in GnRH-a alone group after treatment(P<0.05).②The‘add-back’ therapy group showed a higher estradiol level and a lower follicle-stimulating hormone level compared with GnRH-a alone group ( P<0 .05 ) .③ There were no significant differences in reducing pelvic pain symptoms between ‘add-back’ therapy group and GnRH-a alone group ( P>0 .05 ) .④ The patients in ‘add-back ’ therapy group had a lower incidence of sleepless and hot flushes compared with those in GnRH-a alone group(P<0.05).⑤There were no significant differences in the levels of low density lipoprotein and triglyceride between ‘add-back’ therapy group and GnRH-a alone group(P>0.05).Conclusion The“add-back”therapy with GnRH-a plus hormone can improve the hypoestrogenic symptom,relieve the peri-menopausal syndrome and bone loss ,and keep the therapeutic effect .It has little effect on blood lipid metabolism in the short term .关键词
子宫内膜异位症/促性腺激素释放激素激动剂/反向添加/Meta分析/雌激素/孕激素Key words
Endometriosis/Gonadotropin-releasing hormone analogue/Add-back therapy/Meta-analysis/Estrogen/Progestogen分类
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林丽娜,徐红,韦仕洋..促性腺激素释放激素激动剂联合激素反向添加治疗子宫内膜异位症的 Meta 分析[J].广西医学,2014,(5):618-623,630,7.
