目的 系統(tǒng)評價(jià)結(jié)合雌激素聯(lián)合甲硝唑陰道給藥治療老年性陰道炎的療效和安全性。方法 檢索PubMed、Medline、中國知網(wǎng)（CNKI）、萬方數(shù)據(jù)庫、維普全文數(shù)據(jù)庫（VIP）中結(jié)合雌激素軟膏（乳膏）聯(lián)用甲硝唑栓（復(fù)方甲硝唑栓）與甲硝唑栓（復(fù)方甲硝唑栓）單用對照治療老年性陰道炎臨床隨機(jī)對照研究，時(shí)間為2000年1月—2017年8月，采用RevMan 5.2軟件進(jìn)行Meta-分析。結(jié)果 納入13篇文獻(xiàn)（1 269例患者）。Meta-分析顯示：與甲硝唑栓（復(fù)方甲硝唑栓）單用組相比，結(jié)合雌激素軟膏（乳膏）聯(lián)用甲硝唑栓（復(fù)方甲硝唑栓）組治愈率高[RR=1.55，95% CI（1.39～1.72），P<0.001]、復(fù)發(fā)率低[RR=0.35，95% CI（0.24～0.49），P<0.001]，同時(shí)血清雌二醇（E₂）低[MD=-12.94，95% CI（-14.45～-11.42），P<0.001]和血清促卵泡（FSH）水平高[MD=44.56，95% CI（41.25～47.87），P<0.001]，不良反應(yīng)發(fā)生率高[RR=2.66，95% CI（1.37～5.15），P=0.004]，但是不良反應(yīng)以乳房脹痛、輕度惡心等為主，停藥后明顯好轉(zhuǎn)。結(jié)論 結(jié)合雌激素聯(lián)合甲硝唑局部陰道給藥治療老年性陰道炎治愈率高，復(fù)發(fā)率低，不良反應(yīng)輕，患者依從性好。

Objective To systematically evaluate the effect and safety of conjugated estrogen combined with metronidazole with vaginal drug delivery in treatment of senile vaginitis. Methods Randomized controlled trials (RCTs) of conjugated estrogen ointment (cream) combined with metronidazole suppository or compound metronidazole suppository vs metronidazole suppository or compound metronidazole suppository in treatment of senile vaginitis were searched from PubMed, Medline, CNKI, WanFang Data, and VIP full-test database. Date were collected from January 2000 to August 2017 and also retrieved manually. Then meta-analysis was conducted by RevMan 5.2 software. Results A total of 13 RCTs (1269 patients) were included. Meta-analysis showed that, compared with metronidazole suppository or compound metronidazole suppository alone group, conjugated estrogen ointment (cream) combined with metronidazole suppository or compound metronidazole suppository was higher in the cure rate[RR=1.55, 95%CI(1.39-1.72), P<0.001], and was lower in the recurrence rate[RR=0.35, 95%CI(0.24-0.49), P<0.001]; Moreover, the serum estradiol (E₂) levels of combination group was lower[MD=-12.94, 95%CI(-14.45——11.42), P<0.001] and the serum follicle-stimulating (FSH) levels were higher[MD=44.56, 95%CI(41.25-47.87), P<0.001], and the rate of ADR was higher[RR=2.66, 95%CI(1.37-5.15), P=0.004]; The main side effects were breast pain and mild nausea, which can be obviously alleviated after drug withdrawal. Conclusion Conjugated estrogen combined with metronidazole by vaginal drug delivery in treatment of senile vaginitis has high cure rate and low recurrence rate, mild ADR, and good compliance.