三种方法治疗月经过多的临床分析

发布时间：2018-08-10 07:09

【摘要】：目的月经过多是育龄期和围绝经期妇女的常见症状，在世界范围内约30％的育龄期妇女罹患有月经过多。而特发性月经过多无内分泌功能异常及器质性病变，血生殖激素水平也有正常周期波动，育龄期妇女多见。本研究将病例根据不同治疗方法进行分组，对比分析左炔诺孕酮宫内缓释系统、复方口服避孕药、非甾体消炎药治疗特发性月经过多的临床疗效及安全性有无差异，以指导临床合理用药。方法收集2012年1月到2013年9月就诊于宁夏自治区人民医院的特发性月经过多的育龄期妇女，严格纳入标准，收集符合病例101例，将收集病例按治疗方法不同进行分组，比较分析治疗前、治疗后1个月、3个月、6个月月经量、经期、月经周期有无差异性，以评估其有效性，同时记录不良反应发生情况，以评估其安全性；对三种治疗方法治疗后的月经量降幅、治疗有效率以及药物不良反应发生率两两之间进行统计分析，比较其差异有无统计学意义，同时调查记录患者的依从性，以指导临床合理用药。结果三组治疗前与治疗后1个月、3个月、6个月月经量明显减少、经期明显缩短，P均＜0.05,差异有统计学意义。三组治疗前与治疗后不同时期月经周期均轻微波动，P均＞0.05，差异无统计学意义。曼月乐组较COC组及NSAIDs组月经量降幅明显，有效率明显高于COC组及NSAIDs组，P均0.05，差异有统计学意义。COC组与NSAIDs组月经量降幅、有效率差距不显著，P均＞0.05，差异无统计学意义。COC组治疗后不良反应主要为类早孕反应（9.1％）、NSAIDs组不良反应主要是胃肠道反应（6.2％），曼月乐治疗组主要不良反应是阴道不规则流血（19.4％），三组之间不良反应总发生率两两之间进行比较，P均＞0.05，差异无统计学意义。三组患者表示愿意继续目前治疗的比例依次是COC（38％）、NSAIDs（41％）、曼月乐（95.7％）。结论1、复方口服避孕药、非甾体消炎药、左炔诺孕酮宫内释放系统均能明显减少月经量、经期，且对月经周期无明显影响，不良反应发生较少，均是治疗特发性月经过多安全有效的方法2、曼月乐在月经量降幅及治疗有效率上均明显优于另外两种治疗方法，而不良反应无明显差异，同时患者的继续治疗的愿望亦明显优于避孕药组及非甾体消炎药组，因此曼月乐是一种效果显著、更容易被患者接受的一种新型治疗特发性月经过多的方法，，有较高的临床应用价值。
[Abstract]:Objective menorrhagia is a common symptom in women of childbearing age and perimenopause. About 30% of women of childbearing age worldwide suffer from excessive menstruation. There is no endocrine dysfunction and organic pathological changes of idiopathic menorrhagia. The level of blood reproductive hormones also fluctuates normally. The treatment methods were divided into groups, compared and analyzed the levonorgestrel intrauterine sustained release system, the compound oral contraceptive pill, the non steroidal anti-inflammatory drugs in the treatment of the clinical efficacy and safety of idiopathic menorrhagia, in order to guide the clinical rational use of drugs. Methods collected from January 2012 to September 2013 in the Ningxia Autonomous Region People's Hospital of special menstruation Too many women of childbearing age, strictly included in the standard, collect 101 cases of cases, collect cases according to different treatment methods to group, compare and analyze before treatment, 1 months, 3 months, 6 months of menstrual, menstrual period, menstrual cycle have no difference, to assess its effectiveness, and record the occurrence of adverse reactions, in order to assess their safety. A statistical analysis was made between the decrease of menstrual volume, the effective rate of treatment and the incidence of adverse drug reactions (22) after the treatment of the three treatments. There was no statistical significance between the three groups before treatment and 1 months, 3 months and 6 months after treatment. Obviously decreased, the menstrual period was significantly shortened, P < 0.05, the difference was statistically significant. The menstrual cycle of the three groups before and after the treatment were slightly fluctuating, P > 0.05, the difference was not statistically significant. The Meno group was significantly lower than the COC group and the NSAIDs group, and the effective rate was significantly higher than that of the COC group and the NSAIDs group, P was 0.05, the difference was statistically significant. There was no significant difference in the rate of menstruation between group.COC and group NSAIDs. The difference in efficiency was not significant, P was > 0.05. There was no statistically significant difference between group.COC and group.COC. The main adverse reaction was gastrointestinal reaction (6.2%) in group NSAIDs, and the main ungood reaction was irregular vaginal bleeding in the treatment group of menlla (19.4%), and the three groups were not between them. The total incidence of good reaction was compared with 22, P was > 0.05, and the difference was not statistically significant. The proportion of the three groups said to continue the current treatment was COC (38%), NSAIDs (41%), and menlle (95.7%). Conclusion the compound oral contraceptives, non steroidal anti-inflammatory drugs, and levonorgestrel intrauterine release system can significantly reduce the amount of menstruation, During menstruation, there is no obvious influence on menstrual cycle and less adverse reactions, which are 2 safe and effective methods to treat idiopathic menorrhagia. Menses are obviously superior to the other two methods in menstrual decline and treatment efficiency, but there is no significant difference in adverse reactions, and the desire for continued treatment is obviously superior to contraception. The drug group and the non steroidal anti-inflammatory drug group, so menlon is a new method of treating idiopathic menorrhagia which is more effective and easier to be accepted by the patients. It has high clinical value.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.52

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