手术与溴隐亭治疗中国女性催乳素瘤的Meta分析

摘要

目的：应用循证医学系统评价方法对手术与口服溴隐亭治疗中国女性催乳素瘤的疗效和安全性进行系统评价，以期为中国女性催乳素瘤的治疗提供临床决策依据。方法：检索Cochrane library、PubMed、Em-base、中国生物医学文献服务系统（ SinoMed）、中国期刊全文数据库（ CNKI）和中文科技期刊数据库（ VIP）中关于外科手术与口服溴隐亭对中国女性催乳素瘤的病例对照文献，并补充检索纳入研究的参考文献，根据纳入和排除标准筛选文献、提取资料并进行质量评价后，使用RevMan 5.1软件进行Meta分析，检索时间从各数据库建库至2013年1月31日。结果：纳入5篇研究共466名诊断明确的女性垂体催乳素瘤患者。Meta分析结果显示：在治疗6月后的PRL水平、治疗有效率和临床症状改善情况（月经改善或恢复率和泌乳改善或停止率）方面，手术与口服溴隐亭疗效差异无明显统计学意义（ P>0.05）。两组患者短期并发症的发生率差异无明显统计学意义（OR=1.00，95%CI：0.22-4.62，P=1.00）。结论：目前国内手术与溴隐亭治疗女性催乳素瘤的疗效和短期并发症差异均无统计学意义。但本研究纳入的文献量较少且质量不高，尚需更多高质量研究（如多中心随机对照试验等）来进一步明确两种治疗方法的疗效与并发症。%Objective:To evaluate the efficacy and safety of surgery versus bromocriptine for patients with prolacti-noma and provide evidence for the treatment of female prolactinoma patients in China. Methods:The databases Co-chrane library,PubMed,Embase,SinoMed,CNKI and VIP was electronically searched,and the relevent references of the included papers were also manually searched. The studies of surgery versus bromocriptine for patients in China with prolactinoma were included,the quality of included studies were evaluated and analyzed by RevMan 5. 1 soft-ware. The search was finished in January 31,2013. Results:Five studies involving 466 patients were included. Meta-analysis results suggested that the difference of two groups was not statistically significant in the PRL concentration af-ter 6 months of treatment,the treatment efficiency and the improvement of clinical symptoms(P>0. 05). The results of Meta-analysis showed that there were no significant difference between the two groups in the incidence of short-term complications(OR=1. 00,95%CI:0. 22-4. 62,P=1. 00). Conclusion:At present,there was no significant difference between the surgery and bromocriptine in the efficacy and short-term complications for female patients in China with prolactinoma. However,this study included a small amount of literature and the quality is not high. We need more and more high-quality research(RCTs)to study the efficacy and complications of two treatment methods.