不同剂量的米非司酮治疗子宫肌瘤的有效性和安全性：荟萃分析。

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-01 DOI:10.1016/j.ejogrb.2024.10.059

Xiaoxiao Yin, Liuqing He, Haofei Xu, Shunping Lou, Ying Tan, Yunqing Wang, Xinyu Luo, Yefang Huang

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引用次数: 0

摘要

目的：系统评估米非司酮治疗子宫肌瘤的安全性和有效性：系统评估米非司酮治疗子宫肌瘤的安全性和有效性，剂量分别为 2.5 毫克、5 毫克、10 毫克、25 毫克和 50 毫克：该方案已在 INPLASY 注册（注册号为 INPLASY202460075）。计算机检索PubMed、Cochrane图书馆、Embase数据库中相关的（米非司酮组）与安慰剂和米非司酮或常规治疗（对照组）相比治疗子宫肌瘤的随机对照试验（RCT），检索时限为图书馆至2023年10月，参考Cochrane面对纳入文献的质量评价6.0，并使用RevMan 5.4.1软件进行Meta分析和敏感性分析：共有 18 项研究，2066 名患者参与了研究。荟萃分析发现，米非司酮组患者的子宫体积或子宫肌瘤体积低于对照组，差异有统计学意义。米非司酮治疗 3 个月子宫体积变小的效果优于 6 个月，差异有统计学意义。与对照组相比，米非司酮可改善盆腔疼痛、盆腔压痛、膀胱压痛、泌尿系统症状、腰痛、排尿困难、直肠痛、月经过多、闭经等临床症状。米非司酮组出现潮热、子宫内膜厚度增加，相关肝转氨酶的发生率明显高于对照组，10 mg/d 米非司酮组患者的子宫内膜厚度大于 5 mg/d 米非司酮组：结论：米非司酮可减少子宫肌瘤体积并改善临床症状，米非司酮5毫克/天、持续3个月可能是最佳的临床治疗方案。

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Efficacy and safety of different doses of mifepristone in the treatment of uterine fibroids: A meta-analysis

Objective

To systematically assess the safety and effectiveness of mifepristone at doses of 2.5 mg, 5 mg, 10 mg, 25 mg, and 50 mg in the treatment of uterine fibroids.

Methods

The protocol is registered with INPLASY (registration number is INPLASY202460075). Computer retrieval PubMed, the Cochrane Library, Embase database related (mifepristone group) compared to placebo and mifepristone or conventional treatment (control group) in the treatment of uterine fibroids randomized controlled trial (RCT), retrieve the time limit for a Library to in October 2023, Refer to the Cochrane faced the quality evaluation of the literature of included in the 6.0 and uses the RevMan 5.4.1 software Meta-analysis and sensitivity analysis.

Results

There were 18 studies with a total of 2066 patients as participants. A meta-analysis found that the patients in the mifepristone group had lower uterine volume or uterine fibroid volume than the control group, with a statistically significant difference. Mifepristone treatment for 3 months uterine volume smaller is better than 6 months the difference is statistically significant. Compared with the control group, mifepristone can improve pelvic pain, pelvic pressure, bladder pressure, urinary symptoms, lower back pain, dyspareunia, rectal pain, menorrhagia, hypermenorrhea, and other clinical symptoms. The Mifepristone group had hot flashes, endometrium thickness increases, the incidence of hepatic transaminases associated is significantly higher than the control group, the patients in the 10 mg/d mifepristone group had endometrial thickness that was greater than those in the 5 mg/d mifepristone group.

Conclusions

Mifepristone reduces fibroid volume and improves clinical symptoms, and 5 mg/day of mifepristone for three months may be the optimal clinical regimen.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.