A Systematic Review of Guidelines and Expert Consensus Related to Pain Management in Endometriosis

doi:10.12114/j.issn.1007-9572.2025.0016

Abstract

Abstract:

Background

As the understanding of pain management in endometriosis deepens, an increasing number of related guidelines and expert consensus have emerged both domestically and internationally, providing significant guidance and reference for clinical practice. However, the quality of these guidelines and expert consensuses is inconsistent, necessitating a systematic review to guide clinical practice.

Objective

To systematically evaluate the quality of guidelines and expert consensus related to pain management in endometriosis, thereby providing an evidence base for the development of pain management protocols.

Methods

Evidence-based guidelines involving recommendations for pain management in endometriosis were searched in CNKI, SinoMed, Wanfang Data, VIP, PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Guideline Central, GIN, as well as the official websites of ACOG, NICE, SIGN, WHO, IASP, APS and BPS, and other sources from inception to 12 November, 2024. AGREEⅡ was utilized to assess the quality of guidelines and expert consensus related to pain management in endometriosis, and relevant recommendations were summarized.

Results

A total of 15 guidelines/expert consensus were ultimately included, of which 9 were guidelines and 6 were expert consensuses. 7 guidelines/expert consensus were from China, and 8 were from abroad. The publication dates ranged from 2018 to 2024. Among the 6 domains of AGREE Ⅱ, the average scores of the 15 guidelines/expert consensuses were as follows: scope and purpose (83.15%), stakeholder involvement (71.11%), rigor of development (44.79%), clarity of presentation (65.74%), applicability (35.55%), editorial independence (87.78%). 33 recommendations were extracted and summarized from 15 guidelines/expert consensus, involving 6 domains, namely general principles of pain management, pain assessment, medication management, surgical management, non-pharmacologic/surgical management, health education.

Conclusion

The quality of the included guideli`nes/expert consensus is at a moderate level and provides a reference point for clinical practice, but further improvement is needed in the areas of the rigour of development and applicability.

Key words: Endometriosis, Pain, Management, Guideline, Expert consensus, Quality appraisal

摘要：

背景

随着对子宫内膜异位症疼痛管理认识的深入，相关国内外的指南/专家共识逐渐增多，为临床实践提供了重要的指导和参考，但其质量参差不齐，需进行系统评价以指导临床实践。

目的

系统评价子宫内膜异位症疼痛管理相关指南/专家共识的质量，为制订疼痛管理方案提供依据。

方法

计算机检索中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普网、PubMed、Embase、Cochrane Library、Web of Science、CINAHL数据库、Guideline Central、国际指南协作网（GIN）以及美国妇产科医学会（ACOG）、英国国家卫生与临床优化研究所（NICE）、苏格兰校际指南网（SIGN）、WHO、国际疼痛研究协会（IASP）、美国疼痛协会（APS）、大不列颠疼痛协会（BPS）官网及其他途径获取发布的子宫内膜异位症疼痛管理相关指南，检索时限为建库至2024-11-12。运用临床指南研究与评价工具Ⅱ（AGREE Ⅱ）对子宫内膜异位症疼痛管理相关指南/专家共识进行质量评价，并对相关推荐意见进行汇总。

结果

最终纳入15部指南/专家共识，其中9部为指南，6部为专家共识；7部来自中国，8部来自国外；发布时间为2018—2024年。AGREEⅡ的6个领域中，15部指南/专家共识平均得分分别为：范围和目的83.15%、参与人员71.11%、严谨性44.79%、清晰性65.74%、应用性35.55%、独立性87.78%。纳入的15部指南/专家共识中，A级推荐1部，B级推荐14部。从15部指南/专家共识中共提取33条子宫内膜异位症疼痛管理相关推荐意见，涉及疼痛管理总原则、疼痛评估、药物管理、手术管理、非药物/手术管理、健康教育6个方面。

结论

纳入的指南/专家共识质量处于中等水平，为临床实践提供了参考依据，但在严谨性、应用性领域仍有待进一步改进。

关键词: 子宫内膜异位症, 疼痛, 管理, 指南, 专家共识, 质量评价

CLC Number:

R 711.71

XIE Wan,TU Xulian,WU Liping, et al. A Systematic Review of Guidelines and Expert Consensus Related to Pain Management in Endometriosis[J]. Chinese General Practice, 2026, 29(23): 3351-3358. DOI: 10.12114/j.issn.1007-9572.2025.0016.
谢婉,涂旭莲,吴丽萍等. 子宫内膜异位症疼痛管理相关指南和专家共识的系统评价[J]. 中国全科医学, 2026, 29(23): 3351-3358. DOI: 10.12114/j.issn.1007-9572.2025.0016.

Figures/Tables 5

References 34

[1]	林勇清, 刘玥君, 张少芬, 等. 《2022欧洲人类生殖与胚胎学学会子宫内膜异位症》指南解读[J]. 现代妇产科进展, 2023, 32(6): 452-454, 457. DOI: 10.13283/j.cnki.xdfckjz.2023.06.009.
[2]	Tripoli T M, Sato H, Sartori M G, et al. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis[J]. J Sex Med, 2011, 8(2): 497-503. DOI: 10.1111/j.1743-6109.2010.01976.x.
[3]	Privitera G, O'BRIEN K, Misajon R, et al. Endometriosis symptomatology, dyspareunia, and sexual distress are related to avoidance of sex and negative impacts on the sex lives of women with endometriosis[J]. Int J Environ Res Public Health, 2023, 20(4): 3362. DOI: 10.3390/ijerph20043362.
[4]	Bulun S E, Yilmaz B D, Sison C, et al. Endometriosis[J]. Endocr Rev, 2019, 40(4): 1048-1079. DOI: 10.1210/er.2018-00242.
[5]	姬苗苗, 袁明, 王国云. 患者教育在子宫内膜异位症长期管理中的重要意义[J]. 中国实用妇科与产科杂志, 2021, 37(3): 292-296. DOI: 10.19538/j.fk2021030107.
[6]	孙伟伟, 于波, 刘永, 等. 子宫内膜异位症长期管理理念及管理原则[J]. 中华健康管理学杂志, 2019, 5(3): 262-264.
[7]	Nezhat C, Vang N, Tanaka P P, et al. Optimal management of endometriosis and pain[J]. Obstet Gynecol, 2019, 134(4): 834-839. DOI: 10.1097/aog.0000000000003461.
[8]	Brouwers M C, Kho M E, Browman G P, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182(18): E839-E842. DOI: 10.1503/cmaj.090449.
[9]	谢胜, 李建锋, 李娟, 等. 难治性胃食管反流病临床指南的系统评价[J]. 中国全科医学, 2019, 22(8): 901-908. DOI: 10.12114/j.issn.1007-9572.2018.00.397.
[10]	Shrout P E. Measurement reliability and agreement in psychiatry[J]. Stat Methods Med Res, 1998, 7(3): 301-317. DOI: 10.1177/096228029800700306.
[11]	陈景伟, 刘慧敏, 马艺鸣. 子宫内膜异位症相关疼痛中医诊疗指南[J]. 中华中医药学刊, 2024, 42(5): 250-258.
[12]	中华预防医学会生殖健康分会, 中国医师协会妇产科医师分会子宫内膜异位症学组. 子宫内膜异位症疼痛管理指南(2024年实践版)[J]. 中国实用妇科与产科杂志, 2024, 40(1): 50-61. DOI: 10.19538/j.fk2024010114.
[13]	中国中西医结合学会妇产科专业委员会. 子宫内膜异位症中西医结合诊治指南[J]. 中国中西医结合杂志, 2019, 39(10): 1169-1176.
[14]	中国医师协会妇产科医师分会子宫内膜异位症专业委员会, 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症长期管理中国专家共识[J]. 中华妇产科杂志, 2018, 53(12): 836-841. DOI: 10.3760/cma.j.issn.0529-567x.2018.12.007.
[15]	Liu J Y, Sheu B C, Chang C Y, et al. Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts[J]. Taiwan J Obstet Gynecol, 2024, 63(6): 823-825. DOI: 10.1016/j.tjog.2024.07.015.
[16]	Wisawasukmongchol W, Chalermchockcharoenkit A, Panyakhamlerd K, et al. Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain[J]. J Obstet Gynaecol, 2022, 42(6): 1607-1612. DOI: 10.1080/01443615.2022.2036965.
[17]	Harada T, Taniguchi F, Kitajima M, et al. Clinical practice guidelines for endometriosis in Japan (The 3rd edition)[J]. J Obstet Gynaecol Res, 2022, 48(12): 2993-3044. DOI: 10.1111/jog.15416.
[18]	Allaire C, Yong P J, Bajzak K, et al. Guideline No. 445: management of chronic pelvic pain[J]. J Obstet Gynaecol Can, 2024, 46(1): 102283. DOI: 10.1016/j.jogc.2023.102283.
[19]	National Institute for Health and Care Excellence. Endometriosis: diagnosis and management. NG73[EB/OL].(2024-11-11)[2024-12-10].
[20]	Kedzia M, Basta P, Czajkowski K, et al. Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis[J]. Ginekol Pol, 2024, 95(9): 729-758. DOI: 10.5603/gpl.100261.
[21]	Kim M R, Chapron C, Römer T, et al. Clinical diagnosis and early medical management for endometriosis: consensus from Asian expert group[J]. Healthcare, 2022, 10(12): 2515. DOI: 10.3390/healthcare10122515.
[22]	Becker C M, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis[J]. Hum Reprod Open, 2022, 2022(2): hoac009. DOI: 10.1093/hropen/hoac009.
[23]	贺豪杰, 陈娟, 侯征, 等. 女性慢性盆腔痛诊治中国专家共识[J]. 中华妇产科杂志, 2024, 59(10): 747-756.
[24]	中国医师协会妇产科医师分会子宫内膜异位症学组. 地诺孕素临床应用中国专家共识[J]. 中华妇产科杂志, 2024, 59(7): 505-512. DOI: 10.3760/cma.j.cn112141-20240212-00091.
[25]	Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218[J]. Obstet Gynecol, 2020, 135(3): e98-109. DOI: 10.1097/AOG.0000000000003716.
[26]	Nnoaham K E, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries[J]. Fertil Steril, 2011, 96(2): 366-373.e8. DOI: 10.1016/j.fertnstert.2011.05.090.
[27]	李雷, 冷金花. 子宫内膜异位症卫生经济学的研究进展[J]. 现代妇产科进展, 2013, 22(7): 596-598. DOI: 10.13283/j.cnki.xdfckjz.2013.07.026.
[28]	Simoens S, Dunselman G, Dirksen C, et al. The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres[J]. Hum Reprod, 2012, 27(5): 1292-1299. DOI: 10.1093/humrep/des073.
[29]	Benzon H T, Joshi G P, Gan T J, et al. Development, reporting, and evaluation of clinical practice guidelines[J]. Anesth Analg, 2019, 129(6): 1771-1777. DOI: 10.1213/ANE.0000000000004441.
[30]	晏利姣, 梁宁, 张海力, 等. 患者指南制定方法(三)——报告内容与呈现方式[J]. 中医杂志, 2024, 65(22): 2304-2309. DOI: 10.13288/j.11-2166/r.2024.22.005.
[31]	邱丽, 钟晓玲, 凌静, 等. 曹大农治疗子宫内膜异位症经验特色[J]. 辽宁中医杂志, 2023, 50(5): 24-26. DOI: 10.13192/j.issn.1000-1719.2023.05.006.
[32]	冷金花, 史精华. 子宫内膜异位症复发的高危因素及其防治策略[J]. 中华妇产科杂志, 2018, 53(9): 640-643.
[33]	刘文婷, 张莉, 周倩, 等. 多学科慢性病管理模式在子宫内膜异位症患者中的应用[J]. 临床与病理杂志, 2022, 42(9): 2174-2179.
[34]	Leonardi M, Lam A, Abrão M S, et al. Ignored because it is benign-it is time to treat endometriosis as if it were cancer[J]. J Obstet Gynaecol Can, 2020, 42(4): 507-509. DOI: 10.1016/j.jogc.2019.12.014.

序号	纳入指南/专家共识起草机构/作者	名称	发布/更新年份	国家/地区	开发机构	目标人群	参考文献数量（篇）	证据分级	推荐强度
1	中华中医药学会子宫内膜异位症相关疼痛中医诊疗指南起草组	子宫内膜异位症相关疼痛中医诊疗指南^[11]	2024年发布	中国	中华中医药学会子宫内膜异位症相关疼痛中医诊疗指南起草组	子宫内膜异位症患者	79	有	有
2	中华预防医学会生殖健康分会，中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症疼痛管理指南（2024年实践版）^[12]	2024年发布	中国	中华预防医学会生殖健康分会、中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症患者	61	有	无
3	中国中西医结合学会妇产科专业委员会	子宫内膜异位症中西医结合诊治指南^[13]	2019年发布	中国	中国中西医结合学会妇产科专业委员会	子宫内膜异位症患者	55	有	有
4	中国医师协会妇产科医师分会子宫内膜异位症专业委员会，中华医学会妇产科学分会子宫内膜异位症协作组	子宫内膜异位症长期管理中国专家共识^[14]	2018年发布	中国	中国医师协会妇产科医师分会子宫内膜异位症专业委员会、中华医学会妇产科学分会子宫内膜异位症协作组	子宫内膜异位症患者	40	无	无
5	Liu等	Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts^[15]	2024年发布	中国	Taiwan Endometriosis Society	子宫内膜异位症患者	16	无	无
6	Wisawasukmongchol等	Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain^[16]	2022年发布	泰国	Thai Interest Group for Endometriosis	子宫内膜异位症患者	55	无	无
7	Harada等	Clinical practice guidelines for endometriosis in Japan (The 3rd edition)^[17]	2022年更新	日本	Reproductive and Endocrine Committee、Japan Society of Obstetrics and Gynecology General Rules for Clinical Management of Endometriosis Subcommittee	子宫内膜异位症患者	268	有	有
8	Allaire等	Guideline No.445: Management of Chronic Pelvic Pain^[18]	2024年发布	加拿大	The Society of Obstetricians and Gynaecologists of Canada	女性慢性盆腔疼痛患者	187	有	有
9	National Institute for Health and Care Excellence	Endometriosis: diagnosis and management^[19]	2024年更新	英国	National Institute for Health and Care Excellence	子宫内膜异位症患者	249	无	无
10	Kedzia等	Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis^[20]	2024年发布	波兰	Polish Society of Gynecologists and Obstetricians	子宫内膜异位症患者	229	无	无
11	Kim等	Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group^[21]	2022年发布	亚洲	未说明	子宫内膜异位症患者	87	无	无
12	Becker等	ESHRE guideline: endometriosis^[22]	2022年更新	欧洲	European Society of Human Reproduction and Embryology	子宫内膜异位症患者	126	有	有
13	贺豪杰等	女性慢性盆腔痛诊治中国专家共识^[23]	2024年发布	中国	未说明	女性慢性盆腔疼痛患者	44	有	有
14	中国医师协会妇产科医师分会子宫内膜异位症学组	地诺孕素临床应用中国专家共识^[24]	2024年发布	中国	中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症患者	58	无	无
15	American College of Obstetricians and Gynecologists	Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218^[25]	2020年更新	美国	American College of Obstetricians and Gynecologists	女性慢性盆腔疼痛患者	72	有	有

序号	纳入指南/专家共识起草机构/作者	名称	发布/更新年份	国家/地区	开发机构	目标人群	参考文献数量（篇）	证据分级	推荐强度
1	中华中医药学会子宫内膜异位症相关疼痛中医诊疗指南起草组	子宫内膜异位症相关疼痛中医诊疗指南^[11]	2024年发布	中国	中华中医药学会子宫内膜异位症相关疼痛中医诊疗指南起草组	子宫内膜异位症患者	79	有	有
2	中华预防医学会生殖健康分会，中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症疼痛管理指南（2024年实践版）^[12]	2024年发布	中国	中华预防医学会生殖健康分会、中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症患者	61	有	无
3	中国中西医结合学会妇产科专业委员会	子宫内膜异位症中西医结合诊治指南^[13]	2019年发布	中国	中国中西医结合学会妇产科专业委员会	子宫内膜异位症患者	55	有	有
4	中国医师协会妇产科医师分会子宫内膜异位症专业委员会，中华医学会妇产科学分会子宫内膜异位症协作组	子宫内膜异位症长期管理中国专家共识^[14]	2018年发布	中国	中国医师协会妇产科医师分会子宫内膜异位症专业委员会、中华医学会妇产科学分会子宫内膜异位症协作组	子宫内膜异位症患者	40	无	无
5	Liu等	Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts^[15]	2024年发布	中国	Taiwan Endometriosis Society	子宫内膜异位症患者	16	无	无
6	Wisawasukmongchol等	Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain^[16]	2022年发布	泰国	Thai Interest Group for Endometriosis	子宫内膜异位症患者	55	无	无
7	Harada等	Clinical practice guidelines for endometriosis in Japan (The 3rd edition)^[17]	2022年更新	日本	Reproductive and Endocrine Committee、Japan Society of Obstetrics and Gynecology General Rules for Clinical Management of Endometriosis Subcommittee	子宫内膜异位症患者	268	有	有
8	Allaire等	Guideline No.445: Management of Chronic Pelvic Pain^[18]	2024年发布	加拿大	The Society of Obstetricians and Gynaecologists of Canada	女性慢性盆腔疼痛患者	187	有	有
9	National Institute for Health and Care Excellence	Endometriosis: diagnosis and management^[19]	2024年更新	英国	National Institute for Health and Care Excellence	子宫内膜异位症患者	249	无	无
10	Kedzia等	Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis^[20]	2024年发布	波兰	Polish Society of Gynecologists and Obstetricians	子宫内膜异位症患者	229	无	无
11	Kim等	Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group^[21]	2022年发布	亚洲	未说明	子宫内膜异位症患者	87	无	无
12	Becker等	ESHRE guideline: endometriosis^[22]	2022年更新	欧洲	European Society of Human Reproduction and Embryology	子宫内膜异位症患者	126	有	有
13	贺豪杰等	女性慢性盆腔痛诊治中国专家共识^[23]	2024年发布	中国	未说明	女性慢性盆腔疼痛患者	44	有	有
14	中国医师协会妇产科医师分会子宫内膜异位症学组	地诺孕素临床应用中国专家共识^[24]	2024年发布	中国	中国医师协会妇产科医师分会子宫内膜异位症学组	子宫内膜异位症患者	58	无	无
15	American College of Obstetricians and Gynecologists	Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218^[25]	2020年更新	美国	American College of Obstetricians and Gynecologists	女性慢性盆腔疼痛患者	72	有	有

纳入指南/专家共识	各领域标准化得分（%）						>60%的领域数（个）	≥30%的领域数（个）	推荐级别（级）
纳入指南/专家共识	范围和目的	参与人员	严谨性	清晰性	应用性	独立性	>60%的领域数（个）	≥30%的领域数（个）	推荐级别（级）
子宫内膜异位症相关疼痛中医诊疗指南^[11]	86.11	77.78	53.13	30.56	25.00	100.00	2	5	B
子宫内膜异位症疼痛管理指南（2024年实践版）^[12]	94.44	58.33	40.63	63.89	25.00	87.50	3	5	B
子宫内膜异位症中西医结合诊治指南^[13]	83.33	88.89	57.29	33.33	12.50	70.83	3	5	B
子宫内膜异位症长期管理中国专家共识^[14]	91.67	61.11	25.00	66.67	16.67	8.33	3	3	B
Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts^[15]	86.11	83.33	17.71	44.44	20.83	100.00	3	4	B
Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain^[16]	77.78	47.22	29.17	69.44	29.17	91.67	3	4	B
Clinical practice guidelines for endometriosis in Japan (The 3rd edition)^[17]	83.33	86.11	68.75	80.56	58.33	91.67	5	6	B
Guideline No.445: Management of Chronic Pelvic Pain^[18]	69.44	63.89	55.21	66.67	52.08	100.00	4	6	B
Endometriosis: diagnosis and management^[19]	77.78	77.78	78.13	77.78	75.00	100.00	6	6	A
Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis^[20]	75.00	55.56	39.58	63.89	27.08	100.00	3	5	B
Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group^[21]	83.33	75.00	33.33	66.67	33.33	91.67	4	6	B
ESHRE guideline: endometriosis^[22]	83.33	83.33	81.25	72.22	58.33	100.00	5	6	B
女性慢性盆腔痛诊治中国专家共识^[23]	86.11	63.89	19.79	80.56	37.50	75.00	3	5	B
地诺孕素临床应用中国专家共识^[24]	80.56	66.67	19.79	88.89	14.58	100.00	4	4	B
Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218^[25]	88.89	77.78	53.13	80.56	47.91	100.00	4	6	B

纳入指南/专家共识	各领域标准化得分（%）						>60%的领域数（个）	≥30%的领域数（个）	推荐级别（级）
纳入指南/专家共识	范围和目的	参与人员	严谨性	清晰性	应用性	独立性	>60%的领域数（个）	≥30%的领域数（个）	推荐级别（级）
子宫内膜异位症相关疼痛中医诊疗指南^[11]	86.11	77.78	53.13	30.56	25.00	100.00	2	5	B
子宫内膜异位症疼痛管理指南（2024年实践版）^[12]	94.44	58.33	40.63	63.89	25.00	87.50	3	5	B
子宫内膜异位症中西医结合诊治指南^[13]	83.33	88.89	57.29	33.33	12.50	70.83	3	5	B
子宫内膜异位症长期管理中国专家共识^[14]	91.67	61.11	25.00	66.67	16.67	8.33	3	3	B
Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts^[15]	86.11	83.33	17.71	44.44	20.83	100.00	3	4	B
Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain^[16]	77.78	47.22	29.17	69.44	29.17	91.67	3	4	B
Clinical practice guidelines for endometriosis in Japan (The 3rd edition)^[17]	83.33	86.11	68.75	80.56	58.33	91.67	5	6	B
Guideline No.445: Management of Chronic Pelvic Pain^[18]	69.44	63.89	55.21	66.67	52.08	100.00	4	6	B
Endometriosis: diagnosis and management^[19]	77.78	77.78	78.13	77.78	75.00	100.00	6	6	A
Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis^[20]	75.00	55.56	39.58	63.89	27.08	100.00	3	5	B
Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group^[21]	83.33	75.00	33.33	66.67	33.33	91.67	4	6	B
ESHRE guideline: endometriosis^[22]	83.33	83.33	81.25	72.22	58.33	100.00	5	6	B
女性慢性盆腔痛诊治中国专家共识^[23]	86.11	63.89	19.79	80.56	37.50	75.00	3	5	B
地诺孕素临床应用中国专家共识^[24]	80.56	66.67	19.79	88.89	14.58	100.00	4	4	B
Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218^[25]	88.89	77.78	53.13	80.56	47.91	100.00	4	6	B

纳入指南	ICC	95%CI	F值	P值
子宫内膜异位症相关疼痛中医诊疗指南^[11]	0.802	0.588~0.911	13.316	<0.001
子宫内膜异位症疼痛管理指南（2024年实践版）^[12]	0.899	0.777~0.956	1.409	<0.001
子宫内膜异位症中西医结合诊治指南^[13]	0.922	0.826~0.966	7.006	<0.001
子宫内膜异位症长期管理中国专家共识^[14]	0.923	0.828~0.967	1.335	<0.001
Long-term dienogest treatment in endometriosis: consensus from Taiwanese experts^[15]	0.886	0.751~0.950	7.358	<0.001
Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain^[16]	0.824	0.628~0.921	2.249	<0.001
Clinical practice guidelines for endometriosis in Japan (The 3rd edition)^[17]	0.830	0.640~0.924	2.885	<0.001
Guideline No. 445: Management of Chronic Pelvic Pain^[18]	0.808	0.599~0.914	19.475	<0.001
Endometriosis: diagnosis and management^[19]	0.802	0.588~0.911	4.044	<0.001
Guidelines of the Polish Society of Gynecologists and Obstetricians on the management of women with endometriosis^[20]	0.846	0.672~0.932	2.049	<0.001
Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group^[21]	0.865	0.709~0.941	5.863	<0.001
ESHRE guideline: endometriosis^[22]	0.815	0.612~0.917	2.095	<0.001
女性慢性盆腔痛诊治中国专家共识^[23]	0.842	0.628~0.933	6.346	<0.001
地诺孕素临床应用中国专家共识^[24]	0.891	0.742~0.954	9.155	<0.001
Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218^[25]	0.876	0.707~0.947	8.055	<0.001