地诺孕素治疗子宫腺肌病疗效与安全性meta分析OACSTPCD

Objective:To systematically evaluate the efficacy and safety of dienogest in the treatment of adenomyosis,so as to provide an evidence-based basis for the treatment of ade-nomyosis.Methods:Retrieved from PubMed,Embase,Cochrane Library,CBM,CNKI and Wan-fang database(searched from inception to July 30,2023),randomized controlled trials(RCTs)about dienogest(trial group)versus positive drugs or placebo(control group)in the treatment of adenomyosis were collected.The quality of included literature was screened,extracted and eval-uated by Cochrane 5.1.0 risk of bias assessment tool,and meta-analysis was performed using Rev Man 5.3 software.Results:A total of 10 RCTs were included,including 820 patients.Meta-analysis showed that the VAS score of trial group was significantly lower than that of control group(SMD=-2.50,95%CI:-4.73～-0.27,P=0.03).There was no statistical significance in the changes of uterine volume between dienogest group and control group(MD=0.24,95%CI:-0.87～1.36,P=0.67),the clinical response rate in trial group was significantly higher than that in control group(RR=1.30,95%CI:1.19～1.41,P<0.01).There was little differ-ence in CA125 levels between the two groups(MD =-4.25,95%CI:-13.16～4.66,P = 0.35).The incidence of hot flashes(RR=0.72,95%CI:0.03～15.53,P=0.83)and abnor-mal uterine bleeding(RR=2.11,95%CI:0.87～5.15,P=0.10)were similar between the two groups.Conclusion:Compared with the control group,the trial group had better pain relief and higher clinical response,comparable changes in uterine volume and CA125 levels.In terms of safety,the incidence of side effects of hot flushes was similar.The incidence of abnormal uterine bleeding was comparable to that of the positive control group,but was significantly higher than that of the placebo group,so the risk of uterine bleeding should be vigilant when using dinorg-estrel.Large-scale RCTs are needed to evaluate the effect in the future.