Abstract：
BACKGROUND: Adenomyosis is a gynaecological lesion that impairs female fertility and contributes to reduced quality of life. There are several surgical and medical options for the management of this lesion; however, women who wish to conceive opt for medical therapies such as the levonorgestrel intrauterine device (LNG-IUS) and dienogest, which have various outcomes. To date, there is no consensus regarding which is more effective.
OBJECTIVE: To compare the effectiveness of LNG-IUS and dienogest for the management of adenomyosis, and explore the risk of occurrence of known side effects for both treatments.
METHODS: Systematic review and meta-analysis exploring the effectiveness of LNG-IUS and dienogest for the management of adenomyosis.
METHODS: A literature search was conducted using PICO guidelines and EMBASE, PubMed/MEDLINE, Scopus and Web of Science databases. Only clinical trials were collected and analysed.
RESULTS: Of the 792 studies that were initially identified, six were eligible for inclusion in this study. The studies included a total of 707 women; of these, 270 were treated with LNG-IUS, 354 were treated with dienogest, and 83 were controls. All the studies were from Asia (Bangladesh n = 1, China n = 2, India n = 1, Japan n = 1, South Korea n = 1). Dienogest was found to reduce pelvic pain significantly, evidenced by a lower visual analogue scale score, compared with LNG-IUS. Also, dienogest led to a significant reduction in uterine volume compared with LNG-IUS. However, subjects in the LNG-IUS group had significantly higher levels of haemoglobin than those in the dienogest group. Nonetheless, the occurrence of side effects such as weight gain, breast tenderness/distension, headache, insomnia/sleep disorder, depression/mood disorder, skin disorder/acne, and coital discomfort/reduced libido were comparable in both treatment groups.
CONCLUSIONS: Dienogest may be more effective than LNG-IUS for the management of adenomyosis, as it shows a superior effect in the reduction of pelvic pain and uterine volume. As only six studies were included in the present meta-analysis due to the paucity of data in the literature, it is recommended that well-designed randomized controlled trials comparing the effectiveness of dienogest with LNG-IUS should be conducted.
OBJECTIVE: To compare the effectiveness of LNG-IUS and dienogest for the management of adenomyosis, and explore the risk of occurrence of known side effects for both treatments.
METHODS: Systematic review and meta-analysis exploring the effectiveness of LNG-IUS and dienogest for the management of adenomyosis.
METHODS: A literature search was conducted using PICO guidelines and EMBASE, PubMed/MEDLINE, Scopus and Web of Science databases. Only clinical trials were collected and analysed.
RESULTS: Of the 792 studies that were initially identified, six were eligible for inclusion in this study. The studies included a total of 707 women; of these, 270 were treated with LNG-IUS, 354 were treated with dienogest, and 83 were controls. All the studies were from Asia (Bangladesh n = 1, China n = 2, India n = 1, Japan n = 1, South Korea n = 1). Dienogest was found to reduce pelvic pain significantly, evidenced by a lower visual analogue scale score, compared with LNG-IUS. Also, dienogest led to a significant reduction in uterine volume compared with LNG-IUS. However, subjects in the LNG-IUS group had significantly higher levels of haemoglobin than those in the dienogest group. Nonetheless, the occurrence of side effects such as weight gain, breast tenderness/distension, headache, insomnia/sleep disorder, depression/mood disorder, skin disorder/acne, and coital discomfort/reduced libido were comparable in both treatment groups.
CONCLUSIONS: Dienogest may be more effective than LNG-IUS for the management of adenomyosis, as it shows a superior effect in the reduction of pelvic pain and uterine volume. As only six studies were included in the present meta-analysis due to the paucity of data in the literature, it is recommended that well-designed randomized controlled trials comparing the effectiveness of dienogest with LNG-IUS should be conducted.
摘要：
背景：子宫腺肌病是一种影响女性生育能力并导致生活质量下降的妇科病变。这种病变的治疗有几种手术和医疗选择；然而，希望怀孕的女性选择药物治疗，如左炔诺孕酮宫内节育器（LNG-IUS）和dienogest，有各种结果。迄今为止,对于哪个更有效，没有共识。
目的：为了比较LNG-IUS和Dienogest治疗子宫腺肌病的有效性，并探讨两种治疗方法发生已知副作用的风险。
方法：系统评价和荟萃分析探讨LNG-IUS和dienogest治疗子宫腺肌病的有效性。
方法：使用PICO指南和EMBASE进行了文献检索，PubMed/MEDLINE,Scopus和WebofScience数据库。仅收集和分析临床试验。
结果：在最初确定的792项研究中，6人符合纳入本研究的条件.这些研究共包括707名女性；其中，270用LNG-IUS处理，354人接受了Dienogest治疗，83个是对照组。所有研究均来自亚洲（孟加拉国n=1，中国n=2，印度n=1，日本n=1，韩国n=1）。发现Dienogest可显着减少骨盆疼痛，由较低的视觉模拟量表评分证明，与LNG-IUS相比。此外，与LNG-IUS相比，dienogest导致子宫体积显着减少。然而,LNG-IUS组受试者的血红蛋白水平显著高于denogest组.尽管如此，副作用的发生，如体重增加，乳房压痛/扩张，头痛,失眠/睡眠障碍，抑郁症/情绪障碍,皮肤病/痤疮,和性交不适/性欲降低在两个治疗组中具有可比性。
结论：在子宫腺肌病的治疗中，Dienogest可能比LNG-IUS更有效，因为它在减少盆腔疼痛和子宫体积方面显示出优异的效果。由于文献中缺乏数据，目前的荟萃分析中只包括了六项研究，建议进行精心设计的随机对照试验,比较dienogest和LNG-IUS的有效性.
目的：为了比较LNG-IUS和Dienogest治疗子宫腺肌病的有效性，并探讨两种治疗方法发生已知副作用的风险。
方法：系统评价和荟萃分析探讨LNG-IUS和dienogest治疗子宫腺肌病的有效性。
方法：使用PICO指南和EMBASE进行了文献检索，PubMed/MEDLINE,Scopus和WebofScience数据库。仅收集和分析临床试验。
结果：在最初确定的792项研究中，6人符合纳入本研究的条件.这些研究共包括707名女性；其中，270用LNG-IUS处理，354人接受了Dienogest治疗，83个是对照组。所有研究均来自亚洲（孟加拉国n=1，中国n=2，印度n=1，日本n=1，韩国n=1）。发现Dienogest可显着减少骨盆疼痛，由较低的视觉模拟量表评分证明，与LNG-IUS相比。此外，与LNG-IUS相比，dienogest导致子宫体积显着减少。然而,LNG-IUS组受试者的血红蛋白水平显著高于denogest组.尽管如此，副作用的发生，如体重增加，乳房压痛/扩张，头痛,失眠/睡眠障碍，抑郁症/情绪障碍,皮肤病/痤疮,和性交不适/性欲降低在两个治疗组中具有可比性。
结论：在子宫腺肌病的治疗中，Dienogest可能比LNG-IUS更有效，因为它在减少盆腔疼痛和子宫体积方面显示出优异的效果。由于文献中缺乏数据，目前的荟萃分析中只包括了六项研究，建议进行精心设计的随机对照试验,比较dienogest和LNG-IUS的有效性.
