School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 610000 Sichuan, China.
People's Hospital of Deyang City, Deyang, 618000 Sichuan, China.
Biomed Res Int. 2021 Dec 2;2021:9946060. doi: 10.1155/2021/9946060. eCollection 2021.
To discuss the effects of dydrogesterone combined with letrozole on the effectiveness, sex hormone levels, and serological indicators in patients with endometriosis. This study is registered with PROSPERO (CRD42020213172).
We searched relevant randomized controlled trials (RCTs) through PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database. The standardized mean differences (SMDs), the mean differences (MDs), or odds ratios (ORs) with their 95% confidence intervals (95% CIs) were computed to be outcome indicators, including total effectiveness, Vascular Endothelial Growth Factor (VEGF) level, Carbohydrate Antigen 125 (CA125) level, Follicle-Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level, estrogen (E2) level, progesterone (P) level, interleukin-6 (IL-6) level, and tumor necrosis factor-a (TNF-a) level.
A total of 19 RCTs involving 1,591 patients were included in this study. Our results showed that letrozole combined with dydrogesterone can significantly reduce the levels of VEGF (SMD -2.23, 95% CI -2.39 to -2.07; < 0.00001), CA125 (MD -10.53, 95% CI -11.19 to -9.88; < 0.00001), E2 (SMD -1.64, 95% CI -1.81 to -1.47; < 0.00001), P (MD -5.11, 95% CI -6.26 to -3.96; < 0.00001), IL-6 (MD -4.41, 95% CI -5.16 to -3.67; < 0.00001), and TNF-a (MD -5.67, 95% CI -6.34 to -5.00; < 0.00001) in patients with endometriosis compared with the control group. In addition, the results indicated that total effectiveness was significantly higher in the experiment group (OR 6.21, 95% CI 4.17 to 9.24; < 0.00001) compared to the control. However, there was no significant difference between FSH and LH levels in both groups ( > 0.05).
This combination therapy can effectively decrease the levels of VEGF, CA125, E2, P, IL-6, and TNF-a and increase the total effectiveness when comparing with the control group.
探讨地屈孕酮联合来曲唑对子宫内膜异位症患者有效性、性激素水平和血清学指标的影响。本研究已在 PROSPERO（CRD42020213172）注册。
我们通过 PubMed、Cochrane 图书馆、中国知网（CNKI）、万方和 VIP 数据库检索相关的随机对照试验（RCT）。采用标准化均数差（SMD）、均数差（MD）或比值比（OR）及其 95%置信区间（95%CI）作为结局指标，包括总有效率、血管内皮生长因子（VEGF）水平、糖链抗原 125（CA125）水平、卵泡刺激素（FSH）水平、黄体生成素（LH）水平、雌二醇（E2）水平、孕酮（P）水平、白细胞介素-6（IL-6）水平和肿瘤坏死因子-α（TNF-a）水平。
本研究共纳入 19 项 RCT，涉及 1591 例患者。结果显示，来曲唑联合地屈孕酮可显著降低 VEGF（SMD-2.23，95%CI-2.39 至-2.07；<0.00001）、CA125（MD-10.53，95%CI-11.19 至-9.88；<0.00001）、E2（SMD-1.64，95%CI-1.81 至-1.47；<0.00001）、P（MD-5.11，95%CI-6.26 至-3.96；<0.00001）、IL-6（MD-4.41，95%CI-5.16 至-3.67；<0.00001）和 TNF-a（MD-5.67，95%CI-6.34 至-5.00；<0.00001）水平。此外，与对照组相比，实验组的总有效率显著更高（OR 6.21，95%CI 4.17 至 9.24；<0.00001）。然而，两组的 FSH 和 LH 水平无显著差异（>0.05）。
与对照组相比，这种联合治疗可有效降低 VEGF、CA125、E2、P、IL-6 和 TNF-a 的水平，并提高总有效率。
