关键词: font-size:medium, ">甲氨蝶呤；米非司酮；异位妊娠；系统评价

Abstract: Objective： Comprehensive evaluation of the efficacy and safety of methotrexate combined with mifepristone in the treatment of ectopic pregnancy， providing scientific basis for clinical treatment. Methods： Randomized controlled trials (RCTs) of methotrexate combined with mifepristone for ectopic pregnancy were searched from the following electronic databases： EMbase、PubMed、CNKI、CBM、VIP、Wanfang and the Cochrane Library(from establish to Apr 2020). Quality assessment， and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion， and data analyses were performed with RevMan 5.3 software. Results： A total of 25 articles were included in this study， including 2 399 patients. Meta-analysis results showed that in terms of validity， the total effective rate of the methotrexate compared with mifepristone group was significantly different from that of the control group. The total effective rate[RR=1.26，95%CI（1.22， 1.31），P＜0.000 01]， such as negative conversion time of blood β-HCG [WMD=-8.44， 95%CI(-9.68， -7.20）， P＜0.000 01] 、Bellyache disappear time[WMD=-8.03， 95%CI(-10.57，-5.49）， P＜0.000 01]、 Vaginal hemostasis time[WMD=-9.27，95%CI(-10.24， -8.30）， P＜0.000 01] and Chunks disappear time [WMD=-10.71，95%CI(-12.87，-8.54），P＜0.000 01]. In terms of safety， there was no significant difference in the incidence of adverse reactions between the treatment group and the control group. Conclusion： Based on the existing clinical evidence， the methotrexate combined with mifepristone group is more effective than methotrexate or mifepristone alone in the treatment of ectopic pregnancy. However， due to the small number of included research literatures and uneven research quality， this conclusion still needs more large samples and high-quality clinical randomized controlled trials to confirm.
 

Key words: font-size:medium, ">Methotrexate； Mifepristone； Ectopic pregnancy； System assessment