耐受性和共享决策在荷尔蒙管理子宫内膜异位症相关的疼痛
Diogo Pinto da Costa Viana1,2,3, Leonardo Jacobsen2, Igor Padovesi2
1Brazilian Society of Endocrinology and Metabolism in Sports and Exercise, Florianópolis 88070-800, Brazil.
治疗子宫内膜异位症相关疼痛的荷尔蒙疗法,包括GnRH类似物,dienogest和gestrinone,表现出类似的疗效,但在耐受性方面有所不同. 以患者为中心的护理和共享决策对于根据个人需求和副作用耐受性选择最佳治疗至关重要.
科学领域:
- 生殖医学 生殖医学
- 药理学 药理学是指药理学的学科.
- 临床妇科 临床妇科
背景情况:
- 子宫内膜异位症疼痛管理传统上优先考虑止痛疗效.
- 一个范式的转变有利于以患者为中心的护理和共享决策,由于荷尔蒙药物的治疗等价性.
- 现在的重点是可用的治疗方法的长期耐受性和安全性.
研究的目的:
- 批判性地综合三种主要激素治疗子宫内膜异位症相关疼痛的证据.
- 为了比较不同的耐受性和安全性GnRH类似物,二凝和gestrinone的个人资料.
- 为现代临床框架提供信息,优先考虑以患者为中心的护理和共享决策.
主要方法:
- 根据SANRA的指导方针进行叙事审查.
- 在PubMed,Embase和Web of Science中进行全面的文献搜索.
- 对疗效,耐受性和安全性数据的比较分析.
主要成果:
- 这三种激素类 (GnRH类似物,二诺,孕) 都对子宫内膜异位症疼痛有效.
- GnRH类似物诱导低雌激素,需要补充疗法.
- 迪恩格斯特可能会导致出血不规则和情绪障碍;格斯特林具有影响坚持的雄激素作用.
- 格斯特林显示出良好的心血管和骨安全性.
结论:
- 这些激素疗法之间没有明确的疗效等级.
- 最佳治疗选择取决于患者的价值和对特定不良反应的耐受性.
- 一种协作式的,共享的决策方法对于个性化的子宫内膜异位症疼痛管理至关重要.
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