IIMPACT in Health, University of South Australia, Adelaide, SA, Australia.
Centre for IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.
Reprod Sci. 2023 Feb;30(2):390-407. doi: 10.1007/s43032-022-00952-9. Epub 2022 Apr 29.
Self-management is critical for the care of endometriosis. Females with endometriosis frequently use self-management strategies to manage associated symptoms; however, the efficacy of such strategies is unknown. The aim of this review was to systematically appraise the evidence concerning efficacy of self-management strategies for endometriosis symptoms. Electronic databases, including Medline, Embase, Emcare, Web of Science Core Collection, Scopus, and the Cochrane Central Register of Controlled Trials, were searched from inception to March 2021. We included peer-reviewed experimental studies published in English evaluating the efficacy of self-management strategies in human females laparoscopically diagnosed with endometriosis. Studies underwent screening, data extraction, and risk of bias appraisal (randomised studies: Risk of Bias 2 tool; non-randomised studies: Risk Of Bias In Non-randomized Studies - of Interventions tool). Of the fifteen studies included, 10 evaluated dietary supplements, three evaluated dietary modifications, one evaluated over-the-counter medication, and one evaluated exercise. Most studies had a high-critical risk of bias. Many self-management strategies were not more effective at reducing endometriosis symptoms compared to placebo or hormonal therapies. Where studies suggest efficacy for self-management strategies, no recommendations can be made due to the poor quality and heterogeneity of evidence. High-quality empirical evidence is required to investigate the efficacy of self-management strategies for females with endometriosis.
自我管理对于子宫内膜异位症的治疗至关重要。患有子宫内膜异位症的女性经常使用自我管理策略来控制相关症状；然而，这些策略的疗效尚不清楚。本综述的目的是系统评价关于自我管理策略对子宫内膜异位症症状疗效的证据。从建库到 2021 年 3 月，我们检索了电子数据库，包括 Medline、Embase、Emcare、Web of Science 核心合集、Scopus 和 Cochrane 对照试验中心注册库。我们纳入了评估人类女性腹腔镜诊断为子宫内膜异位症的自我管理策略疗效的同行评审实验性研究，这些研究发表在英文期刊上。研究经历了筛选、数据提取和偏倚风险评估（随机研究：风险偏倚 2 工具；非随机研究：干预措施的非随机研究偏倚风险工具）。在纳入的十五项研究中，有 10 项评估了膳食补充剂，3 项评估了饮食调整，1 项评估了非处方药物，1 项评估了运动。大多数研究的偏倚风险较高。与安慰剂或激素治疗相比，许多自我管理策略在减轻子宫内膜异位症症状方面并没有更有效。在一些研究中，自我管理策略具有一定的疗效，但由于证据质量差和异质性较大，无法提出推荐意见。需要高质量的实证证据来研究自我管理策略对子宫内膜异位症女性的疗效。
