丙酸睾丸素和米非司酮联合治疗绝经过渡期功能性子宫出血的临床效果观察

目的：探索丙酸睾丸素和米非司酮联合治疗绝经过渡期功能性子宫出血的临床疗效。方法：将64例确诊为无排卵型功能性子宫出血患者进行药物治疗。从月经期第一天开始每天肌注丙酸睾丸素25mg,共5天。每天口服米非司酮12.5mg,连续服用三个月。治疗期间如出现药物性闭经则停用丙酸睾丸素。治疗前后均检测血常规、肝功能、卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、孕酮（P）、泌乳素（PRL）和雄激素（T）。结果：64例中有28例患者出现药物性绝经,30例患者在服药期间出现暂时性药物性闭经,停药后月经逐步恢复正常。贫血得以纠正。6例停药半年后复发,改用其他方法治疗,治愈率90.62%,治疗后血FSH、LH、E2、P平均水平较用药前下降,其中E2和P的下降差异具有非常显著性（P〈0.01）,用药后PRL变化不明显,而T轻度升高。结论：丙酸睾丸素和米非司酮治疗绝经过渡期功能性子宫出血效果好,副反应小,复发率低,是一种理想的药物治疗方法。

Clinical Observation on Testosterone propionate and Mifepristone＇s Treatment to Dysfunctional Uterine Bleeding during the Stage of Menopausal Transition

Objective：To probe the clinical efficacy of testosterone propionate and mifepristones treatment to dysfunctional uterine bleeding during the stage of menopausal transition. Method ： Drug treatments were used on 64 anovulatory dysfunctional uterine bleeding patients. From the first day of menstrual period, intramuscular injection of 25mg testosterone propionate was used for five days and 12.5 mg per day oral mifepristone was used for three months. If drug-induced amenorrhea emerges during the treatment, stop using testosterone propionate. Blood routine, liver function, follicle--stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （E2）, progesterone （P）, prolactin （PRL） and androgen （T） were all detected before and after treat- ment. Result： Drug--induced amenorrhea emerges on 28 out of 64 patients, emerges contemporarily on 30 patients. After the treatment menstruation became normal gradually. Anemia have been cured. 6 patients relapsed in half a year. Other treatments were used, the cure rate is 90. 62%, after the treatment the average level of blood FSH, LH, E2, and P dropped, in which E2 and P＇s decline are significant ,while PRL did not change and T has increased a little. Conclusion.. Testosterone propionate and mifepristone＇s treatment to dysfunctional uterine bleeding during the stage of menopausal transition is an effective drug treatment because of good clinical efficacy, small side reaction and low recurrence rate. And this treatment hardly induces other hormone-dependent diseases.