产妇安合剂联合妈富隆预防人流术后宫腔黏连I晦床观察

目的：观察产妇安合剂联合妈富隆预防人流术后宫腔黏连的疗效。方法：选择2010年5月-2011年2月我院门诊人工流产患者1804f4,随机分成两组：治疗组100例,于术后当日开始给予短效12服避孕药妈富隆片,每晚1片口服,连服21天;同时加服产妇安合剂,每日2次,每次25mL。对照组80例：于术后当日开始给予短效口服避孕药妈富隆片,每晚1片口服,连服21天。结果：治疗组术后阴道出血量和持续时间,腹痛情况,月经周期、月经量、宫腔黏连等情况与对照组相比有差异（P〈0．05）。结论：在人工流产术后服用产妇安合剂联合妈富隆,能明显减少术后阴道出血的天数,减少阴道出血量,减轻腹痛情况,有效恢复月经周期并预防宫腔黏连。     

不同剂量米非司酮联合去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血的临床试验研究

目的 研究不同剂量米非司酮联合去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血(dysfunctional uterine bleeding during perimenopause,P-DUB)的临床疗效.方法 选择2015年3月至2016年2月于河南省中医院接受治疗的P-DUB患者158例,按照随机数字表法分为A、B、C组,每组53例.3组均给予去氧孕烯炔雌醇治疗.A组给予米非司酮10 mg,B组给予米非司酮15 mg,C组给予米非司酮20 mg.观察3组子宫出血控制时间、停止时间,治疗前后子宫内膜厚度、月经量、血红蛋白水平、性激素水平和不良反应.结果 A组子宫出血控制时间、子宫出血停止时间长于B、C组( P<0.05).B、C组子宫出血控制时间、子宫出血停止时间差异无统计学意义(P>0.05).治疗后,A组子宫内膜厚度及促黄体激素(LH)、雌二醇(E2)、孕酮(P)、促卵泡生成素(FSH)大于B、C组,血红蛋白小于B、C组(P<0.05).治疗后,B、C组子宫内膜厚度、血红蛋白及LH、E2、P和FSH差异无统计学意义(P>0.05).A组总有效率(69.81%)低于B组(92.45%)、C组(96.23%)(P<0.05).B、C组总有效率差异无统计学意义(P>0.05).A组不良反应发生率(5.66%)低于B组(9.43%)(P>0.05).A组不良反应发生率低于C组(22.64%)(P<0.05).B、C组不良反应发生率差异无统计学意义(P>0.05).结论 15 mg剂量米非司酮联合去氧孕烯炔雌醇治疗P-DUB疗效显著,安全可靠,值得临床推广应用.     

妈富隆复方口服避孕药的使用对江苏农村地区已婚育龄妇女生活质量的影响

目的：评价妈富隆复方口服避孕药（简称妈富隆）的使用对江苏省农村地区已婚育龄妇女生活质量的影响。方法：采用自填式问卷前瞻性调查772例首次使用妈富隆妇女使用前后生活质量变化。结果：①使用妈富隆后妇女的生活质量问卷总分和身体健康、情绪、劳动／工作／学习、生活状态、想象力、总体身心愉悦状况和总体满意程度等项目的评分较使用前均显著提高（P〈0．05）；②生活质量问卷总分≥57的妇女所占比例在使用妈富隆前后分别为11．50％和11．79％，总分≤45的妇女比例由使用前9．09％上升到使用后的11．65％；③多元线性回归分析显示，位于苏南地区（系数=－1．02，95％CI：－1．84，－0．19）和发生副反应（系数=－1．45，95％CI：－2．38，－0．53）不利于使用妈富隆后妇女的生活质量改善。结论：妈富隆的使用有利于江苏省农村地区已婚育龄妇女生活质量改善，总体改善效果低于发达国家。     

Bone mineral density in young women with long-standing amenorrhea: Limited effect of hormone replacement therapy with ethinylestradiol and desogestrel

To assess bone mineral density (BMD) at different skeletal sites in women with hypothalamic or ovarian amenorrhea and the effect of estrogen-gestagen substitution on BMD we compared BMD of 21 amenorrheic patients with hypothalamic or ovarian amenorrhea with that of a control population of 123 healthy women. All amenorrheic patients were recruited from the outpatient clinic of the Division of Gynecological Endocrinology at the University of Berne, a public University Hospital. One hundred and twenty-three healthy, regularly menstruating women recruited in the Berne area served as a control group. BMD was measured using dual-energy X-ray absorptiometry (DXA). At each site where it was measured, mean BMD was lower in the amenorrheic group than in the control group. Compared with the control group, average BMD in the amenorrheic group was 85% at lumbar spine (p<0.0001), 92% at femoral neck (p<0.02), 90% at Ward's triangle (p<0.03), 92% at tibial diaphysis (p<0.0001) and 92% at tibial epiphysis (p<0.03). Fifteen amenorrheic women received estrogen-gestagen replacement therapy (0.03 mg ethinylestradiol and 0.15 mg desogestrel daily for 21 days per month), bone densitometry being repeated within 12–24 months. An annual increase in BMD of 0.2% to 2.9% was noted at all measured sites, the level of significance being reached at the lumbar spine (p<0.0012) and Ward's triangle (p<0.033). In conclusion BMD is lower in amenorrheic young women than in a population of normally menstruating, age-matched women in both mainly trabecular (lumbar spine, Ward's triangle, tibial epiphysis) and mainly cortical bone (femoral neck, tibial diaphysis). In these patients, hormone replacement therapy resulted in a limited recovery of BMD. Therefore, early hormone replacement therapy is mandatory for young amenorrheic women to minimize bone loss.     

2种方案治疗生育期功能失调性子宫出血的最小成本分析

目的:比较去氧孕烯炔雌醇片和炔雌醇环丙孕酮片治疗生育期女性功能失调性子宫出血的疗效与成本。方法:选择95例生育期功能失调性子宫出血患者,运用药物经济学成本-效果分析方法,对去氧孕烯炔雌醇片和炔雌醇环丙孕酮片治疗方案的临床疗效及成本进行分析、比较。结果:去氧孕烯炔雌醇片和炔雌醇环丙孕酮片治疗生育期功能失调性子宫出血总有效率分别为98.08%和97.67%,2组比较差异无统计学意义(P>0.05);费用分别为(425.7±70.5)元和(515.5±88.2)元,2组比较差异有统计学意义(P<0.05)。结论:去氧孕烯炔雌醇片治疗生育期女性功能失调性子宫出血疗效较好,且更为经济。     

Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive

This randomized, double-blind, placebo-controlled exploratory study examined the efficacy and safety of a low-dose oral contraceptive (Mircette®), desogestrel/ethinyl estradiol [DSG/EE] and ethinyl estradiol [EE]) in relieving the symptoms of dysmenorrhea. Twenty-three clinics in the United States enrolled 77 women (age ≤32 years) with primary dysmenorrhea documented for at least four consecutive cycles. Forty participants received DSG/EE&EE and 37 received placebo for four consecutive 28-day cycles. The intensity of menstrual-related distress was measured with the Menstrual Distress Questionnaire (MDQ). Patient diaries were used to assess number of school/work days missed as well as the use of rescue medication. Participants receiving DSG/EE&EE recorded reduced menstrual pain severity, lower total MDQ scores, and significantly less menstrual cramping. No significant change in bloating, anxiety, loneliness, weight gain, or acne was reported. The DSG/EE&EE formulation shows promise for the treatment of primary dysmenorrhea and was well tolerated by the participants in this study.     

A prospective study on the effects on hemostasis of two oral contraceptives containing drospirenone in combination with either 30 or 20 microg ethinyl estradiol and a reference containing desogestrel and 30 microg ethinyl estradiol

PURPOSE: In this open-label, randomized study, we assessed the effects on hemostasis of two combined oral contraceptives containing drospirenone (DRSP) as progestogen component. METHODS: Three milligrams of DRSP, a progestogen with antimineralocorticoid activity, was combined with either 30 or 20 microg ethinyl estradiol (EE) (DRSP/30EE; DRSP/20EE) and compared with a preparation containing 150 microg desogestrel (DSG) and 30 microg ethinyl estradiol (DSG/30EE). A total of 75 healthy female volunteers aged 18-35 years were enrolled. The hemostasis variables were measured in the medication-free precycle (baseline); in the first, third and sixth treatment cycle; and in the follow-up phase. The target variables for comparison were the relative changes from baseline to Cycle 6. RESULTS: Data of 25 volunteers in each group were valid for the per-protocol evaluation. Most changes in hemostasis variables were similar in the three treatment groups. All procoagulatory variables and the anticoagulatory variable protein C antigen increased slightly, while protein S antigen and activity decreased. For fibrinogen and protein S activity, the changes were statistically significant: less pronounced with DRSP/20EE compared to DSG/30EE at Cycle 6. There were no statistically significant differences in the changes of antifibrinolytic variables, the global clotting tests and D-dimer. All pairwise comparisons of DRSP/30EE vs. DSG/30EE yielded nonsignificant results; however, there was a trend of a lower impact of DRSP/20EE on nearly all hemostatic parameters compared to the 30EE products. All three study treatments were safe and well tolerated by the volunteers and provided adequate contraceptive reliability. CONCLUSION: The changes in the hemostatic variables for DRSP/20EE were less pronounced compared to DSG/30EE and DRSP/30EE. The results were in accordance with previous reports on effects of similar OCs.     

去氧孕烯炔雌醇配合诊断性刮宫治疗绝经过渡期功能性子宫出血的临床观察

目的：探讨诊断性刮宫（诊刮）后加用去氧孕烯炔雌醇（妈富隆）治疗绝经过渡期子宫出血的临床效果。方法：对56例确诊为绝经过渡期功血患者行诊刮后口服去氧孕烯炔雌醇治疗1～3个周期,比较血色素、经量及治疗前后子宫内膜厚度情况。结果：去氧孕烯炔雌醇止血效果好,月经量减少,贫血得以纠正,停药后恢复正常月经周期,子宫内膜厚度变薄。结论：去氧孕烯炔雌醇治疗绝经过渡期功血有显著疗效。     

Postoperative desogestrel for pelvic endometriosis-related pain: a randomized controlled trial

Objective: To determine the effectiveness of desogestrel for relieving endometriosis-related pain.

Methods: A double-blinded randomized placebo-controlled trial was conducted in 40 patients who had endometriosis with moderate-to-severe dysmenorrhea or chronic pelvic pain undergoing laparoscopic conservative surgery. After surgery, patients were randomized to desogestrel or placebo group. Outcomes included changes in visual analog scale (VAS) of dysmenorrhea, pelvic pain and dyspareunia, patient satisfaction, and adverse effects.

Results: Forty patients were randomized to desogestrel group (n?=?20) and placebo group (n?=?20). At month 6, the desogestrel group had significantly lower median VAS of overall pelvic pain, dysmenorrhea and noncyclic pelvic pain. Comparing with the placebo group, the desogestrel group had greater reduction in VAS of overall pain, dysmenorrhea and pelvic pain, but comparable reduction in VAS of dyspareunia. No patient in the desogestrel group but 4 patients in the placebo group still had moderate-to-severe pelvic pain at 6?months postoperatively. The proportion of patients who rated the treatment as very satisfied was higher in the desogestrel group than in the placebo group. There was no serious adverse event during the study period.

Conclusions: Desogestrel is effective and acceptable for postoperative therapy for patients with moderate-to-severe pain related to endometriosis.