Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Mianyang 404 Hospital, Mianyang, China.
J Evid Based Med. 2015 May;8(2):61-74. doi: 10.1111/jebm.12150.
To assess the efficacy and safety of focused ultrasound therapy (FU) and microwave therapy (MW) for cervical ectopy (CE).
We searched PubMed, EMbase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journals Database (VIP), China Academic Journals Full-text Database (CNKI), and WanFang Data for randomized controlled trials (RCTs) comparing FU with MW for women with symptomatic CE from inception to 30 August 2014. Two review authors (Tang XL and Gao Z) independently screened for eligible studies according to the inclusion and exclusion criteria, extracted data and assessed risk of bias of included RCTs. Then, meta-analysis was performed using the RevMan 5.2 software. Funnel plots were used to evaluate publication bias.
A total of 33 RCTs with 11,759 participants were included. All studies had high risk of bias. The results of meta-analysis indicated that compared to MW, FU significantly reduced the risk of vaginal bleeding (RR = 0.09, 95%CI 0.05 to 0.17, P < 0.00001) and vaginal discharge (RR = 0.10, 95%CI 0.04 to 0.24, P < 0.00001), increased the cure rate (RR = 1.10, 95%CI 1.05 to 1.15, P < 0.0001) and the total effectiveness rate (RR = 1.04, 95%CI 1.02 to 1.06, P = 0.0005), and decreased the recurrence rate (RR = 0.13, 95%CI 0.02 to 1.00, P = 0.05); however, this last difference was not statistically significant.
Current available evidence suggests that FU is safer and more effective than MW for treating CE. However, some limitations will reduce the reliability of our results. Further well-designed clinical trials are needed to provide further clarification.
评估聚焦超声疗法（FU）和微波疗法（MW）治疗宫颈上皮异位（CE）的疗效和安全性。
我们检索了 PubMed、EMbase、Cochrane 图书馆、中国生物医学文献数据库（CBM）、中国科技期刊数据库（VIP）、中国学术期刊全文数据库（CNKI）和万方数据，以获取截至 2014 年 8 月 30 日比较 FU 与 MW 治疗有症状 CE 女性的随机对照试验（RCT）。两位综述作者（Tang XL 和 Gao Z）根据纳入和排除标准独立筛选合格研究，提取数据并评估纳入 RCT 的偏倚风险。然后使用 RevMan 5.2 软件进行荟萃分析。漏斗图用于评估发表偏倚。
共纳入 33 项 RCT，共计 11759 名参与者。所有研究均存在高偏倚风险。荟萃分析结果表明，与 MW 相比，FU 显著降低了阴道出血风险（RR=0.09，95%CI 0.05 至 0.17，P<0.00001）和阴道分泌物（RR=0.10，95%CI 0.04 至 0.24，P<0.00001），增加了治愈率（RR=1.10，95%CI 1.05 至 1.15，P<0.0001）和总有效率（RR=1.04，95%CI 1.02 至 1.06，P=0.0005），降低了复发率（RR=0.13，95%CI 0.02 至 1.00，P=0.05）；然而，最后这一差异无统计学意义。
现有证据表明，FU 治疗 CE 比 MW 更安全、更有效。但是，一些局限性会降低我们研究结果的可靠性。需要进一步设计良好的临床试验来提供进一步的澄清。
