背景：血管舒缩症状（VMS）是更年期的标志，发生在英国大约75%的绝经后妇女中，25％严重。
目的：确定哪些治疗方法对无子宫切除术的自然绝经妇女的VMS缓解最有效。
方法：MEDLINE的英文出版物，Embase,搜索了截至2015年1月13日的Cochrane图书馆。
方法：对有子宫的女性进行治疗的随机对照试验（RCT），以评估VMS频率（长达26周）的结局，阴道出血,和中止。
方法：使用平均比率（MR）和奇数比率（OR）的贝叶斯网络荟萃分析（NMA）。
结果：在三个网络中，纳入了16个治疗类别的47个RCTs（n=8326名女性）。与安慰剂相比，经皮雌二醇和孕激素（O+P）是最有效的VMS缓解治疗的可能性最高（69.8%;MR0.23;95%可信间隔，95%CrI0.09-0.57),而口服O+P低于透皮O+P，尽管口服和经皮O+P对该结果没有差异(MR2.23;95%CrI0.7-7.1)。异黄酮和黑升麻比安慰剂更有效，虽然没有明显优于O+P。不仅发现选择性5-羟色胺再摄取抑制剂（SSRIs）或5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）对缓解VMS无效，但他们的停药几率也明显高于安慰剂.出血的数据有限，因此无法得出结论。
结论：对于未进行子宫切除术的妇女，经皮O+P是缓解VMS最有效的治疗方法。
结论：哪种治疗方法能最好地缓解更年期潮红？来自#NICE指南网络meta分析的结果。
BACKGROUND: Vasomotor symptoms (VMSs) are the hallmarks of menopause, occurring in approximately 75% of postmenopausal women in the UK, and are severe in 25%.
OBJECTIVE: To identify which treatments are most clinically effective for the relief of VMSs for women in natural menopause without hysterectomy.
METHODS: English publications in MEDLINE, Embase, and The Cochrane Library up to 13 January 2015 were searched.
METHODS: Randomised controlled trials (RCTs) of treatments for women with a uterus for the outcomes of frequency of VMSs (up to 26 weeks), vaginal bleeding, and discontinuation.
METHODS: Bayesian network meta-analysis (NMA) using mean ratios (MRs) and odd ratios (ORs).
RESULTS: Across the three networks, 47 RCTs of 16 treatment classes (n = 8326 women) were included. When compared with placebo, transdermal estradiol and progestogen (O+P) had the highest probability of being the most effective treatment for VMS relief (69.8%; MR 0.23; 95% credible interval, 95% CrI 0.09-0.57), whereas oral O+P was ranked lower than transdermal O+P, although oral and transdermal O+P were no different for this outcome (MR 2.23; 95% CrI 0.7-7.1). Isoflavones and black cohosh were more effective than placebo, although not significantly better than O+P. Not only were selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) found to be ineffective in relieving VMSs, but they also had significantly higher odds of discontinuation than placebo. Limited data were available for bleeding, therefore no conclusions could be made.
CONCLUSIONS: For women who have not undergone hysterectomy, transdermal O+P was the most effective treatment for VMS relief.
CONCLUSIONS: Which treatment best relieves menopause flushes? Results from the #NICE
guideline network meta-analysis.
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