子宫内膜异位症术后使用甲羟孕酮/达菲林疗效观察简

目的探讨子宫内膜异位症患者保守性手术术后使用甲羟孕酮／达菲林疗效对比观察。方法将120例患者随机分为A、B两组（各60例），术后分别给予甲羟孕酮150mg、达菲林3．75mg肌注，每28d一次，连续用六次。研究持续12个月，包括6个月的药物治疗和6个月的随访。结果两组用药前后血清（follicle-stimulatinghormone，FSH）、黄体生成素（1uteinizinghormone，LH）、血清雌二醇（estradiol，E2）、CAl25水平变化明显（P〈0．05）。两组用药前血清FSH、LH、E2、CAl25差异无统计学意义（P〉0．05）；用药后除CAl25外，差异有统计学意义（P〈0．05）。两组治疗前后视觉模拟评分（visualanaloguescale，VAS）差异有统计学意义（P〈0．05）；A组与B组治疗前后疼痛评分差异无统计学意义（P〉0．05）。观察至停药时，甲羟孕酮组与达菲林组完全缓解率分别为85．1％、94．7％，观察至停药6个月累计复发率分别为11．1％、8．9%，两组疗效疗效差异无统计学意义（χ2=2．602，P=0．626）。两组患者不规则阴道流血发生率、围绝经期症状发生率差异有统计学意义（χ2分别为21．823，53．218，P均=0．000）。结论甲羟孕酮和达菲林用药后对患者血清性激素、CA125数值均有明显影响，其中达菲林影响较大。两药在子宫内膜异位症保守性手术术后治疗上，总有效率、累计复发率相似，副作用各有侧重。甲羟孕酮针剂值得临床推广。

Efficacy Observation of Postoperative Use of Medroxyprogesterone Acetate / Diphereline for Patients with Endometriosis

Objective To investigate effects of medroxyprogesterone / Diphereline after conservative surgery of patients with endometriosis. Methods A total of 120 patients were randomly divided into groups A and B with 60 cases each, treated postoperatively by medroxyprogesterone acetate 150rag and Diphereline 3.75rag intramuscularly respectively every 28 days for six courses. The study lasted for 12 months, including six months of drug treatment and 6 months of fol- low-up. Results Serum follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （E2）, CA125 levels changed significantly before and after treatment in both groups （P〈0. 05）. These indexes were not different between two groups before treatment and different between two groups after treatment except CA125. Visual analogue scale （VAS） pain scores were different before and after treatment in both groups （P〈0. 05） and were not different between two groups after treatment （P）0. 05）. The complete remission rates were 85.1%,94. 7% in groups A and B at the treatment with- drawal, and the cumulative recurrence rates were 11.1 %,8. 9% at six months after the treatment withdrawal,which were not different between two groups （χ2 = 2. 602, P = 0. 626）. Two groups of patients The incidence of irregular vaginal bleeding and perimenopausal symptom were different between two groups （;i2 = 21,823, P = 0. 000;χ2 = 53. 218, P = 0. 000）. Conclusion Postoperative use of medroxyprogesterone and Diphereline has obvious effect on serum hormone and CA125 levels, and Diphereline has greater impact. Two drugs have similar total effective rate and cumulative recurrence rates,and different side effects. Medroxyprogesterone injection is worthy of promotion.