目的 系统评价结合雌激素联合甲硝唑阴道给药治疗老年性阴道炎的疗效和安全性。方法 检索PubMed、Medline、中国知网（CNKI）、万方数据库、维普全文数据库（VIP）中结合雌激素软膏（乳膏）联用甲硝唑栓（复方甲硝唑栓）与甲硝唑栓（复方甲硝唑栓）单用对照治疗老年性阴道炎临床随机对照研究，时间为2000年1月—2017年8月，采用RevMan 5.2软件进行Meta-分析。结果 纳入13篇文献（1 269例患者）。Meta-分析显示：与甲硝唑栓（复方甲硝唑栓）单用组相比，结合雌激素软膏（乳膏）联用甲硝唑栓（复方甲硝唑栓）组治愈率高[RR=1.55，95% CI（1.39～1.72），P<0.001]、复发率低[RR=0.35，95% CI（0.24～0.49），P<0.001]，同时血清雌二醇（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]，不良反应发生率高[RR=2.66，95% CI（1.37～5.15），P=0.004]，但是不良反应以乳房胀痛、轻度恶心等为主，停药后明显好转。结论 结合雌激素联合甲硝唑局部阴道给药治疗老年性阴道炎治愈率高，复发率低，不良反应轻，患者依从性好。

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.