| Method:1、 Search strategy: We searched PUBMED,MEDLINE,CBM,CNKI andreference lists of articles. Languages were restricted to Chinese and English,andwithout limiting the searching time.2、Selection criteria: Trials were included if they were controlled clinical trialsabout mirena treatment of adneomyosis.Readed the collection literature abstracts andfull text,excluding not meet the purpose of study and the lower quality article.3、Data collection and analysis:Data extraction and quality assessment wasperformed independently by the author.All the data extracted was put in RevMan5.2software and analyzed by it.Results: Nine case-contorl trials were indentified and included in thisreview,involving586Patients were included. All included studies were Chineseliterature.Includeding two randomized controlled trials and seven controlled clinicaltrials.None of the RCTs and CCTs grouping method were deseribed in detailed, alsodid not mention whether blinded. Meta-analysis showed that:1、Comparing mirena with oral drugs for remission rates in patients withdysmenorrhea:3months: OR=3.14,95%Cl (1.62-6.11), z=3.38, P=0.0007<0.05;6months: OR=12.52,95%Cl (6.79-23.09), Z=8.09, P <0.0001;12months: OR=108.39,95%Cl (7.10-1653.59), Z=3.37, P=0.0008<0.05. Differences were statisticallysignificant, that Mirena compared with oral medications can relieve dysmenorrheacaused by adenomyosis.2、Comparing mirena with oral drugs for menstrual flow in patients withadenomyosis:6months: MD=-63.33,95%Cl (-146.43-19.77), Z=1.49, P=0.14> 0.05, the difference was not statistically significant. After6months treatment,therewas no difference between mirena with oral drugs for menstrual flow in patients withadenomyosis.3、Comparing mirena with oral drugs of adenomyosis patients with uterinevolume:6months: MD=7.65,95%Cl (-14.29-1.01), Z=2.26, P=0.02<0.0512months: MD=-11.44,95%Cl (-19.62-3.25), Z=2.74, P=0.006<0.05. Differenceswere statistically significant, that Mirena compared with oral drugs can significantlyreduce the volume of uterine in adenomyosis patients.4、Comparing mirena with oral drugs of adenomyosis patients with uterineendometrial thickness:6months: MD=-1.77,95%Cl (-4.31-0.77), Z=1.36, P=0.17>0.05, the combined statistics diamond line intersected the vertical line, thedifference was not statistically significant;12months: MD=-0.93,95%Cl (-1.42-0.45), Z=2.74, P=0.006<0.05. Combined statistics diamond line was located on theleft side of the vertical line, and did not intersect with the vertical line, the differencewas statistically significant, the thickness of the endometrium of patients with Mirenagroup was significantly lower than the oral medication.5、Comparing mirena with oral drugs of adenomyosis patients adverse reactions:6months: OR=1.07,95%Cl (0.23-4.98), Z=0.08, P=0.93>0.05. Combinedstatistics diamond center line intersected the vertical line, the difference was notstatistically significant. After6months treatment,there was no difference betweenmirena with oral drugs for the adverse reactions in patients with adenomyosis.Conclusion: Comparing mirena with oral drugs in the treatment of adenomyosis,thetotal treatment effectiveness difference was statistically significance.However,therewas no significant difference in the short-term treatment of adenomyosishypermenorrhea. therefore,for the adenomyosis with simple hypermenorrhea whohave fertility requirement in the short term can be prefered treatment of oral drugs.However,in the collected CCTs and RCTs, there are the possibility of the selection bias、publication bias、measurement bias.,it is bound to affect the outcome ofargumentation intensity, Further conclusions need more high quality、 multicenter、large randomized double-blind controlled trial to confirm. |
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