非药物治疗子宫内膜异位症慢性盆腔疼痛的疗效：一项系统综述和荟萃分析。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction Pub Date : 2025-08-05 DOI:10.1016/j.jogoh.2025.103006

Hegila da Silva Dantas , Maiara Costa de Oliveira , Tatiana CLA da Silva , Joyce MP de Oliveira , Maria LAS de Carvalho , Maria TABC Micussi

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引用次数: 0

摘要

简介：子宫内膜异位症是一种表现为慢性盆腔疼痛和不孕的疾病。目前的治疗方案不能提供完全缓解，并可能导致不良的副作用。目的：评价非药物治疗与安慰剂治疗在缓解子宫内膜异位症患者慢性盆腔疼痛方面的疗效。方法：根据系统评价和荟萃分析的首选报告项目（PRISMA）指南制定，并在Prospero注册（CRD42023455704）。检索在Web of Science、PubMed、Scielo、Embase和Pedro数据库中进行。我们纳入了采用非药物治疗的临床试验，并将慢性盆腔疼痛作为主要结局进行评估。采用Cochrane risk of bias 2 （RoB 2）工具评估偏倚风险，采用分级推荐评估、发展和评价（GRADE）评估证据质量。结果：纳入9项研究。所有的研究都涉及疼痛。除了一项研究外，干预组在减轻疼痛方面比对照组表现出更大的疗效。5项研究显示高偏倚风险，4项显示低偏倚风险。疼痛结果的荟萃分析由五篇文章进行。干预优于对照组，有效减轻疼痛，平均差值为-1.40；95% ci -1.71, -1.09。结论：通过非药物治疗，疼痛缓解和质量得到改善。然而，证据置信度非常低。这表明需要更严格的研究来证实非药物干预在减轻子宫内膜异位症疼痛方面的有效性。

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Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: a systematic review and meta-analysis

Introduction

Endometriosis is a condition that manifests through chronic pelvic pain and infertility. Current therapeutic options do not provide complete relief and may result in undesirable side effects.

Objective

To evaluate the efficacy of non-pharmacological therapies in relieving chronic pelvic pain compared to placebo therapies in women with endometriosis.

Methods

Developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in Prospero (CRD42023455704). The searches were conducted in the Web of Science, PubMed, Scielo, Embase, and Pedro databases. We included clinical trials that employed non-pharmacological therapies and evaluated chronic pelvic pain as the primary outcome. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of the evidence.

Results

Nine studies were included. All studies addressed pain. The intervention group showed greater efficacy in reducing pain compared to the control group, except in one study. Five studies presented a high risk of bias, while four showed a low risk of bias. The meta-analysis for the pain outcome was conducted with five articles. The intervention was superior to the control, effectively reducing pain, with a mean difference of –1.40; 95 % CI –1.71, –1.09.

Conclusion

The studies showed improvements in pain relief and quality of through non-pharmacological therapies. However, evidence confidence was very low. This highlights the need for more rigorous studies to confirm the efficacy of non-pharmacological interventions in reducing pain in endometriosis.

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来源期刊

Journal of gynecology obstetrics and human reproduction Medicine-Obstetrics and Gynecology

CiteScore

3.70

自引率

5.30%

发文量

210

审稿时长

31 days

期刊介绍： Formerly known as Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Journal of Gynecology Obstetrics and Human Reproduction is the official Academic publication of the French College of Obstetricians and Gynecologists (Collège National des Gynécologues et Obstétriciens Français / CNGOF). J Gynecol Obstet Hum Reprod publishes monthly, in English, research papers and techniques in the fields of Gynecology, Obstetrics, Neonatology and Human Reproduction: (guest) editorials, original articles, reviews, updates, technical notes, case reports, letters to the editor and guidelines. Original works include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses.