GnRH-a联合反加疗法治疗子宫内膜异位症的疗效及安全性分析

目的探讨促性腺激素释放激素激动剂(GnRH-a)联合反加疗法治疗子宫内膜异位症的疗效和安全性。方法 2009年1月-2010年12月在我院诊治的86例子宫内膜异位症患者随机分成实验组和对照组,每组43例。对照组单纯采用GnRH-a类似物醋酸曲普瑞林治疗;实验组采用醋酸曲普瑞林联合戊酸雌二醇与安宫黄体酮反加治疗。观察比较两组的糖链抗原125(CA125)、性激素指标水平、疼痛视觉模拟评分(VAS)、绝经症状严重程度Kupperman评分及各项绝经症状和不良反应的发生情况。结果两组用药后的CA125和性激素水平均明显降低,实验组用药后的雌激素(E2)水平显著高于对照组(P<0.05);两组用药后的VAS评分和Kupperman评分明显降低,实验组用药后的潮热分值显著低于对照组(P<0.05);实验组潮热盗汗、骨痛等绝经症状和不良反应的发生率显著小于对照组(P<0.05)。结论临床应用GnRH-a联合反加疗法治疗子宫内膜异位症既可以缓解低激素症状,又可以改善潮热盗汗、骨痛等绝经症状,降低不良反应的发生。

Clinical efficacy and safety of GnRH-a combined with estrogen-dydrogesteronea in the treatment for endometriosis

Objective To investigate the clinical efficacy and safety of GnRH-a combined with estrogen-dydrogesteronea in the treatment for endometriosis.Methods 86 cases of endometriosis admitted to our hospital from January 2009 to December 2010 were randomly divided into two groups,control group(n=43)and treatment group(n=43).The control group was given triptorelin acetate only,and the treatment group was given estradiol valerate and medroxyprogesterone acetate at the same time.The levels of CA125 and sex hormones,scores of VAS and Kupperman,the incidence of menopause symptoms and adverse reactions of the two groups were observed and compared.Results The levels of CA125 and sex hormones of the two groups after treatment were significantly reduced,and the level of E2 of treatment group was significantly higher than that of control group(P<0.05);the scores of VAS and Kupperman of the two groups after treatment was significantly reduced,and the scores of hot flashes of treatment group was significantly lower than that of control group(P<0.05);the incidence of hot flashes and night sweats,bone pain of treatment group were significantly less than those of control group(P<0.05).Conclusion Clinical application of GnRH-a combined with estrogen-dydrogesteronea can alleviate the symptoms of low hormone and reduce menopause,and decrease the rate adverse reactions in the treatment for endometriosis.