首页|地诺孕素联合左炔诺孕酮宫内节育系统治疗子宫内膜异位症患者的临床研究

地诺孕素联合左炔诺孕酮宫内节育系统治疗子宫内膜异位症患者的临床研究

扫码查看
目的 研究地诺孕素联合左炔诺孕酮宫内节育系统治疗子宫内膜异位症(EMs)效果及对子宫内膜厚度与激素水平的影响.方法 入选EMs患者作为研究对象,并按队列法分为试验组和对照组.对照组患者给予左炔诺孕酮宫内缓释系统治疗,试验组患者在对照组基础上给予地诺孕素2 mg治疗.比较2组患者疗效,用视觉模拟评分法(VAS)评分对疼痛评分,记录月经血占卫生巾面积,计算子宫内膜厚度,用放射免疫测定法体内激素水平[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)]的变化.结果 对照组和试验组分别入组40例.对照组和试验组患者临床总有效率分别为75%和95%,在统计学上差异有统计学意义(P<0.05).治疗后对照组和试验组患者痛经评分分别为(3.27±1.04)和(1.36±0.69)分,性交痛评分分别为(2.42±0.89)和(1.04±0.55)分,非经期下腹疼痛评分分别为(2.17±1.25)和(1.49±1.03)分,子宫内膜厚度分别为(6.02±1.25)和(3.64±1.04)mm,血红蛋白浓度分别为(106.58±12.07)和(112.85±12.37)g·L-1,月经量评分分别为(38.41±15.21)和(12.41±4.81)分,FSH 水平分别为(3.89±2.19)和(2.52±1.30)U·L-1,LH 水平分别(6.90±2.92)和(8.51±3.72)U·L-1,PRL 水平分别(367.98±77.99)和(322.01±57.95)μg·L-1,E2水平分别(548.67±79.38)和(504.92±61.31)pmol·L-1,P 水平分别(17.69±7.38)和(12.23±6.61)nmol·L-1.试验组上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05).试验组的药物不良反应主要有阴道出血、发热、眩晕,对照组的药物不良反应主要有出血、发热、眩晕.试验组和对照组的总药物不良反应发生率分别为12.50%和10.00%,在统计学上差异无统计学意义(P>0.05).结论 地诺孕素联合左炔诺孕酮宫内缓释系统治疗子宫内膜异位症效果显著,降低了子宫内膜厚度,优化了激素水平.
Clinical trial of dinorgestrel combined with levonorgestrel intrauterine birth control system in treatment of patients with endometriosis
Objective To study the effect of dinorgestrel combined with levonorgestrel intrauterine birth control system in the treatment of endometriosis(EMs)and its effect on endometrial thickness and hormone levels.Methods EMs patients were selected as the research objects and divided into treatment group and control group according to the cohort method.Patients in the control group were treated with levonorgestrel intrauterine birth control system,while patients in the treatment group were treated with dinorgestrel on the basis of the control group.Compared the efficacy of two groups of patients before and after treatment,use visual analogue scale(VAS)to score pain,calculate endometrial thickness based on menstrual blood to sanitary napkin area,and use radioimmunoassay to measure changes in hormone levels[follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),prolactin(PRL),and progesterone(P)]in vivo.Results The control group and the treatment group were enrolled in 40 patients.The total effective rates of treatment in the control group and the treatment group were 75%and 95%,respectively.After treatment,the scores of dysmenorrhea in 2 groups were 3.27±1.04 and 1.36±0.69;the scores of dyspareunia pain were 2.42±0.89 and 1.04±0.55;the scores of abdominal pain in non-menstrual period were 2.17±1.25 and 1.49±1.03,respectively;endometrial thickness were(6.02±1.25)and(3.64±1.04)mm;hemoglobin concentration were(106.58±12.07)and(112.85±12.37)g·L-1;menstrual volume score were 38.41±15.21 and 12.41±4.81;FSH levels were(3.89±2.19)and(2.52±1.30)U·L-1;LH levels were(6.90±2.92)and(8.51±3.72)U·L-1;PRL levels were(367.98±77.99)and(322.01±57.95)μg·L-1;E2 levels were(548.67±79.38)and(504.92±61.31)pmol·L-1;P levels were(17.69±7.38)and(12.23±6.61)nmol·L-1,respectively.Compared with control group,the above indexes in treatment group were statistically significant(all P<0.05).The adverse drug reactions in the treatment group were mainly vaginal bleeding,fever and vertigo,the adverse drug reactions in the control group were mainly bleeding,fever and vertigo.The total incidence of adverse drug reactions in treatment group and control group was 12.50%and 10.00%,respectively,with no statistically significant difference(P>0.05).Conclusion The combination of dexamethasone and dexamethasone has a significant therapeutic effect on endometriosis,reducing endometrial thickness and optimizing hormone levels.

dinorgestrellevonorgestrel intrauterine birth control systemendometriosisendometrial thicknesshormones

郭立文、高琛、陈锦果、陈子春

展开 >

福建医科大学第三临床医学部(宁德师范学院附属宁德市医院)妇科,福建宁德 352100

福建医科大学第三临床医学部(宁德师范学院附属宁德市医院)药学室,福建宁德 352100

地诺孕素 左炔诺孕酮宫内节育系统 子宫内膜异位症 子宫内膜厚度 激素

福建省自然科学基金资助项目宁德师范学院文件基金资助项目宁德师范学院文件基金资助项目

2020J011342宁师科院[2023]8号2023T12

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(4)
  • 15