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对更年期性尿生殖综合征的基于能源的干预措施:随机对照试验和前性观察研究的系统审查
Nicholas L Zerzan1, Nancy Greer1, Kristen E Ullman1
1From the Center for Care Delivery & Outcomes Research, VA Health Care System, Minneapolis, MN.
概括
与假冒或雌激素治疗更年期症状相比,CO2激光等基于能源的疗法几乎没有差异. 需要更多的研究来了解这些非激素治疗的益处和危害.
科学领域:
- 生殖医学 生殖医学
- 妇科 妇科医生 妇科
- 基于证据的医学基于证据的医学.
背景情况:
- 对于更年期的生殖尿综合征 (GSM) 的荷尔蒙疗法有局限性.
- 不激素疗法,包括基于能源的干预措施,正在为GSM探索.
- 基于能源的GSM干预措施的好处和危害尚未得到充分证实.
研究的目的:
- 评估基于能源的疗法 (CO2激光,Er:YAG激光,射频) 对GSM的益处和危害.
- 评估结果,包括失足症,干燥,不适,失尿症,生活质量和不良影响.
- 综合来自随机对照试验和观察性研究的证据.
主要方法:
- 随机对照试验 (RCT) 和前性观察性研究的系统审查.
- 在Ovid/MEDLINE,Embase和CINAHL数据库中搜索到2023年12月.
- 包括≥8周随访的研究;需要≥12个月的不良事件数据.
主要成果:
- 包括32项研究 (16项RCT,1项准RCT,15项非随机化).
- 与假冒或阴道雌激素相比,CO2激光在关键GSM症状 (证据确定性低) 中几乎没有差异.
- 对Er:YAG激光,射频和其他结果的证据仍然非常不确定;报告的不良事件很少.
结论:
- 对于GSM症状,CO2激光对假或阴道雌激素几乎没有任何优势,其他比较的证据高度不确定.
- 关于不良事件的有限报告需要谨慎的解释.
- 需要进一步进行高质量的研究,以确定基于能源的干预措施对GSM的有效性和安全性.
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