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(1)子宫肌瘤的单独药物治疗 :①单独应用促性腺激素释放激素类似物 :RCT发现 ,与安慰剂相比 ,GnRHa(gonadorelinanalogues)可改善子宫肌瘤的症状 ,但副作用较大。其中 1个研究表明 ,与安慰剂相比 ,达菲林在治疗 12周时能明显增加闭经 ;另 1个系统性回顾研究显示 ,无充分证据证实达菲林和布舍瑞林疗效的优劣。 1个RCT发现 ,达菲林高剂量治疗较低剂量治疗在治疗 16周时显著增加闭经。两个RCT发现 ,达菲林与安慰剂相比 ,在治疗 16周后能显著减少骨密度 ,但治疗停止 6个月后 ,骨密度可以回升到治疗前水平。两个RCT发现 ,与安慰剂和布舍瑞林相比 ,达菲林引起的潮热显著增加。②GnRHa联合雌 /孕激素 :1个小样本RCT比较了GnRHa +雌 /孕激素和GnRHa +孕酮改善子宫肌瘤症状的效果的差异 ,但这些证据很不充分。③GnRHa +孕酮 :1小样本RCT发现 ,与单独使用醋酸亮丙瑞林治疗相比 ,醋酸亮丙瑞林加孕酮能显著减少出血过多。两个小样本RCT发现 ,与单独应用GnRHa相比 ,GnRHa +孕酮能显著减少潮热。④GnRHa +7 甲异炔诺酮 :小样本RCT发现 ,在子宫、子宫肌瘤大小及症状改善方面 ,单独使用Gn RHa和GnRHa +7 甲异炔诺酮比较 ,无显著差异。⑤非类固醇抗炎药物 :两个小样本RCT发现 ,无充分证据显示非类固醇抗炎药物对子宫肌瘤?
(1) Single drug treatment of uterine fibroids: ① gonadotropin-releasing hormone analogs alone: RCT found that compared with placebo, GnRHa (gonadorelinanalogues) can improve the symptoms of uterine fibroids, but the side effects. One of the studies showed that diphenhydramine significantly increased amenorrhea at 12 weeks of treatment compared with placebo, and a second systematic review showed no good evidence of the efficacy of diphenarylamine and buserelin. One RCT found that dafening high-dose therapy at lower doses significantly increased amenorrhea at 16 weeks of treatment. Both RCTs found that dafening significantly reduced BMD after 16 weeks of treatment compared with placebo, but returned to pretreatment levels 6 months after discontinuation of treatment. Both RCTs found a significant increase in hot flashes of daflin compared to placebo and buserelin. GnRHa combined with estrogen / progesterone: A small sample of RCTs compared the effect of GnRHa + estrogen / progesterone and GnRHa + progesterone on the improvement of uterine fibroids, but these were poorly documented. ③ GnRHa + progesterone: a small sample of RCT found that compared with the treatment of leuprolide acetate alone, leuprolide plus progesterone can significantly reduce excessive bleeding. Two small sample RCTs found that GnRHa + progesterone significantly reduced hot flashes compared to GnRHa alone. ④ GnRHa +7 Norepinephrine: A small sample of RCT found no significant difference in the size and symptoms of uterine and uterine fibroids between Gn RHa and GnRHa + 7 metronidazole alone. ⑤ non-steroidal anti-inflammatory drugs: RCT found two small samples, there is no sufficient evidence that non-steroidal anti-inflammatory drugs on uterine fibroids?