荟萃分析氨甲环酸治疗特发性月经过多的疗效

Meta-analysis of tranexamic acid in the treatment of Idiopathetic menorrhagia

关键词:  月经过多  药物治疗  氨甲环酸  meta分析

Key words:  menorrhagia  pharmacotherapy  tranexamic acid  meta-analysis

摘要:

目的 系统评价氨甲环酸治疗特发性月经过多文献的质量，荟萃分析氨甲环酸治疗特发性月经过多的疗效。方法 全面收集关于氨甲环酸治疗月经过多的相关文献，并根据改良Jadad量表严格评价文献质量，用Rev Man 4.2荟萃分析软件分析比较氨甲环酸与安慰剂、孕激素类药物及非甾体类药物治疗月经过多的有效性与安全性。结果 根据纳入与排除标准对收集到的文献进行筛选，共有8篇文献纳入本次研究，其中英文文献7篇，中文文献1篇。优质文献的比例为87.5%。氨甲环酸与孕激素、非甾体类等止血药物均可在某种程度上减少特发性月经过多患者的月经量。但在月经量减少程度、治疗有效率、患者自我感觉改善的比例上，氨甲环酸的效果均显著高于安慰剂及其他药物组。氨甲环酸并不改变患者的经期长度，且引起不良反应的比例显著低于孕激素类药物。结论 氨甲环酸是一种用于治疗特发性月经过多的安全有效的药物，值得临床推广。但由于纳入本次研究的文献数量偏少，且中文只有1篇，结论存在一定的偏倚，有待更大样本量研究的验证。

Abstract:

Objective To review the quality of studies about the treatment of tranexamic acid in idiopathetic menorrhagia systematically and meta-analyze the effect of tranexamic acid on idiopathetic menorrhagia. Methods Collected all the studies about the treatment of tranexamic acid in idiopathetic menorrhagia, then evaluated their qualities by using the Jadad scale. Finally, compared the efficacy and safety of tranexamic acid with placebo, progesterone and non-steroidal drugs in the treatment of idiopathetic menorrhagia. Results According to the inclusion and exclusion criteria, a total of eight articles were include in this study, seven of them were English literatures and one was Chinese. The proportion of high quality articles was 87.5%. All the drugs used in these articles could reduce the bleeding of patients with idiopathetic menorrhagia. However, on the reduction in loss, treatment efficiency and the improvement ratio of patient feel, the effect of tranexamic acid was significantly higher than placebo and other drug group. Tranexamic acid didn’t change the length of the patient's menstrual period, and the proportion of adverse reactions was significantly lower than progesterone drugs. Conclusion Tranexamic acid is a safe and effective drug for the treatment of idiopathetic menorrhagia. However, because the number of literatures rolled in this study was small, there is a certain bias, which needed further research.