[摘要] 目的 評(píng)價(jià)散結(jié)鎮(zhèn)痛膠囊聯(lián)合左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)（曼月樂(lè)）治療子宮腺肌病的效果及安全性。 方法 計(jì)算機(jī)檢索中國(guó)知網(wǎng)、萬(wàn)方、維普、CBM、Pubmed、The Cochrane Library、The Web of Science中英文數(shù)據(jù)庫(kù)關(guān)于散結(jié)鎮(zhèn)痛膠囊聯(lián)合曼月樂(lè)治療子宮腺肌病的隨機(jī)對(duì)照試驗(yàn)，各個(gè)數(shù)據(jù)庫(kù)檢索時(shí)間均由建庫(kù)至2017年12月10日。分為散結(jié)鎮(zhèn)痛膠囊聯(lián)合曼月樂(lè)組、單用曼月樂(lè)組兩組，觀察指標(biāo)：總有效率、病灶縮小率、痛經(jīng)評(píng)分、子宮內(nèi)膜厚度、血清CA125水平。對(duì)符合納入和排除標(biāo)準(zhǔn)的文獻(xiàn)進(jìn)行數(shù)據(jù)提取及方法學(xué)質(zhì)量評(píng)價(jià)，并采用RevMan 5.3軟件作Meta分析。結(jié)果 共納入文獻(xiàn)6篇，包括602例患者。Meta分析結(jié)果示：散結(jié)鎮(zhèn)痛膠囊聯(lián)合曼月樂(lè)組與單用曼月樂(lè)組對(duì)比，聯(lián)合用藥組總有效率更高（OR=5.38，95%CI：[3.01，9.63]，P < 0.000 01），病灶縮小率（OR=17.94，95%CI：[7.47，43.10]，P < 0.000 01）、痛經(jīng)評(píng)分（MD =-1.72，95%CI：[-3.37，-0.07]，P = 0.04）、子宮內(nèi)膜厚度（MD=-1.52，95%CI：[-1.77，-1.27]，P < 0.000 01）、血清CA125水平（MD =-5.74，95%CI：[-8.12，-3.35]，P < 0.000 01）等指標(biāo)改善程度均優(yōu)于單藥組，且未出現(xiàn)明顯不良反應(yīng)。 結(jié)論 現(xiàn)有證據(jù)顯示散結(jié)鎮(zhèn)痛膠囊聯(lián)合曼月樂(lè)治療子宮腺肌病效果顯著，能明顯改善患者的痛經(jīng)評(píng)分、病灶大小、子宮內(nèi)膜厚度、血清CA125等指標(biāo)，提高總有效率，可供臨床參考借鑒。
　　[關(guān)鍵詞] 散結(jié)鎮(zhèn)痛膠囊；曼月樂(lè)；子宮腺肌病；Meta分析
　　[中圖分類(lèi)號(hào)] R711.71 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2018）02（c）-0088-06
　　Meta analysis of the efficacy of San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System in treatment of adenomyosis
　　GU Zijuan1 LU Ruling2 YUAN Shuo2 DENG Gaopi2
　　1.Guangzhou University of Traditional Chinese Medicine， Guangdong Province， Guangzhou 510405， China； 2. Women and Children Center the second Department of Gynecology， the First Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510405， China
　　[Abstract] Objective To evaluate the clinical efficacy and safety of San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System in the treatment of adenomyosis. Methods Published papers about randomized controlled trials （RCTs） of San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System in the treatment of adenomyosis from the establishment of the database till December 10， 2017 with language restriction of Chinese and English were searched from various databases， which included PubMed， the Cochrane Library， Web of Science， CBM， Wanfang Data， CNKI， VIP. The subjects were divided into two groups， including Sanjie Zhentong capsules combined with Levonorgestrel Intrauterine System group and mere Levonorgestrel Intrauterine System group. Moreover， the observations including the total efficiency and the indexes of Lesion reduction rate and dysmenorrhea score and endometrial thickness and serum CA125 levels. In addition， a Meta-analysis was conducted with Review Manager 5.3 software. Results Six articles involving 602 patients were included. The Meta-analysis showed that there was a significantly positive effect of San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System in the treatment of adenomyosis. Conclusion San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System can improve not only the indexes of Lesion reduction rate （OR=17.94， 95%CI： [7.47， 43.10]， P < 0.000 01）， Dysmenorrhea score （MD=-1.72， 95%CI： [-3.37， -0.07]， P=0.04）， Endometrial thickness （MD =-1.52， 95%CI： [-1.77， -1.27]， P < 0.000 01）， Serum CA125 levels （MD =-5.74， 95%CI： [-8.12， -3.35]， P < 0.000 01）， but also the total efficiency （OR=5.38， 95%CI： [3.01， 9.63]， P < 0.000 01） and it seems to have no obvious adverse reactions. Conclusion The evidences support that San Jie Zhen Tong Capsules combined with Levonorgestrel Intrauterine System have potential advantages compared to mere Levonorgestrel Intrauterine System therapy in the treatment of adenomyosis.

相關(guān)熱詞搜索：散結(jié) 鎮(zhèn)痛 子宮 膠囊 治療