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目的:评价射频热凝固(RF)治疗无排卵型功能失调性子宫出血(ADUB)的疗效。方法:检索2002年9月1日至2012年9月1日Cochrane图书馆、MEDLINE、PubMed、Web of Science、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP)、中国学术期刊全文数据库(CNKI),提取纳入文献的资料,并严格评价文献质量。应用Review Manager 5.0软件对符合质量标准的随机对照试验(RCT)进行Meta分析。结果:最终纳入6篇RCT研究,共计313例患者,其中治疗组(使用RF)156例,对照组(使用宫腔镜内膜电切除术、微波内膜去除术)157例。两组患者均进行常规口服孕激素和对症支持治疗。Meta分析结果显示:与对照组比较,治疗组治疗3个月后PBAC(月经量评分)显著下降(WMD为-22.70,95%CI为-24.65～-20.75)、痛经症状显著缓解(RR=0.62,95%CI为0.40～0.95)、Hb含量显著上升(WMD为23.83,95%CI为21.47～26.19),差异均有统计学意义。结论:RF较宫腔镜内膜电切除术和微波内膜去除术,能显著提高ADUB的疗效。
Objective: To evaluate the therapeutic effect of radiofrequency thermocoagulation (RF) on anovulatory dysfunctional uterine bleeding (ADUB). METHODS: The Cochrane Library, MEDLINE, PubMed, Web of Science, CECDB, CQVIP, and Chinese Academic Journal Full-text Database were searched from September 1, 2002 to September 1, (CNKI), extract the information included in the literature, and strictly evaluate the quality of the literature. Meta-analysis of quality-matched randomized controlled trials (RCTs) using Review Manager 5.0 software. RESULTS: Six RCTs were enrolled in a total of 313 patients, including 156 in the treatment group (using RF) and 157 in the control group (hysteroscopic endometrial resection and microwave endometrium ablation). Both groups received routine oral progestin and symptomatic supportive care. The results of Meta analysis showed that the PBAC decreased significantly (WMD -22.70, 95% CI -24.65 ~ -20.75) and the symptoms of dysmenorrhea were significantly relieved (RR = 0.62 , 95% CI 0.40 ~ 0.95), Hb content increased significantly (WMD 23.83, 95% CI 21.47 ~ 26.19), the differences were statistically significant. Conclusion: RF compared with hysteroscopic endometrial resection and microwave endometrial ablation, can significantly improve the efficacy of ADUB.