類風濕性關節炎女性患者之性功能障礙相關因素的系統性文獻回顧

目的:許多研究顯示類風溼性關節炎(RA)女性有性功能障礙，但沒有系統性文獻回顧針對RA女性性功能障礙相關因素做全面審查。本研究主要目的為應用系統性文獻回顧整合分析RA女性之性功能障礙的相關因素。研究方法:本研究搜尋Web of Science、PudMed、華藝線上圖書館、台灣碩博士論文知識加值系統及HyRead台灣全文資料庫2018年1月以前的中英文獻。以關鍵字”類風溼性關節炎”、”性功能”或”性功能障礙”，根據本研究納入排除條件獨立篩選文獻主題和摘要，以JBI橫斷性研究評讀工具評讀並進行數據提取和數據合成。本研究在PROSPERO註冊編號為CRD42018098867。研究結果:本研究最後納入八篇文獻。將文獻中相關因素整理出23項，歸類為人口學因素、生理因素及心理社會因素。人口學中年齡結果歧異，其他因素不顯著相關。生理因素共病症、髖關節疼痛、疾病活動度結果顯著相關，其他因素有些結果歧異，有些不顯著相關。心理社會因素憂鬱、心理壓力顯著相關，其他因素顯著不相關。結論: RA女性性功能障礙有顯著相關因素有共病症、髖關節疼痛、疾病活動度、憂慮及心理壓力。本研究可協助臨床醫療人員更瞭解RA女性影響性功能障礙相關因素，並提供未來研究方向。

關鍵字

類風溼性關節炎；性功能；性功能障礙

並列摘要

Purpose: Many studies have shown that women with rheumatoid arthritis have sexual dysfunctions (SD), but there was no systematic review for a comprehensive review on the factors correlated to SD in RA women. The main purpose of this study was to apply the methodology of systematic review for the identification of the correlates of SD in RA women. Methods: A systematic review search was performed in the data-bases of Wed of Science, PudMed, airtiLibrary, National Digital Library of Theses and Dissertations in Taiwan and HyRead Jounal for the literatures published before January of 2018. The keywords of “rheumatoid arthritis,” sexual function, or “sexual dysfunction” were used. Publications were screened based on the predefined inclusion criteria. The literature quality was assessed using JBI critical appraisal checklist for analytical cross sectional studies. Relevant data on study characteristics and results were extracted and synthesized in standardized tables.. The systematic review study was registered in PROSPERO (CRD42018098867). Results: Eight research articles were included. There were 23 correlates of sexual dysfunction in RA women, which were classified into 3 domains: demographic factors, physiological factors and psychosocial factors. In demographic factors the result on the relationship of age and SD was not consistent, and other demographic factors were not significantly correlated. The findings of physiological factors, including comorbidity, hip pain, and disease activity were significantly correlated with SD, some other factors were inconsistent, and some were not significantly correlated. In psychosocial factors, depression and psychological stress were significant correlates of SD in RA women, and others were not significantly correlated. Conclusion: The significant correlates of SD in women with RA were comorbidity, joint pain, arthritis disease activity, depression, and psychological stress. In summary, this review can be helpful to the clinical care of SD in RA women and point out the directions for future research.