目的 通过循证医学的方法评价左炔诺孕酮宫内缓释系统(曼月乐)治疗子宫内膜异位症的安全性及有效性.方法 计算机检索Medline、Embase、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间从各数据库建立至2012年4月;同时辅助其他检索方法,所检索文献由两名系统评价者独立评价纳入研究并提取资料,并用Revman 5.1软件进行统计学分析.结果 共纳入11项研究,meta分析结果显示,与促性腺激素释放激素类似物相比,曼月乐可以取得相当的缓解疼痛的效果.与子宫全切术相比,曼月乐可以明显缓解患者疼痛,且对其性生活质量影响较小.保守手术后使用曼月乐与期待疗法相比,可以缓解患者疼痛.结论 曼月乐可以有效缓解子宫内膜异位症患者的疼痛,不良反应发生率低,值得临床推广应用.%Objective To evaluate the efficacy and safety of the levonorgestrel-releasing intrauterine system (mirena) in the treatment of endometriosis.Methods Medline,Embase,The Chinese Biomedical Database (CJFD) and Chinese Science and Technology Journal Full-text Database (CSJD) from their establishment to April 2012 were employed in the study.All the studies included were evaluated by Cochrane Handbook,and homogenous studies were analyzed by Revman 5.1 software.Results Eleven studies were included.Compared with gonadotropin releasing hormone group,the mirena group had no statistical difference in visual analogue score; compared with hysterectomy group,the mirena group had statistical significance in pain relief rate; compared with expectant management group,the mirena group also had statistical significance in pain relief rate.The mirena group showed no statistical significance in adverse effect.Conclusion The mircna can significantly relieve the pain of the patients of cndometriosis,and it is worth generalization in clinical.But the related studies are limited and the measure or index of these studies are different,so we look forward to more studies with high quality to prove the effectiveness of the mirena.
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