妈富隆治疗青春期功能失调性子宫出血的meta分析

A meta-analysis of treatment of puberty dysfunctional uterine bleeding with Marvelon

目的：系统评价妈富隆治疗青春期功能失调性子宫出血的疗效与安全性。方法：计算机检索VIP、CNKI、FMJS，收集以妈富隆为主要干预措施治疗青春期功血的随机对照试验（RcT），根据Cochrane系统评价方法，评价纳入文献的方法学质量并进行meta分析。结果：共纳入7个RCT，包括555名青春期功血患者。分析结果显示：与传统雌孕激素联合法或单一性激素治疗相比，妈富隆可明显提高青春期功血总有效率（OR=9．19，95％CI：3．56～23．75，P〈0．01）和痊愈率（OR=3．51，95％CI：2．46～4．99，P〈0．01），缩短完全止血时间（加权平均差=-22．76，95％CI：-26．67～-18．86，P〈0．01），试验组和对照组均出现不同程度不良反应。结论：本meta分析显示妈富隆在治疗青春期功血的总有效率、痊愈率和完全止血时间方面具有一定优势。由于纳入文献综合质量不高，存在偏倚风险，而且未能评价妈富隆的长期安全性，使得该结果对青春期功血临床治疗的指导意义受限。

Objective： To evaluate the efficacy and the safety of Marvelon in treating puberty dysfunctional uterine bleeding. Methods： Randomized controlled trials （RCTs） which interfered with puberty dysfunctional uterine bleeding by Marvelon in the databases VIP,CNKI and FMJS were searched. According to the systemic review methods of Co- ehrane Library, the quality of methodologies of the involved studies were evaluated before raeta-analysis was eonduc ted. Results： Ten RCTs involving 555 patients were included. Compared with the therapy of estrogen in combination with progesterone or the therapy of the single reproductive hormone, Marvelon not only signifieantly inereased the total effective rate （OR ： 9.19, 95%CI： 3.56, 23.75, P〈0.01） and the recovery rate （OR ： 3.51, 95%CI： 2.46, 4.99, P〈0. 01）, but also shortened the complete hemostasis time （WMD： -22.76, 95% CI： -26.67, -28.86, P〈0. 01）. While different levels of adverse reactions appeared in both the trial and controlled groups. Conclusion： The meta-anal- ysis reveals that in the treatment of puberty dysfunctional uterine bleeding, Marvelon possess certain advantages, such as increasing the total effective rate and the recovery rate as well as shortening the complete hemostasis time. Howev er, this evidence contributes limited sense to the clinical treatment of puberty dysfunctional uterine bleeding due to the quality of involved trails, possible bias risk and no long-term safety evaluation on Marvelon.