The Efficacy And Safety Of Dospirone Estradiol And Tibolone In The Treatment Of Menopausal Symptoms:A Meta-Analysis

Objective: Objective To explore the clinical efficacy and safety of two different drugs(dospirone estradiol and Tibolone)in the treatment of menopausal symptoms.Methods: Keywords were used to search CNKI,CBM,Wanfang Data,VIP,Pub Med,Embase,The Cochrane Library,Web Of Science and clinical trial register platform(https://clinicaltrials.gov/),retrieval time limit for the database to build library until February 2022.Randomized controlled trials(RCTS)of the use of drospirone estradiol and Tibolone in perimenopausal women with menopausal symptoms were selected to screen out literature that met the inclusion criteria,and quality evaluation was conducted using the risk assessment criteria of bias of the Cochrane Collaboration.Meta-analysis was conducted on the efficacy and safety of drospirone estradiol and Tibolone using Rev Man 5.4software provided by the Cochrane Collaboration.Results: According to the above retrieval methods,a total of 10 RCT trials on drospirone estradiol and tibolone were included.Meta-analysis results showed that there were no statistically significant differences in changes of serum hormone FSH(MD=0.56,95%CI=[-6.56,7.69],P=0.88>0.05)and estradiol(MD=0.95,95%CI=[-0.80,2.71],P=0.29>0.05),improved MRS score(MD=0.38,95%CI=[-1.40,2.16],P=0.68 > 0.05),Systolic blood pressure(MD=0.49,95%CI=[16.84,17.83],P=0.96>0.05)and diastolic blood pressure change(MD=4.59,95%CI=[10.48,1.29],P=0.13>0.05),incidence of vaginal bleeding(RR=2.42,95%CI=[0.91,6.41],P=0.08>0.05),and incidence of breast swelling(RR=0.98,95%CI=[0.69,1.41],P=0.93>0.05)before and after treatment between the two groups,while there were statistically significant differences in improvement of KMI score(MD=-6.35,95%CI=[-12.57,-0.15],P=0.04<0.05)and endometrial thickness(MD=0.08,95%CI=[0.02,0.13],P=0.01 <0.05).Conclusions: There were no statistically significant differences in the influence of dospirone estradiol and Tibolone on serum FSH level,estradiol level,improvement of MRS score,blood pressure change,incidence of vaginal bleeding,incidence of breast tenderness and other aspects of menopausal symptoms,Dospirone estradiol was more advantageous than Tibolone in improving KMI scores,Tibolone has less effect on endometrial changes than dospirone estradiol,and does not significantly increase endometrial thickness.However,high quality,long course of treatment,large sample and multi-center research literatures are still needed to confirm its clinical application value.