摘要
目的:评估两种(0.75mg双剂、1.5mg单剂)左炔诺孕酮(LNG)及两种低剂量(10mg、25mg)米非司酮(MFP)紧急避孕方案的有效性和副作用。方法:通过电子及手工检索方式检索相关文献,筛选出其中的随机对照临床试验,提取信息并进行Meta分析。结果:共检索到63篇相关文献,其中28篇纳入本评估。结果显示,两种剂量LNG方案有效性及副反应的发生率均相似。在服用紧急避孕药后无性生活的对象中,25mgMFP与10mgMFP(方法失败率)相似,然而25mgMFP总失败率(在所有对象中计算出的失败率)略低于10mgMFP,但差别没有统计学意义。25mgMFP方案恶心发生率比10mgMFP方案略高。10mgMFP方案与单剂1.5mgLNG方案总失败率相似,而前者方法失败率略低。25mgMFP方案方法失败率与总失败率均略低于单剂及双剂LNG方案,但差别无统计学意义。MFP紧急避孕方案月经延迟的发生率比LNG方案高,而后者点滴出血的发生率比前者高。无保护性生活后越早接受紧急避孕,失败率越低。结论:两种LNG方案和两种MFP方案有效性和副反应发生基本相似,由于LNG为传统避孕药物,其安全性已被证实,并为非处方药,故优先推荐使用LNG方案,单剂1.5mgLNG方案更为方便。
Objective: To assess the efficacy and side effects of levonorgestrel regimens (two doses of 0. 75mg and one dose of 1.5mg) and low-dose mifepristone regimens (10 and 25mg) as emergency contraceptives. Methods: Electronic search and hand search were used to identify randomized controlled clinical trials (RCT). Key outcomes were abstracted. Meta analysis was done. Results: A total of 63 papers were identified. Of them 28 were included in the review. The efficacy and percentage of side effects between one - dose levonorgestrel 1. 5mg and two - dose levonorgestrel 0.75mg were similar. The failure rates among those who had no further intercourse after emergency contraceptive treatment were similar between 25mg and 10mg of mifepristone (RR=0.98, 95%CI: 0.32-3.03), although the overall failure rate of mifepristone 25mg was somewhat lower than that of mifepristone 10mg (RR =0.69, 95% CI: 0.46-1.03). Users of 10mg mifepristone were associated with lower risk of nausea than women who had used 25mg of mifepristone. Comparing with one or two doses levonorgestrel regimens, the failure rates of the low dose mifepristone regimens (10mg and 25mg) were not significantly different, albeit those of the mifepristone regimens were somewhat lower. Mifepristone regimens were associated with lower risk of spotting and higher risk of delayed menses than levonorgestrel regimens. Conclusions: The difference of efficacy and percentage of side effects between the two levonorgestrel regimens and the two mifepristone regimens were not statistically significant. However, priority should be given to the levonorgestrel regimens, whose safety has been proven, and one dose levonorgestrel regimen is more convenient.
出处
《中国计划生育学杂志》
北大核心
2005年第4期217-222,共6页
Chinese Journal of Family Planning
