Comparison Of The Efficacy Of Mirena And Gestrinone In The Treatment Of Adenomysis:meta-analysis

Objective:To evaluate the efficacy and safety of mirena and gestrinone in the treatment of adenomyosis by means of evidence-based medicine.Methods: CNKI 、 Wanfang 、 VIP Datebase 、 The Chinese Journal of Biomedical Literature(CBM)and Pubmed,Ovid,EMBase,Medline,The Cochrane Library and other foreign databases were searched by computer.Chinese Journal of Obstetrics and Gynecology,And retrieved according to the references of the relevant literatures that have been retrieved.Search time from the reservoir to February 2017,language and geographical was not limited,a comprehensive collection of domestic and foreign research on the treatment of adenomyosis clinical trials using mirena.The type of trial design that requires the inclusion of the literature must be a clinical case-control study,requiring two reviewers to screen all the literature according to the inclusion criteria and exclusion criteria,and to select the final inclusion document.Data were extracted and summarized,and Meta-analysis was performed using RevMan 5.3software.Results: A total of 9 articles were included in the standard,6 RCTs,3 CCTs,a total of 706 cases of adenomyosis,the experimental group was Mirena(n=359),The control group of gestrinone(n=347).Observed indicators include dysmenorrhea score(VAS),menstrual flow,endometrial thickness,uterine volume and adverse reactions.Meta-analysis showed that:(1)dysmenorrhea score(VAS): misoprosthesis score in the Mirena group was lower than that in the gestrinone group(MD =-1.43,95% CI = [-1.65,-1.21]),P <0.00001),The difference was statistically significant.(2)menstrual flow :The Mirena group was decreased significant(MD=-60.00,95% CI = [-102.52,-17.47],P=0.006),the difference was statistically significant(P <0.05).(3)endometrial thickness :The Mirena group was thinner than the other group,(MD =-1.08,95% CI = [-1.49,-0.66],P <0.0001),the difference was significant Statistical significance.(4)uterine volume :The Mirena group was more smaller,(MD =-18.05,95%CI=[-26.95,-9.15],P<0.0001),the difference was statistically significant(P<0.05).(MD =0.45,95%CI= [0.29,0.69],P = 0.0003),the difference was statistically significant(P <0.05).(5)The incidence of adverse reactions: the incidence of adverse reactions in the mirena group is lower than the gestrinone group.Conclusion: The meta analysis suggests that mirena and gestrinone in patients with adenomyosis can alleviate the associated clinical symptoms and may be associated with gestrinone in terms of dysmenorrhea,menstrual,intima thickness and uterine volume,The effect is more obvious,the incidence of adverse reactions,Mirena may be lower than gestrinone.In view of the inclusion of this literature on the quality and quantity of the restrictions,follow-up need further clinical trials confirmed.