孕激素治疗子宫内膜异位症的现状及进展

子宫内膜异位症（endometriosis，EMs）是妇科常见、良性、慢性疾病，需长期或重复性使用药物来控制相关症状。手术是治疗EMs的常用方法，但单纯手术复发率高，术后患者常需辅助药物治疗。EMs是一种雌激素依赖性疾病，药物治疗的目的是营造低雌激素环境，抑制异位内膜的生长或使之萎缩。孕激素因具有良好的耐受性、轻微的代谢影响及相对较低的成本，成为目前术后治疗EMs唯一安全且经济的首选药物，而左炔诺孕酮宫内缓释系统特别适用于合并子宫腺肌病的EMs患者。针对个体状况的不同，孕激素治疗方案的选择不同，选择治疗方案时应考虑药物不良反应及其准确的作用机制。就孕激素治疗EMs最新分子机制的研究、常用种类、常用剂型和剂量及其应用前景等方面作一综述。

Current Situation and Progress of Progesterone in the Treatment of Endometriosis

Endometriosis （ EMs ） is a common , benign and chronic disease of gynecology , it requires long-term or repeated courses of medication treatment to control its related symptoms. EMs is often treated surgically but with a higher rate of recurrence,patients of postoperation often need medical adjuvant therapy. EMs is a kind of estrogen dependent disease ,the purpose of drug treatment is to creat an environment of low estrogen, inhibit the growth of ectopic endometrium or make it atrophy. Progestins have good tolerability,minor metabolic effects and low cost,there must therefore be considered drugs of choice and are currently the only safe and economic alternative to surgery, and levonorgestrel releasing intrauterine system is especially suitable for the patients who have EMs combined uterine muscle gland disease. According to the stage of individual , the choice of progestin program is different when select a therapeutic schedule drug adverse reaction and mechanism of accurate action should be considered. This article reviews the latest researches of progestins in treating EMs on molecular mechanism , commonly used types,commonly used formulations and dosage,application prospect.