| 摘要: | 本研究是以系統性文獻回顧與統合分析法彙整維生素D在減緩原發性經痛之相關性，文獻蒐集2012年1月至 2021年7月止，使用PubMed、Medline、Embase、Cochrane library、Web of Science、Scopus、Cinahl等七個英文資料庫進行文獻搜尋，依納入與排除條件篩選文章。以The Cochrane Collaboration’s Tool for Assessing Risk of Bias進行文獻品質評讀，並使用Review Manager 5.3軟體進行統合分析，採隨機效應模式 (random effect model) 以平均差 (Mean Difference, MD) 估計合併效果量。文獻搜尋後共有333篇文章，經過刪除重複文獻、檢視文章標題、摘要及全文後，符合納入條件的文章共有10篇，其中7篇進行統合分析，另3篇不進行統合分析，以文字描述其結果的呈現。結果顯示維生素D能有效減緩原發性經痛疼痛的嚴重程度，總效果量為-2.11 (95% CI= -3.52～-0.70, P=0.003)。在次群體分析中，血清25(OH)D水平與疼痛強度之間呈現負相關，維生素D介入後血清25(OH)D顯著增加，其總效果量為24.17 (95% CI=5.98～42.36 , P＝0.009)；單次口服維生素D 300,000IU，總效果量為-2.91 (95% CI=-4.94～-0.88, P＝0.005)；受試時間為60天，總效果量為-1.79 (95% CI=-2.75～-0.84, P＝0.0002)，皆比控制組有顯著成效，顯示服用維生素D對於增加血清25(OH)D與單次口服高劑量維生素D在減緩原發性經痛皆有顯著性效果。本研究結果發現維生素D能減緩原發性經痛疼痛的嚴重程度，止痛藥的使用量減少，同時提升血清25(OH)D。
This study summarized the relevance of vitamin D in alleviating primary dysmenorrhea with a systematic literature review and meta-analysis method. The literature collection January 2012 to July 2021, seven English databases including PubMed, Medline, Embase, Cochrane library, Web of Science, Scopus, and Cinahl were used for literature search, and articles were selected according to the inclusion and exclusion criteria. Use The Cochrane Collaboration’s Tool for Assessing Risk of Bias to evaluate the quality of the literature, and use the Review Manager 5.3 software to perform integrated analysis, and use the random effect model to estimate the combined effect by Mean Difference (MD). After the literature search, there were a total of 333 articles. After deleting duplicate articles, reviewing the title, abstract and full text of the article, there were a total of 10 articles that meet the criteria for inclusion, of which 7 were used for meta-analysis, and the other 3 were not used for meta-analysis, but only used words to describe the presentation of the results. The results showed that vitamin D can effectively reduce the severity of primary dysmenorrhea, with a total effect size of -2.11 (95% CI＝-3.52～-0.70, P=0.003). In subgroup-analysis, there was a negative correlation between serum 25(OH)D level and pain intensity. After vitamin D intervention, serum 25(OH)D increased significantly, and the total effect size was 24.17 (95% CI=5.98～42.36, P=0.009); single oral vitamin D 300,000IU, total effect size was -2.91 (95% CI=-4.94～-0.88, P=0.005); test time was 60 days, total effect size was -1.79 (95 % CI=-2.75～-0.84, P=0.0002), both have significant effects than the control group. It showed that taking vitamin D can increase serum 25(OH)D, and a single oral high-dose vitamin D can show a significant effect in alleviating primary dysmenorrhea. The results of this study found that vitamin D can reduce the severity of the pain of primary dysmenorrhea, reduce the use of analgesics, and increase serum 25(OH)D. |
