米非司酮配伍甲基睾丸素治疗子宫肌瘤的临床观察

目的 探讨米非司酮配伍或不配伍甲基睾丸素治疗子宫肌瘤的临床效果及副作用。方法将绝经前有症状的子宫肌瘤患者173例随机分两组，A组：米非司酮组88例，米非司酮5mg口服，日一次；B组：米非司酮、甲基睾丸素组85例，米非司酮5mg、甲基睾丸素5mg，口服，日一次。两组服药方法：从月经周期第一天开始，连服3个月。在治疗前后B超测量子宫体积，行子宫内膜病检，观察子宫内膜变化；检测雌孕激素水平，血红蛋白，肝、肾功能，观察服药后的副反应，并按期随访。结果两组患者治疗期间均闭经，子宫内膜及雌孕激素水平维持于增殖早期，血红蛋白上升。两组治疗后子宫体积，最大肌瘤的平均体积缩小。治疗后两组之间有显著性（P〈0．01），B组子宫和最大肌瘤体积缩小较大。两组副反应类似且无需特殊处理，停药后多数患者月经逐渐恢复，肌瘤复发。结论米非司酮配伍甲基睾丸素是更合理的方法，但停药后易复发，适于术前或围绝经期用药，无法替代手术治疗。

Clinical Study of Mifepristone with or without Methyltestosterone in the Treatment of Hysteromyoma

Objective To investigate the efficacy of mifepristone with or without methyltestosterone in the treatment of hysteromyoma. Methods 173 symptomatic patients with hysteromyoma were divided into 2 groups randomly.Group A(88 cases) received mifepristone 5mg per day.Group B(85 cases) received mifepristone per day combined with methyltestosterone 5mg twice a day from the first day of menstrul cycle for three moths.Hysteromyoma and uterine size were measured by B ultrasound,the changes of endometrium were examined pathologically.Esrogen and progesterone levels,hemoglobin and liver renal function were all measured,meanwhile,adverse effects of drugs were assessed.Results All the patients in the 2 groups were amenorrhea with increased hemoglobin,the level of estrogen and progesterone remained in the early stage of proliferation phase.The uterus and hysteromyoma sizes in two groups both reduced,but those in group B reduced less significantly (P<0.01).Adverse effects showed similarity and needed no special control.Conclusion Both mifepristone and mifepristone combined with methyltestosterone show good efficacy in the treatment of hysteromyoma,but mifepristone combined with methyltestosterone is more suitable.