摘要
目的 分析地诺孕素联合戈舍瑞林治疗子宫腺肌病(AM)患者的效果.方法 选取2019 年4 月至2022 年3 月上海市宝山区罗店医院AM患者142 例,随机数字表法分为观察组和对照组,每组各71 例.对照组采用戈舍瑞林治疗,观察组在对照组基础上联合地诺孕素.统计治疗效果,比较两组治疗前及治疗 1 个月、3 个月痛经程度、子宫体积、月经量,血清雌二醇(E2)、前列腺素E2(PGE2)、血管内皮生长因子(VEGF)、膜型基质金属蛋白酶1(MT1-MMP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平及不良反应发生情况.结果 观察组总有效率(95.77%)高于对照组(85.92%)(P<0.05);两组治疗1 个月及3 个月月经量、子宫体积、痛经程度、血清E2、PGE2、VEGF、MT1-MMP、IL-8、TNF-α水平均低于治疗前,且观察组低于对照组(P<0.05);观察组不良反应发生率 9.86%(7/71)与对照组 7.04%(5/71)比较,差异无统计学意义(P>0.05).结论 地诺孕素联合戈舍瑞林治疗AM患者效果确切,可降低痛经程度,缩小子宫体积,改善月经不调,降低雌激素水平,抑制内膜病灶浸润及炎症反应,安全可靠.
Abstract
Objective To analyze the effect of dienogest combined with goserelin in the treatment of patients with adenomyosis(AM).Methods A total of 142 patients with AM in Shanghai Baoshan District Luodian Hospital from April 2019 to March 2022 were selected and randomly divided into the observation group and the control group,with 71 cases in each group.The control group was treated with goserelin,and the observation group was combined with dienogest on the basis of the control group.The treatment effect was counted,and the degree of dysmenorrhea,uterine volume,menstrual flow,serum estradiol(E2),prostaglandin E2(PGE2),vascular endothelial growth factor(VEGF),membrane-type matrix metalloproteinase 1(MT1-MMP)levels,interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)levels and adverse reactions were compared between the two groups before treatment and at 1 month and 3 months after treatment.Results The total effective rate in the observation group(95.77%)was higher than that in the control group(85.92%)(P<0.05).The menstrual flow,uterine volume,dysmenorrhea degree,serum E2,PGE2,VEGF,MT1-MMP,IL-8,and TNF-α levels in the two groups for 1 month and 3 months after treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The incidence of adverse reactions(9.86%)in the observation group was compared with the control group(7.04%),and there was no significant difference(P>0.05).Conclusion Dinogest combined with goserelin in the treatment of patients with AM is effective,it can reduce the degree of dysmenorrhea,reduce the volume of the uterus,improve irregular menstruation,reduce the level of estrogen,and inhibit the infiltration of endometrial lesions and inflammatory response,and it is safe and reliable.
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