GnRH-a及反加疗法治疗子宫内膜异位症的疗效和安全性分析

发布时间：2018-08-27 05:54

【摘要】：为了探讨促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,Gn RH-a)用于子宫内膜异位症(endometriosis,EM)保守手术后治疗的临床疗效及药物不良反应,我们将108例保守手术治疗后的EM患者随机分为3组:Gn RH-a反加组(34例)、Gn RH-a单药组(34例)和对照组(38例)。其中,Gn RH-a反加组患者于术后皮下注射诺雷得3.6 mg,每月一次,用药第4个月时使用倍美力0.625 mg/d、安宫黄体5 mg/d,持续3个月;Gn RH-a单药组患者术后仅用诺雷得治疗;对照组患者不进行药物治疗。我们发现,Gn RH-a反加组与单药组患者症状完全缓解率显著高于对照组,患者疾病复发率显著低于对照组,且差异均具有统计学意义(p0.05);Gn RH-a单药组和对照组患者用药后血清黄体生成素(luteotropic hormone,LH)、卵泡雌激素(follicle-stimulating hormone,FSH)和雌二醇(estradiol,E2)水平明显低于用药前,差异有统计学(p0.05),而Gn RH-a反加疗法在缓解低雌激素症状、减缓骨转换方面是安全有效的,既能减轻Gn RH-a的副作用而又不影响其疗效,说明Gn RH-a反加疗法比单加Gn RH-a时对于子宫内膜异位症保守手术治疗的疗效和安全性更好。我们的研究为子宫内膜异位症的术后治疗提供了一定的理论依据。
[Abstract]:To investigate the clinical efficacy and adverse drug reactions of gonadotropin releasing hormone agonist (gonadotropin-releasing hormone agonist,Gn RH-a) in the treatment of endometriosis (endometriosis,EM) after conservative surgery. One hundred and eight patients with EM after conservative surgery were randomly divided into 3 groups: the control group (n = 38) and the control group (n = 34). The patients in the Gn RH-a group were subcutaneously injected with Norrede 3.6 mg, once a month after operation. The patients in the control group were treated only with Norrede after 4 months of treatment with 0.625 mg/d, amelancerin for 5 mg/d, for 3 months. The patients in the control group were not treated with drugs. We found that the complete remission rate of symptoms was significantly higher and the recurrence rate of disease was significantly lower in the Gn RH-a group and the single drug group than in the control group. The serum levels of luteinizing hormone (luteotropic hormone,LH), follicular estrogen (follicle-stimulating hormone,FSH) and estradiol (estradiol,E2) were significantly lower in Gn RH-a group than in control group. The difference was statistically significant (p0.05), and Gn RH-a reverse adduct therapy was safe and effective in relieving the symptoms of low estrogen and slowing bone turnover, which could alleviate the side effects of Gn RH-a without affecting its efficacy. The results showed that Gn RH-a reverse addition therapy was more effective and safe than Gn RH-a alone in the treatment of endometriosis. Our study provides a theoretical basis for postoperative treatment of endometriosis.
【作者单位】：广西桂林医学院附属医院;
【基金】：广西桂林医学院附属医院资助
【分类号】：R711.71

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